Kpmed.co.za

Prophylactic misuse and recommended use of
non-steroidal anti-inflammatory drugs by athletes

Stuart J Warden Br. J. Sports Med. 2009;43;548-549; originally published online 9 Jan 2009; doi:10.1136/bjsm.2008.056697 Updated information and services can be found at: References
This article cites 22 articles, 12 of which can be accessed free at: 1 online articles that cite this article can be accessed at: Rapid responses
Email alerting
Receive free email alerts when new articles cite this article - sign up in the box at Topic collections
Articles on similar topics can be found in the following collections To order reprints of this article go to: British Journal of Sports Medicine selectively of the agent.8–10 As the adversegastrointestinal and cardiovascular effects associated with NSAIDs become morepronounced with increased duration ofuse, athletes risk serious side effects by using NSAIDs prophylactically for pro-longed periods. This is further com- approximately 10% of those who useNSAIDs take up to five different com-pounds concomitantly.3 4 11 terms of blocking pain before it occurs.5 activities such as each player touching a winning streak. These practices are rela- athletes to inadvertently allow pathology petition anxiety, but a concerning ritual the prophylactic use of non-steroidal anti- the synthesis of the extracellular matrix isozymes and, in particular, the inhibition the rate-limiting step in the formation of synthesis immediately before or following mechanical stimuli.13 14 Athletes who reg- have reduced tissue adaptation to prevail- ing loads potentially predisposing them to is unsafe. In addition to participating in lactic use of NSAIDs has the potential to subsequent tissue repair following micro- diovascular functions. As a result, NSAID athletic endeavours, but more recent data suggest athletes misuse their open accessto NSAIDs. Tscholl and colleagues4recently reported in this journal that23% of top-level male football playersused NSAIDs in two out of three matchesduring the 2002 and 2006 Fe´de´rationInternationale de Football AssociationWorld Cup tournaments and that morethan 10% of players took NSAIDs beforeevery match. These data suggest thatmany athletes use NSAIDs prophylacti-cally and presumably for prolonged peri-ods. This hypothesis is supported by thefinding that high-school level Americanfootball players who take NSAIDs daily Correspondence to: Dr Stuart J Warden, Departmentof Physical Therapy, School of Health and RehabilitationSciences, Indiana University, 1140 W Michigan St, CF- Decision tree for the prescription of non-steroidal anti-inflammatory drugs (NSAIDs) to 326, Indianapolis, IN 46202, USA; [email protected] athletes with an acute or chronic musculoskeletal injury.
Rostom A, Dube C, Lewin G, et al. Nonsteroidal anti- inflammatory drugs and cyclooxygenase-2 inhibitors for primary prevention of colorectal cancer: a be as effective as NSAIDs at treating acute systematic review prepared for the U.S. Preventive musculoskeletal pain.23 Alternatively, at- Services Task Force. Ann Intern Med2007;146:376–89.
risk athletes may be offered the option of Tscholl P, Feddermann N, Junge A, et al. The use and abuse of painkillers in international soccer: data that regular use of NSAIDs reduces injury from 6 FIFA Tournaments for female and youth gastroprotection.9 Ultimately, there is no players. Am J Sports Med 2009;37:260–5.
Warden SJ. Cyclooxygenase-2 inhibitors (COXIBs): athlete. While ‘‘absence of evidence is not beneficial or detrimental for athletes with acute evidence of absence’’, there is sufficient musculoskeletal injuries? Sports Med 2005;35:271–83.
concern regarding potential side effects of Forwood MR. Inducible cyclo-oxygenase (COX-2) NSAIDs to warrant their judicious use.
mediates the induction of bone formation bymechanical loading in vivo. J Bone Miner Res Mackey AL, Kjaer M, Dandanell S, et al. The adjuncts for the alleviation of acute pain influence of anti-inflammatory medication on exercise- and inflammation during rehabilitation.
induced myogenic precursor cell responses inhumans. J Appl Physiol 2007;103:425–31.
Simon AM, Manigrasso MB, O’Connor JP. Cyclo- oxygenase 2 function is essential for bone fracture healing. J Bone Miner Res 2002;17:963–76.
Cohen DB, Kawamura S, Ehteshami JR, et al.
World Anti-Doping Agency. The 2009 Prohibited Indomethacin and celecoxib impair rotator cuff List: International Standard. Montreal, Canada, 2008.
NSAIDs for clinical indications (ie, inju- Alaranta A, Alaranta H, Helenius I. Use of prescription drugs in athletes. Sports Med ries, rather than prophylactically) is the Ferry ST, Dahners LE, Afshari HM, et al. The effects observation that their negative effect on of common anti-inflammatory drugs on the healing rat Corrigan B, Kazlauskas R. Medication use in athletes patellar tendon. Am J Sports Med 2007;35:1326–33.
selected for doping control at the Sydney Olympics(2000). Clin J Sport Med 2003;13:33–40.
diminished if the NSAID is taken after the Tscholl P, Junge A, Dvorak J. The use of medication cyclooxygenase-2-specific inhibitor, delays skeletal fact (ie, after exercise) rather than pro- and nutritional supplements during FIFA World Cups muscle healing by decreasing regeneration andpromoting fibrosis. Am J Pathol 2005;167:1105–17.
phylactically.20 If an athlete wants to use 2002 and 2006. Br J Sports Med 2008;42:725–30.
Warden SJ, Avin KG, Beck EM, et al. Low-intensity Warner DC, Schnepf G, Barrett MS, et al.
Prevalence, attitudes, and behaviors related to the pulsed ultrasound accelerates and a nonsteroidal anti- use of nonsteroidal anti-inflammatory drugs (NSAIDs) inflammatory drug delays knee ligament healing.
in student athletes. J Adolesc Health 2002;30:150–3.
indeed indicated (fig 1), its use should be Ekman EF, Ruoff G, Kuehl K, et al. The COX-2 specificinhibitor valdecoxib versus tramadol in acute ankle prostaglandin synthesis with NS-398 has different restricted to the minimal dose and for the sprain: a multicenter randomized, controlled trial.
effects on endocortical and periosteal bone formation induced by mechanical loading. Calcif Tissue Int Buvanendran A, Kroin JS, Tuman KJ, et al.
Gerstenfeld LC, Al-Ghawas M, Alkhiary YM, et al.
Effects of perioperative administration of aselective cyclooxygenase 2 inhibitor on pain Selective and nonselective cyclooxygenase-2 symptoms (ie, active swelling and resting management and recovery of function after knee inhibitors and experimental fracture-healing.
replacement: a randomized controlled trial. JAMA Reversibility of effects after short-term treatment.
during this stage, NSAIDs reduce pain and J Bone Joint Surg Am 2007;89:114–25.
Jones R, Rubin G, Berenbaum F, et al.
Simon AM, O’Connor JP. Dose and time-dependent Gastrointestinal and cardiovascular risks of effects of cyclooxygenase-2 inhibition on fracture- nonsteroidal anti-inflammatory drugs. Am J Med healing. J Bone Joint Surg Am 2007;89:500–11.
Woo WW, Man SY, Lam PK, et al. Randomized Mitchell JA, Warner TD. COX isoforms in the double-blind trial comparing oral paracetamol and oral cardiovascular system: understanding the activities of nonsteroidal antiinflammatory drugs for treating pain Athletes with a history of side effects or non-steroidal anti-inflammatory drugs. Nat Rev Drug after musculoskeletal injury. Ann Emerg Med risk factors for side effects with NSAIDs

Source: http://www.kpmed.co.za/images/Prophylactic%20Misuse%20and%20Recommended%20Use%20of%20NSAIDs.pdf

Some type of interview with authors about a general subject, co

Silica, Nature’s Surgeon Experts believe higher blood serum levels lead to hardening of the arteries, which can cause heart attacks. The authors of the study called for We all want to be beautiful, live longer, be a rethink on giving people calcium supplements healthier and feel better, but how do you know for bone health. "Serum calcium levels have what to do to achieve this? How of

pec.ac.in

Name of the Chemical Qty. required 1-Methylimidazole ≥99%, purified by redistillation Titanium(IV) butoxide( 97% Sigma Aldrich CAS Titanium (IV) iso propoxide (99.9% Sigma Aldrich Titanium (IV) Chloride(99.9% Sigma Aldrich CAS Vinyl magnesium bromide (Sigma Aldrich CAS Grubbs Catalyst, 2nd Generation Cas No. 569747 Oxalyl Chloride 98%( CAS No. O-8801 Sigma 2-Methoxy propene , (97%

© 2008-2018 Medical News