Nonsteroidal anti-inflammatory drugs (NSAID), such as ibuprofen, are medications that are used for a variety of symptoms and conditions. Rheumatoid arthritis (RA) is one of these conditions, and often therapy can become prolonged for a variety of reasons. Patients should be aware of the long-term effects of NSAID therapy before undergoing treatment.
Gastrointestinal Effects
One of the most common systems affected by chronic NSAID use is the gastrointestinal system. Common complaints include nausea and vomiting, abdominal discomfort, diarrhea, constipation and an upset stomach. NSAID use also makes the stomach more susceptible to the damaging effects of stomach acid, and, over the long term, this irritation can result in ulcer formation and bleeding.
Effects on the Kidney
NSAID use has been known to cause kidney damage, which can result in kidney failure. NSAIDs have been known to cause decreased blood flow to the kidney in addition to direct toxic damage to the kidney cells. This can result in decreased urine output, blood and protein in the urine and increased fluid retention.
Effects on the Heart
Many of the effects of NSAID use on the heart can be attributed to the damage done to the kidneys. The increased fluid retention in the body can cause increased blood pressure and exacerbate preexisting congestive heart failure. NSAIDs have also been shown to directly increase the risk of heart attack and stroke, according to the American Journal of Cardiology, so patients must be monitored for cardiac problems.
Effects on the Blood
NSAID use has effects on platelet cells in the blood, which are involved in the formation of clots. As a result the patient has increased tendencies to bruise and bleed; however, this effect is temporary and often reversible.
Effects on the Lungs
In patients with preexisting asthma, NSAID use has been shown to cause trouble breathing and bronchospasm (wheezing). Patients with asthma and other lung diseases should be counseled before beginning NSAID use.
Nervous System Effects
The nervous system is affected on many different fronts by NSAID use. One example is problems with hearing known as tinnitus, which is the perception of a ringing sound in the ears. Dizziness and headache are experienced as well, with increased risk in those not taking a dose after being on therapy for a prolonged period of time, according to the Neurological Clinics of North America.
References
- Neurologic Clinics of North America. "Drug Induced Headache." Silberstein, S.D. 1998
- Ibuprofen tablets, USP package insert. Hauppauga, NY: Interpharm Inc.; 2000
- The American Journal of Cardiology. "An Evidence-Based Review of the Cardiovascular Risks of Nonsteroidal Anti-Inflammatory Drugs." Farkouh M., & Greenberg B. May 2009
