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SIDE EFFECTS OF NSAID TYPE OF DRUGS AS AGAINST SAID (STEROIDS)
OP KAPOOR
Ex. Hon. Physician, Jaslok Hospital and Bombay Hospital, Mumbai, Ex. Hon. Prof. of Medicine, Grant Medical College and JJ Hospital, Mumbai 400 008.
As far as I remember, years back, the doctors and patients were fed up of steroids because of their side effects. The most common side effects were hyperacidity, development of peptic ulcer, appearance of oedema and development of hypertension and diabetes, especially in people prone to the same.
That is why, research was undertaken especially in rheumatic disorders, to look for any drug which could relieve the pain, but not cause the side effects of steroids. The search for such a drug led to search for the NSAID group of drugs (Non-steroidal anti-inflammatory drugs). The 'N' word was to stress upon the patients and doctors that these were not steroids. In practice, I find that the NSAID group of drugs are notorius for causing hyperacidity, peptic ulcer, oedema of the feet and hypertension, though diabetes has not been reported.
Thus, I find that steroids (whom I would like to label as SAID (steroidal anti-inflammatory drugs) - have been blamed for so many side effects a majority of which are also seen by non-steroidal preparations. The only difference lies in the side effects in the respiratory system. The NSAID group of drugs like aspirin and beta-blockers can precipitate bronchial asthma or bronchial spasm, while steroids are infact used for treating the same.
But then, while steroids are known to produce only stomach ulcers, their rival NSAID group of drugs are known to produce severe ulcers and perforations of the small intestines, which was never heard of in the days of steroids. Therefore gastroenterologists, cardiologists and pulmonologists should check the prescription of their patients to make sure that they are not on NSAID group of drugs, that may be kicking up the symptoms.
Alas, I do not think that by bringing out non-steroidal anti-inflammatory drugs, the purpose of reducing the side-effects has been really served. Every family physician must try to avoid the use of these drugs and use physiotherapy, other alternative therapies, paracetamol or codeine, with or without tranquillisers and muscle relaxants or depending on the most important weapon i.e. passage of time, to get relief.
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