LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

NSAIDs dangerous

NSAIDs, First Occurrence of Heart Failure and Relapsing Heart Failure – (02-18-02)

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NSAIDs, First Occurrence of Heart Failure and Relapsing Heart Failure

I was not aware that NSAIDs will increase risk of recurrent attacks of heart failure, but it appears that this risk is quite substantial. This definitely fits the mold of the new selective COX-2 inhibitors increase risk of heart failure. Remember that we do not fully understand the physiology of most processes in the human body, and blocking one pathway artificially will inevitably produce downstream effects (usually harmful) due to the blocked pathway.

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Analgesic use: Predictor of chronic pain, medication overuse headache – (07-21-03)

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Analgesic use: Predictor of chronic pain, medication overuse headache

The results of this study find that in patients with heavy analgesic use, they were more likely to experience chronic pain 11 years later. This is not really a big surprise since it is well known that NSAIDs inhibit proper healing of connective tissue. Consider a patient on long term NSAIDs that sustains an injury. The injury never properly heals because of the block to normal healing. We know have a tissue that is prone to injury, setting up the cycle for further injury and NSAID use.

Neurology — Abstracts: Zwart et al. 61 (2): 160

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Anti inflammatories can damage the heart – (11-16-00)

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NSAIDs, Intestinal Integrity & Bacterial Translocation in Chronic Heart Failure

This is truly a wonderful editorial illustrating how the systems of the body do not work alone, but rather as an intricate web. It demonstrates other side effects that those of us in natural medicine have always warned about with the use of NSAIDs. As little as 800 mg of ibuprofen can begin to destroy the integrity of the barrier in the intestine, thus allowing molecules to leak through that otherwise should not.

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Gastrointestinal bleeding after the introduction of COX 2 inhibitors – (06-18-04)

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Gastrointestinal bleeding after the introduction of COX 2 inhibitors: ecological study

This is a very interesting article. When the COX-2 selective inhibitors were first released, I was seeing many patients come in that were prescribed this class of drugs, most inappropriately (was only supposed to be used in patients at high risk of GI complications). However, the number has dropped off to almost zero. This once blockbuster class of drugs seems to be falling to research that is finally showing that it is not all that effective as a pain med, and it’s side effect profile is really nothing to brag about, either. And all this coupled with the fact that this is a very expensive class of drugs compared to other NSAIDs.

This article notes that, with the 41% increase in NSAID use (due entirely to the increased use of COX-2 inhbitors), a 10% increase in hospitalization rates for upper GI bleeds was seen. Sell your Pharmacia stock.

bmj.com Mamdani et al. 328 (7453): 1415 –

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ANALYSIS OF COMPLICATIONS OF NSAIDS – (05-16-02)

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Metaanalysis of Severe Upper GI Complications of NSAIDs

This huge review of available literature identifies a 3x greater risk of severe GI bleed with NSAID use. This included as little as four days of use. We need to stop thinking of NSAIDs as benign drugs used to treat everything from minor headache to severe pain. It is rare that a chiropractic patient in my office needs to continue use of pain meds. It would be highly likely that an increase in utilization of chiropractic in the general population would drop the estimated 16,000 deaths per year from this class of drugs.

Abstract: –

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USE OF COX-2 AGAINST KNOWN DAMAGES OF NSAIDS – (05-29-03)

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Adverse renal effects of anti-inflammatory agents: evaluation of selective and nonselective cyclooxygenase inhibitors.

With the sharp increase in COX-2 use such as Celebrex and Vioxx (most of this use being inappropriate for its indications), we really need to evaluate the selective COX-2 inhibitors against other known damages from NSAIDs. Here we see that the COX-2 inhibitors are just as dangerous to the kidneys as traditional NSAIDs. And much more expensive. Hey–just use the cheaper NSAIDs and save the extra money for that kidney transplant!!

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CHILDHOOD DEATHS DUE TO INFLUENZA – (01-05-04)

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Influenza-Associated Deaths Reported Among Children Aged <18 Years — United States, 2003–04 Influenza Season

With all the hype going around I thought I should include this one. 42 reported deaths. 40% had underlying chronic medical conditions and the main cause of death the the flu is a secondary bacterial infection. The media has really made it sound like the planet will be wiped out within 3 months. I’m still waiting for the global devastation predicted from the flesh eating bacteria a decade or so ago. Bottom line–unfortunately, a few die from the flu every year. These numbers can’t even be compared to the numbers who die from only one class of drugs (NSAIDs) in ONE DAY!!! And yet the media is hardly tripping over themselves to report that medication related deaths have been ranked close to the 3rd or 4th leading cause of death in the US. Keep your immune systems healthy and don’t even consider the vaccination. Ironically (and I don’t easily subscribed to conspiracy theories…), the Flumist vaccine majorly flopped this year, selling only a small percentage of what the manufacturer expected. However, with the hype of the flu and the “shortage” of the vaccine I have been hearing commercials for Flumist. This wouldn’t be the first time a pharmaceutical company created a market for itself (aka Celebrex…).

Update: Influenza-Associated Deaths Reported Among Children Aged <18 Years — United States, 2003–04 Influenza Season –

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Vioxx News: Risk of Having Heart Attack was Hidden for Years

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In case you hadn’t heard the Vioxx news, it was pulled off the market in Sept of 2004 when it was confirmed that it increased the risk of having a heart attack.

I’m pretty sure none of us think that the drug companies have the best of intentions when it comes to our health. But outright lies, deceit and death in the name of profit? Sounds like a perfect Hollywood plot.

But it’s not.  It’s far too real.

Given that society has a very short memory, I’ll refresh you on what happened as it relates to the selective COX-2 inhibitor story.

The problem with anti-inflammatories is that they had this nasty side effect called bleeding ulcers that kills about 16-21,000 people per year (depending on the year). Not something you want prominently displayed on the front of the pill bottle. (As a side note–I always find this little tidbit of deaths associated with NSAID use pertinent to a discussion of risks vs benefits as it relates to chiropractic care).

This tiny little problem of bleeding ulcers and death is the result of the blockage of an enzyme called cyclo-oxygenase (COX). Now, COX has several isoforms–consider them close cousins. The COX-1 cousin actually protects the lining of the stomach and gut and keeps bleeding from occuring. Block this and you get your GI bleeds.

The other cousin, COX-2, was the version that played a role in the pain cycle.

So, block COX-2, but not the protective cousin COX-1, and you’ve got a blockbuster drug. Thus was born Bextra, Celebrex and Vioxx. And boy did they take off. The drug company advertising on this class of drugs kept the media people in BMWs and Porsches for several years.

There were some low level grumblings about concerns over heart disease risk, but these were brushed aside by the company line and well-prepared pharmaceutical reps.

It wasn’t until a whistle-blower came forward that the dam broke. Only then was the true carnage of this class of drugs understood.

You see, unbeknownst to all, the enzyme COX-2 also effected the production of a compound called prostacyclin that thins the blood. Block this and you run the risk of strokes and heart attacks. So much so that we believe in excess of 100,000 heart attacks and who knows how many deaths occurred.

Not to mention to fact that these drugs really weren’t all that much more protective to the stomach lining.

In the lawsuit that followed, much information came to light about just how subversive Merck was with their product Vioxx. The two major concerns focused on:

  1. The hiding of known data that there were increased cardiac risks
  2. The promotion of faked studies (called seeding studies) produced by the marketing teams to get doctors used to prescribing the drugs

To look a little closer at item number 1, in this particular study, researchers tore through the data in studies done by Merck. Studies that Merck claimed did not show any early warning signs of the coming storms.

Turns out, they DID know. To the tune of a 357% increase in the risk of cardiac deaths taking place in those taking Vioxx. And they knew this a full 40 months prior to Vioxx being pulled from the market.

Just under 3 1/2 years. The number of deaths may never truly be known.

So, the pertinent question is…

It is very likely that this is not an isolated scenario at an isolated drug company for an isolated class of drugs.

Just how many other bombshells have been quietly suppressed, never to be revealed, or how many are yet to come to light in the future of this “blockbuster drug” society we live in?