obat PoldanMIG berbahaya?
- From: "kimihar" <kimiharyanto@xxxxxxxxx>
- Date: 4 Feb 2006 02:06:46 -0800
Rekan sekalian,
Saya mau menceritakan pengalaman istri saya dengan obat PoldanMIG yang
memang dulu sering di konsumsinya. karena Istri saya sering sakit
kepala, memang sakit kepalanya hilang, tetapi berganti dengan sakit mag
berat, bahkan harus ke dokter dan dirawat di Rumah Sakit.
Memang menurut dokter, obat PoldanMIG ini mengandung aspirin atau asam
asetil salisilat, dan pada obatnya dicantumkan "diminum sesudah makan,"
tetapi meskipun begitu untuk orang yang sering mengalami gangguan
lambung, obat ini tetap menyebabkan mual dan sakit lambung.
saya jadi penasaran dan mencoba men-search dari internet.., dan didapat
website sebagai berikut:
http://www.acg.gi.org/patients/women/asprin.asp
setelah saya pelajari lebih lanjut maka jelaslah bahwa kandungan obat
PoldanMIG adalah men-jiplak dari excedrin yang ternyata memang
mengandung aspirin dan memiliki efek samping pada lambung yang bisa
menyebabkan ulkus (luka pada lambung). itu sebabnya ditulis "diminum
sesudah makan" untuk mengurangi efek pada lambung. tetapi seharusnya
untuk orang yang mengalami gangguan lambung...tidak
diperbolehkan....atau seharusnya ditulis "hati-hati untuk yang
mengalami gangguan lambung, tidak diperbolehkan untuk yang sakit mag".
Akibatnya maka cukup fatal untuk penderita sakit maag. oleh karena itu
saya menyuruh istri saya mengganti dengan obat Migran...yang bisa
diminum kapan saja, baik sebelum makan ataupun sesudah makan....karena
tidak mengandung aspirin.
Jadi rekan sekalian jangan tertipu oleh gencarnya iklan yang di
promosikan oleh tukang obat.....dan yang seharusnya tidak diperbolehkan
oleh orang yang terkadang mengalami gangguan lambung....hanya ditulis
"diminum sesudah makan"........Sejak saat itu saya jadi sering melihat
pada kemasan obatnya dan membacanya lebih teliti, karena ternyata efek
samping obat tersebut cukup berbahaya......
berikut saya lampirkan hasil search tersebut yang berjudul the dangers
of aspirin....dari American College of Gastroenterology...
Salam,
Kimi.
---------------------------------------------------------------------------------
The Dangers of Aspirin & NSAIDS
What should I know about Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
The second major cause for ulcers is irritation of the stomach arising
from regular use of non-steroidal anti-inflammatory drugs, or NSAIDs.
NSAIDs are available over-the-counter (OTC) and by prescription.
If you are taking over-the-counter pain medications on a regular basis,
you will want to talk with your physician about the potential for
ulcers and other GI side effects. NSAID-induced gastrointestinal side
effects can be reduced by using alternative therapy. Your doctor may
recommend that you change the medication you are using; or add some
other medication in conjunction with your pain medication.
What are the Complications of Ulcers?
Bleeding: Internal bleeding in the stomach or the duodenum.
Perforation: When ulcers are left untreated, digestive juices and
stomach acid can literally eat a hole in the intestinal lining, a
serious medical problem that requires hospitalization, and often
surgery.
Obstruction: Swelling and scarring from an ulcer may close the outlet
of the stomach, preventing food to pass and causing vomiting and weight
loss.
How are Ulcers Diagnosed?
The two tests most commonly used to evaluate for ulcer are an X-ray
known as an Upper GI Series or UGI, and a procedure called an Endoscopy
or EGD.
Endoscopy: This test involves insertion of a small lighted flexible
tube through the mouth into the esophagus, stomach, and small intestine
(duodenum) to examine for abnormalities and remove small tissue samples
(biopsy). The test is usually performed using medicines to temporarily
sedate you.
Upper GI Series: Alternately, there is an X-ray test where you are
given a chalky material (barium) to drink while X-rays are taken to
outline the anatomy of the upper digestive tract.
NSAIDS - Issues that May Arise with Regular Use of NSAIDS
At one time aspirin was virtually the only non-prescription pain
reliever available. It has always had excellent pain relief benefits,
but it was also recognized that, when used regularly, it could cause
digestive problems for some patients. Some modified versions of aspirin
came onto the market in an effort to achieve the benefits of aspirin
while "buffering" the prospect for stomach discomfort. Acetaminophen
achieves similar benefits of pain relief, with minimal, if any, impact
on the stomach lining.
New NSAID medications became available in prescription form that also
offered excellent pain relief, but like aspirin, these new prescription
medications also had the potential to promote the development of ulcers
and bleeding in the GI tract. Since they were being administered under
a doctor's prescription, any such effects could be monitored.
NSAIDs became more popular as prescription remedies, and the FDA has
approved several for sale to consumers without a prescription. A
partial list of NSAIDs that are available over-the-counter and
recommended maximum daily doses is below.
Some Health Benefits Associated with Aspirin and NSAIDs
The main benefit recognized early on for aspirin was the relief of pain
and the reduction in fever. Other important health benefits from
aspirin have also come to be recognized. One of the more important of
these is the use of aspirin in helping to prevent heart attack and
perhaps stoke. The benefit stems from aspirin's role as a platelet
inhibitor. Studies have shown that these benefits can be obtained with
a relatively small daily dose of aspirin.
NSAIDS were found to have an additional benefit of reducing
inflammation, and so helped alleviate not only the symptom of pain, but
also served to reduce the actual cause of the pain, for example,
reducing joint inflammation in arthritis.
Balancing Pain Relief and Concerns with Side Effects
Adverse side effects can accompany the benefits in a portion of
patients taking any medication. No drugs escape the need for this kind
of risk-benefit evaluation. It has become necessary to balance the
benefits of analgesia, platelet inhibition, and anti-inflammatory
effect from NSAIDs and aspirin against potential adverse effects on the
stomach and digestive system. For patients who are dependent on regular
use of pain relievers, this can mean determining whether there are
alternate ways to achieve pain relief, without risking ulcers or GI
bleeding which may accompany regular use of aspirin and NSAIDs.
In this regard, aspirin and NSAIDs have been found to cause damage to
the lining (or mucosa) of the digestive tract primarily in the stomach
and upper intestine. This damage can result in an ulcer or intestinal
bleeding. Although this can happen to an individual who is an
infrequent user of aspirin or NSAIDs, it is of a much greater concern
in frequent users, and those consuming higher dosages of these
medications.
Personal Medical History is Important
As with any other risk-benefit analysis, the determination of the risk
associated with a particular patient's use of NSAIDs requires a careful
look at the patient's medical history. Here are some key issues:
Age: Has been identified as a risk factor in several studies. Older
patients also often require pain medications more often or in larger
doses, further increasing their risk.
Previous Ulcer: A history of an ulcer or an ulcer complication have
been identified in several studies as risk factors for complications
due to aspirin or NSAIDs use.
Alcohol: Alcohol, taken alone can cause irritation of the GI tract.
There have been some indications that patients who consume alcohol at
the same time they are taking aspirin or NSAIDs have an increased risk
of damage to the intestinal lining, including ulcers and GI bleeding.
There have been some reports that chronic heavy alcohol users may be at
increased risk of liver toxicity from excessive acetaminophen use.
Individuals who consume large amounts of alcohol should not exceed
recommended doses of acetaminophen. In 1993, FDA Advisory Committees
recommended that all OTC pain relievers contain an alcohol warning--to
date, some, but not all OTC pain relief products have complied with
that recommendation. Chronic heavy alcohol users should consult their
physician for advice on when and how to take pain relievers.
Steroids: Patients taking NSAIDs who also are taking a prescription
corticosteroid, medications like prednisone (in doses over 10 mg), have
been found to have a seven fold increased risk of having GI bleeding.
Anti-coagulants: Similarly, patients who are taking NSAIDs at the same
time they are taking oral prescription anti-coagulants (for example,
medications like coumadin) have been found to have a 12-fold increased
risk of bleeding.
Magnitude of NSAID Use
Adverse effects associated with NSAIDs become more likely as the
cumulative amount of NSAID increases, relating both to the size of each
dose you take, as well as how frequently-how many times a day, how
many days a week-you consume NSAIDs.
The most important ground rule, however, is to follow the instructions
on your medication. No medication-whether a prescription or
over-the-counter drug-should be taken more frequently than is
directed in the labeling.
Most NSAID ulcers heal easily if the NSAIDs are stopped. If the
medication cannot be stopped, the dose may often be reduced. Even if
your physician determines that continued administration of NSAIDS is
needed, healing can still occur.
Asymptomatic Patients-Patients Can Have an Ulcer or GI Bleeding
without any Obvious Symptoms
An individual can develop damage to the intestinal lining without being
aware of it-significant GI bleeding occurs frequently without any
symptoms being present.
Of particular concern are patients with arthritic conditions. More than
14 million such patients consume NSAIDs regularly. Up to 60% will have
gastrointestinal side effects related to these drugs and more than 10%
will cease recommended medications because of troublesome
gastrointestinal symptoms.
Medications That May Be Taken to Inhibit or Reverse the NSAIDs-Induced
Injury to the Intestinal Lining and GI Bleeding
Conventional treatments for ulcers (classes of prescription ulcer drugs
called H2 blockers and proton pump inhibitors), have been found to have
a beneficial effect in treating NSAID-induced ulcers and in preventing
GI bleeding. These treatments often will be effective, particularly if
NSAID use is stopped or reduced, although healing can occur in many
cases where a patient receives these anti-ulcer medications, even when
NSAID use continues.
Another medication, misoprostol, has been used effectively to prevent
gastric and duodenal ulcers and has been shown to reduce the risk of
bleeding in those that must continue using NSAIDs. As with all
instances where patients are taking more than one prescription or
over-the-counter medication, patients and their physicians need to
evaluate any side effects, potential drug interactions, or other
factors, for example limitations on use during pregnancy.
What can you do if you are concerned about avoiding GI bleeding?
If you are taking over-the-counter NSAIDs on a regular basis, you will
want to talk with your physician about the potential for ulcers and
other GI side effects. Most patients contact their family doctor, or
primary care physician, when they experience GI problems. Many of these
disorders, including Helicobacter pylori infection, can be treated
readily by your primary care doctor.
In the case of recurring or more serious problems, you may need to see
a gastroenterologist, a physician who specializes in disorders and
conditions of the gastrointestinal tract.
Things to Remember about NSAIDs
GI bleeding is an important, and potentially serious condition. It can
arise initially with few if any symptoms. Ulcers can be promoted by the
use of non-steroidal anti-inflammatory drugs, or NSAIDs. While some
damage may occur with modest, short-term doses, problems are more
likely to arise in regular NSAID users, and increase with the magnitude
of use--more frequent use and/or higher dosages.
NSAIDs and aspirin have some very positive health benefits. Like all
medications, care must be taken with their use. For example, they
should not be taken with alcohol, as the combination can increase the
risk of GI bleeding. Patients who need to use NSAIDs regularly should
consult regularly with their physician to be alert for any potential GI
effects. Since problems may arise with few, if any, symptoms, ongoing
monitoring with your physician is important. If problems do arise, and
are recognized early, there are a variety of ways to minimize or
reverse any adverse effects, either by using alternatives to NSAIDs, or
through your physician prescribing medications that can reduce any
adverse effects.
Over-the-Counter NSAIDs
OTC Brand Name Generic Name Dose
Actron® ketoprofen 1-6 pills/day, (up to 75 mg/day)
Advil® ibuprofen 1-6 pills/day, (up to 1,200 mg/day)
Aleve® naproxen sodium 1-3 pills/day*, (up to 660 mg/day)
Bayer® aspirin 1-12 pills/day, (up to 4,000 mg/day)
Ecotrin® aspirin 1-12 pills/day, (up to 4,000 mg/day)
Excedrin® aspirin, acetaminophen and caffeine 2-8 pills/day, (up to
2,000 mg/day aspirin, 2,000 mg/day acetaminophen, and 520 mg/day
caffeine)
Motrin IB® ibuprofen 1-6 pills/day, (up to 1,200 mg/day)
Nuprin® ibuprofen 1-6 pills/day, (up to 1,200 mg/day)
Orudis KT® ketoprofen 1-6 pills/day, (up to 75 mg/day)
*2-pill limit for patients over age 65.
American College of Gastroenterology
P.O. Box 342260
Bethesda, MD 20827-2260
(301) 263-9000
.
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