INSIDE

Health Matters

By Virginia Lester,
RN, MSN, ARNP

Almost all of us at one time or another have viewed on TV or read in a paper or magazine information about medications that treat all sorts of illnesses. They are presented as being relatively safe and have the potential to heal almost everything.

Of course, the information regarding side effects and dangers are presented but do not capture your attention as well as the benefits. The real danger perhaps is that many people do not read or follow the recommended dosing on the labels of these products. If a little is good, more must be better is a belief that many consumers condone and practice.

I will limit discussion here to the most common over the counter (OTC) analgesic medications, primarily nonsteroidal antiinflammatory drugs (NSAID) and acetaminophen. The brand names for these classes of medications are: Aspirin and aspirin containing products, Motrin, Advil, Rufen, Aleve and Tylenol. It has been estimated that five to seven percent of hospital admissions are related to adverse effects of drugs and these OTC drugs are responsible for more than 30 percent of these admissions.

Motrin (ibuprofen) is considered to be quite safe in the lowest possible dose. However, increasing the dose of any NSAID or accompanying them with another analgesic may be associated with increased risk for a toxic event. Additionally, combining alcohol with any of the above medications may increase the adverse consequences of these medications.

People who have diseases that affect the gastrointestinal system such as ulcers, previous intestinal bleeding or reflux, are at greater risk for intestinal bleeding when NSAIDS are used regularly even in very low doses.

Patients who are being treated for cardiovascular diseases with small doses of daily aspirin should be aware that bleeding times can be increased by the aspirin. When warfarin or Coumadin are added to prevent blood clotting, there is greater risk of increased bleeding. Close monitoring is required and adjustments made in medication dosing.

The liver and kidney are very susceptible to the effects of long term, high dose Tylenol and NSAID use. Any person taking these medications on a regular basis should have lab tests done regularly to monitor the adverse effects on the liver and kidney. 

Older adults often are afflicted with painful arthritic conditions. Tylenol and Motrin are often used to relieve these symptoms. Again caution is advised because older adults are especially at risk for all of the above problems. In addition, NSAID use may lead to mental confusion.

A variety of skin rashes may be the end result of these medications; some are life threatening. As with any other medication, close attention should be paid to any changes in the skin, notify your health care provider to determine if the medication may be the cause. Often, discontinuing the drug will be all that is required and the rash resolves.
The bottom line, there is no completely safe medication. There will always be someone who has an adverse reaction to “just an aspirin.” In fact, it has been said that if aspirin were to be introduced today, it would not pass FDA muster. This article is not intended to scare you, but more to encourage you to read labels and follow directions and precautions.
More is not better!