An elderly friend told Huazi that when he got older, he would have back and leg pain from time to time, and it would be relieved after taking meloxicam on his own, is this medicine safe to take for a long time?
Huazi told him that meloxicam is a non-steroidal anti-inflammatory drug, and commonly used drugs include ibuprofen, diclofenac, aspirin, naproxen, indomethacin, loxoprofen, celecoxib, nimesulide, etoricoxib and other drugs. This class of drugs has good anti-inflammatory and analgesic effects, but it may increase cardiovascular risk, and should be used with caution in the elderly.
1. The real "anti-inflammatory drug"
When the body is stimulated by the outside world, there will be an inflammatory reaction, and symptoms such as redness, swelling, heat, and pain will appear. These include infectious inflammation (inflammation caused by infection by pathogens) and non-infectious inflammation.
People often refer to cephalosporin, penicillin, erythromycin, floxacin and other drugs as "anti-inflammatory drugs", but in fact, these drugs are antibacterial drugs, which relieve inflammation by destroying pathogens, but cannot directly eliminate inflammation and are ineffective against non-infectious inflammation.
There are two types of real anti-inflammatory drugs, one is steroidal anti-inflammatory drugs (glucocorticoids) and the other is non-steroidal anti-inflammatory drugs (NSAIDs), because the adverse effects of hormones are larger, so non-steroidal anti-inflammatory drugs are more commonly used. It should be noted that acetaminophen only has an antipyretic and analgesic effect, but has almost no anti-inflammatory effect, so it is not considered a non-steroidal anti-inflammatory drug.
2. Cardiovascular risk
Non-steroidal anti-inflammatory drugs work by inhibiting cyclooxygenase (COX), the body's cyclooxygenase is mainly divided into COX-1 and COX-2, inhibiting COX-1 has antiplatelet effect, so people at risk of blood clots can use small doses of aspirin to prevent blood clots.
Inhibition of COX-2 will reduce the synthesis of prostaglandins, which are pain-causing substances in the human body, and will also affect the thermoregulatory center, which can produce analgesic and antipyretic effects after reducing synthesis.
However, prostaglandins can also dilate blood vessels and increase the excretion of sodium ions, so when the synthesis is reduced, it will cause vasoconstriction and water and sodium retention, which may cause an increase in blood pressure, increase the workload of the heart, and increase cardiovascular risk. Moreover, NSAIDs can also affect the function of vascular endothelial cells and increase the risk of myocardial infarction.
Elevated blood pressure may also increase the risk of atrial fibrillation and may contribute to the formation of cardiac blood clots. Long-term, high-dose NSAIDs are associated with higher cardiovascular risk, although short-term use can also increase the risk, so NSAIDs should be used with more caution in older people at cardiovascular risk.
3. How to use drugs safely
In terms of pain relief, non-steroidal anti-inflammatory drugs (NSAIDs) are only "palliative, not curative", so older people with chronic pain should actively treat the underlying disease that causes pain and minimize the use of NSAIDs. If used, try to take the drug for a short period of time, and it is not recommended to take the drug for more than 5 days in a row.
For patients with hypertension, when using non-steroidal anti-inflammatory drugs, it is necessary to pay attention to the impact on blood pressure, and antihypertensive drugs can be adjusted according to the blood pressure situation. Patients who already have myocardial infarction, coronary heart disease, atrial fibrillation, cardiac insufficiency, and renal insufficiency are not recommended to take non-steroidal anti-inflammatory drugs on their own, and should use them under the guidance of a doctor.
NSAIDs have a "ceiling effect", and overuse does not increase the effect, only increases adverse effects, and two or more NSAIDs cannot be used at the same time. These drugs have the potential to cause damage to the gastric mucosa and may be combined with gastric mucosal protectants if necessary.
To sum up, the elderly need to be cautious about taking non-steroidal anti-inflammatory drugs, pay attention to the cardiovascular effects of such drugs when taking drugs, try to avoid long-term, high-dose medications, and it is best to use drugs under the guidance of a doctor. If you have any doubts about medication, please consult a doctor or pharmacist, I am a pharmacist Huazi, welcome to follow me and share more health knowledge.