Painkillers are commonly used medicines for the treatment and management of pain related to injuries, surgery, and disease. There are different physiological mechanisms of painkillers depending on their type. The pain process is very complicated that's why several pain-relieving medicines can be used. The mechanism of medicines for nerve pain is different from general or arthritis pain medicines¹. 

The opioids have well studied and documented side effects that can be controlled effectively. Other disorders, like underlying cancer, are also signs of many of the typical side effects of painkillers. It is essential to have an interdisciplinary approach to the treatment of symptoms. 

 

Side effects of Opioid pain killers

The following are the common side effects of opioids and other pain-relieving medications. 

 

Constipation

Constipation is a common side effect due to the use of opioid analgesic medicines. However, it can be managed by different approaches like moderate exercise, increase fluid intake, and increase dietary fiber. Moreover, this can also be effectively managed by stool softeners and laxatives.

 

Nausea

Many people experience symptoms like nausea and vomiting in the first or two after taking opioids medicine. If a patient feels or experiences signs of nausea and vomiting, then he must report to a doctor or nurse. In such conditions, anti-nausea medicines are commonly used. 

 

Slowed Breathing

Opioids, especially at high doses, can slow breathing. Usually, once the body gets used to the drug, the condition resolves. Throughout each individual's hospital stay, we closely track respiration and other vital signs. Still, if slow breathing gets painful or is otherwise inconvenient, the cancer treatment staff should be notified. To treat this adverse effect, extra medications should be recommended.

 

Sedation, Drowsiness, or Clouded Thinking

Drowsiness, sedation, and sleepiness are common side effects with opioids for the day or when the dose is increased. It was also reported that some people become disoriented and confused after receiving opioid analgesics. If you experience any of these symptoms, then you should consult your doctor immediately. Your doctor may change your drug, may add a new drug, and or may change the dose.  

 

Depression and anxiety 

Apart from the common side effects of opioids, some serious side effects are also associated with them. It includes confusion, paranoia, anxiety, depression, brain damage, and liver damage. It also causes feelings of anger and brain damage². 

 

Side effects of NSAIDs

There are many known side effects of NSAIDs, just like other drugs. People suffering from various chronic illnesses are at high risk for side effects from NSAIDs. However, the side effects of NSAIDs are well tolerated. To counter the side effects of NSAID, your doctor may add additional drugs or reduce the dose. 

The following are the side effects of NSAIDs. 

 

Heart attack and stroke

The risk of heart attack, high blood pressure, and stroke increases by the long term use of NSAIDs, other than aspirin. The Food and Drug Administration (FDA), in 2015, warns about the increased risk of heart attack and stroke by using NSAIDs. By increasing the dose, the risk of side effects increases. The warning of the FDA also explains that the risk of heart diseases and stroke equally affects heart patients or healthy individuals. 

 

Increased blood pressure

Hypertension is a common side effect with the use of NSAIDs, whether you are hypertensive or not. NSAIDs also alter the action of many anti-hypertensive medicines. Research shows that almost 5 millimeters of mercury (mmHg) blood pressure increased by NSAIDs. 

Kidney problems

The side effects of NSAIDs on kidneys are dose-dependent. Fluid retention is the most common kidney-related issue of NSAIDs, it leads to swelling of feet and ankles. NSAIDs may cause a higher risk of unexpected kidney failure or kidney damage, according to the National Kidney Foundation. The foundation warns that you should avoid NSAIDs if you already have compromised kidney function. 

 

Allergic reactions

NSAIDs related allergic reactions are rare. You must seek medical help if you have symptoms of a generalized allergic reaction. The symptoms include rash or hives, wheezing, shortness of breath, swelling of eyes, lips, tongue, and difficulty swallowing. 

 

Bruising or bleeding

The blood clotting ability is affected by using NSAIDs. It increases the chances of bruising. Bleeding may be difficult to stop for small cuts. If you are using a blood thinner like warfarin, then the bruising effect can be serious. 

Some people also experience uncommon side effects like balance issues, dizziness, and trouble concentrating³. 

 

Peptic ulcers and gastrointestinal bleeding

Gastrointestinal bleeding and peptic ulcers are well-known side effects of NSAIDs. It is associated with a high dose of NSAIDs and long term use. 

NSAIDs decrease the activity of prostaglandins, which lowers inflammation, but prostaglandins also support the lining of the stomach by increasing mucus production. NSAIDs leave the stomach vulnerable to the effects of acid in this manner.

People who take NSAIDs at high doses or for a long time should contact their doctor about avoiding ulcers. One solution is to take different medications that decrease acid in the stomach. Another alternative is using a different form of painkiller⁴.

 

References

 

1. PAIN MANAGEMENT MEDICATION TYPES. [internet]. [cited 2020 December 14]; Available from  https://www.rxlist.com/pain_medications/drug-class.htm
2. Managing Pain Medication Side Effects. [internet]. [cited 2020 December 14]; Available from  https://www.mskcc.org/cancer-care/diagnosis-treatment/symptom-management/pain-management/management-side-effects
3. Side Effects from NSAIDs. [internet]. [cited 2020 December 14]; Available from  https://www.healthline.com/health/side-effects-from-nsaids#7-side-effects
4. Everything you need to know about NSAIDs. [internet]. [cited 2020 December 14]; Available from  https://www.medicalnewstoday.com/articles/179211#side_effects

 

 

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