Aliviar el dolor con AINEs

When I got my first gout attack and was diagnosed with the disease, my doctor prescribed me NSAIDs and Coclchicine so I can walk again normally from the pain. That is the only time I used them, because I think I was limping for like 2-3 weeks when I first was diagnosed with gout. My other attacks weren’t as painful and long in duration, only lasting a few days.

Entonces, ¿qué son los AIE (pronunciado En-sedz)?

The acronym stands for “Non-steroidal anti-inflammatory drugs” and that are many different types of these drugs. Did you know that we have been using NSAIDs to treat diseases since 1763? They are painkillers that reduce inflammation in the affected area like your toe or knee from your gout attack, working in reducing the levels of pain and are usually recommended as an initial treatment for gout. NSAIDs are also used to relieve arthritis. Steroids may be taken by mouth or by injection into the bloodstream or muscle.

Los AINE que se utilizan con frecuencia para tratar la gota incluyen los siguientes:

• Diclofenaco (nombre comercial Voltarol)
• Indometacina (generalmente la primera opción de los médicos)
• Etoricoxib (brand name Arcoxia)
• Ibuprofeno (puedes comprarlo en farmacias con nombres comerciales como Advil o Motrin)
• Ketoprofen ( brand names Orudis, Oruvail)
• Naproxen ( brand names Naprosyn, Arthoxen)
• Etodolaco (nombre comercial Lodine)
• Fenoprofeno (nombre comercial Nalfon)
• Tolmetin (nombre comercial Tolectin)
• Nabumetona (nombre comercial Relafen)
• Meloxicam (nombre comercial Mobic)
• Sulindaco (nombre comercial Clinoril)

Out of all the NSAIDs mentioned here, Naproxen seems to be the most recommended since it has the least side effects. Doctors will usually provide this as a first option since it is very effective at treating gout flares. Compared to other gout medications such as colchicine, naproxen is definitely preferable. Too much can be life threatening, meanwhile, naproxen has the least risk for vascular side effects. 

En uno estudio, they compared the effectiveness of this NSAID against colchicine. They followed 399 patients all throughout England. One group consisting of 200 patients took 750mg of naproxen, then took a 250mg dose of it every 8 hours for 7 days. The second group of 199 patients took 500 µg of colchicine three times a day for 4 days.

What they found was that both groups had little difference when it came to pain relief. Both were effective at treating the gout flare. However, those who took colchicine had experienced diarrhea as a side effect of the drug. They also had more headaches and constipation. 

La próxima vez que tengas un brote de gota, opta por naproxeno en su lugar. Está asociado con menos efectos secundarios y tiene un costo menor que la colchicina.

En otros comentarios, Aspirina es un AINE pero no recomendado para la gotaEstudios han demostrado que la aspirina puede elevar los niveles de ácido úrico en la sangre. corticosteroides may also be used and Prednisone is the most commonly prescribed and is often used in people who are unable to take non-steroidal anti-inflammatory drugs (NSAIDs) or colchicine. Use of NSAIDs may usually relieve the symptoms of a gout attack within 48 hours.

Actually, a  Estudio de 2018 publicado En Las Actas de Medicina de Emergencia concluded that there is no significant difference between corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) for short-term pain relief, long-term pain relief, time to resolution of pain, or the need for additional analgesics.

Nueva investigación shows that a steroid pill may be as good as a nonsteroidal anti-inflammatory drug (NSAID) for treating painful gout.

¿Cuáles son los efectos secundarios de los AINE (antiinflamatorios no esteroideos)?

Al igual que con cualquier medicamento, existen efectos secundarios que pueden experimentar diferentes personas, como náuseas, vómitos, diarrea, estreñimiento, cansancio, dolores de cabeza y pueden irritar el revestimiento del estómago, lo que puede causar sangrado en el estómago y/o úlceras, especialmente en personas mayores. Las personas con función renal reducida o aquellas con condiciones como úlceras estomacales o sangrado deben evitar el uso de AINE. Asegúrese de consultar a su médico antes de usar AINE para tratar la gota.

Certain people will be affected by NSAIDs differently. For instance, pregnant women may not be allowed to take NSAIDs after 30 weeks since this can affect the fetus. Or if you have a child with a viral infection, they cannot take aspirin since it puts them at risk for developing Reye’s syndrome. Your doctor will assess your situation so they can provide the best drug that works best for you.

If you experience any serious symptoms like itching, rashes, swelling, black stool, trouble urinating, headache, middle back pain, blurred vision, fatigue, or unexplained weight gain, get help from your doctor right away. More severe side effects from NSAIDs can include difficulty breathing, swelling of the face or throat, slurred speech, or weakness on one part of your body. 

NSAIDs are meant to be taken for a short period of time. Be careful if you are prescribed to take them for longer than 10 days. Ten is the maximum time you can take OTC NSAIDs for pain. And, they should only be taken at the lowest possible dose. Those who take NSAIDs long term are at risk for serious side effects like renal failure, stroke, heart disease, eye damage, and peptic ulcer. 

El uso prolongado de AINE también puede empeorar las enfermedades existentes. Por lo tanto, si tiene una afección como hipertensión o enfermedad cardíaca, tenga mucho cuidado. Se considera que el uso crónico de AINE es cuando se toman durante al menos tres meses.

If you have to take NSAIDs that long, make sure you undergo regular blood tests. This is to check whether everything is working properly and that your organs are not damaged from the drug. NSAIDs aren’t the only drug option for treating chronic pain. Talk to your doctor about it as they might be able to provide much safer options. 

Cuando se usan de manera efectiva y en las dosis adecuadas, los medicamentos antiinflamatorios no esteroideos (NSAID, por sus siglas en inglés) pueden ser muy efectivos contra los ataques de gota. Me gustaría conocer tus experiencias, por favor no olvides agregar tus comentarios.