Nonsteroidal Anti-Inflammator... Health Article

Definition

Nonsteroidal anti-inflammatory drugs are medicines that relieve pain, swelling, stiffness, and inflammation.

Description

Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed for a variety of painful conditions, including arthritis, bursitis, tendonitis, gout, menstrual cramps, sprains, strains, and other injuries.

Although the NSAIDs are often discussed as a group, not all are approved for use in children. As of 2004, the following drugs are approved for pediatric use:

• Ibuprofen (Advil, Motrin, Nuprin).
• Indomethicin (Indocin), not recommended for children under the age of 14 except in circumstances that warrant the risk. Indomethicin has special application in some infants born with heart problems.
• Ketoprofen (Orudis, Oruvail), not given to children under the age of 16 unless directed by a physician.
• Ketorolac tromethamine (Toradol), not approved for use in children but has been reported safe by some pediatric authorities.
• Meclofenamate sodium, safety and efficacy in children under 14 years of age has not been established.
• Mefenamic acid (Ponstel), safety and efficacy in children under 14 years of age has not been established.
• Naproxen (Aleve, Anaprox, Naprosyn), safety and efficacy in children under two years of age has not been established.
• Tolmetin sodium (Tolectin), safety and efficacy in children under two years of age has not been established.

Other NSAIDs have been used in pediatric therapy, but should not be considered as first choice for treatment of children or adolescents.

A new class of NSAIDs, called COX-2 inhibitors, have a lower risk of causing ulcers than do the traditional NSAIDs. These drugs may be appropriate for use in older teenagers but have not been approved for use in younger children, and there is some evidence that they are inappropriate for infants.

General use

Nonsteroidal anti-inflammatory drugs relieve pain, stiffness, swelling, and inflammation, but they do not cure the diseases or injuries responsible for these problems. Two drugs in this category, ibuprofen and naproxen, also reduce fever. Some nonsteroidal anti-inflammatory drugs can be bought without a prescription; others are available only with a prescription from a physician or dentist.

Precautions

Children with certain medical conditions and those who are taking some other medicines can have problems if they take nonsteroidal anti-inflammatory drugs. Before giving children these drugs, parents need to let the physician know about any of the following conditions.

Allergies

The physician needs to know about any allergies to foods, dyes, preservatives, or other substances. For children who have had reactions to nonsteroidal anti-inflammatory drugs in the past, parents should check with a physician before having these drugs prescribed again.

Pregnancy

Teens and young women who are pregnant or who plan to become pregnant should check with their physicians before taking these medicines. Whether nonsteroidal anti-inflammatory drugs cause birth defects in people is unknown, but some do cause birth defects in laboratory animals. If taken late in pregnancy, these drugs may prolong pregnancy, lengthen labor time, cause problems during delivery, or affect the heart or blood flow of the fetus.

Breastfeeding

Some nonsteroidal anti-inflammatory drugs pass into breast milk. Women who are breastfeeding their babies should check with their physicians before taking these drugs.

Other medical conditions

A number of medical conditions may influence the effects of nonsteroidal anti-inflammatory drugs. Parents of children and teens who have any of the conditions listed below should tell their physician about the condition before having nonsteroidal anti-inflammatory drugs prescribed.

• stomach or intestinal problems, such as colitis or Crohn's disease
• liver disease
• current or past kidney disease or current or past kidney stones
• heart disease
• high blood pressure
• blood disorders, such as anemia, low platelet count, low white blood cell count
• bleeding problems
• diabetes mellitus
• hemorrhoids, rectal bleeding, or rectal irritation
• asthma
• epilepsy
• systemic lupus erythematosus
• diseases of the blood vessels, such as polymyalgia rheumatica and temporal arteritis
• fluid retention
• alcohol abuse
• mental illness