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WHAT ARE THE SIDE EFFECTS OF PAIN MEDICATIONS?
NSAIDs
All NSAIDs come with the risk of gastrointestinal ulceration and bleeding. A newer class of anti-inflammatories, the COX-2 inhibitors, was developed to reduce this risk. It did not, though, eliminate it. In fact, another major issue emerged with these drugs: the possibility of severe and deadly vascular problems with long-term use, including heart attack and stroke.
Acetaminophen
Most users of acetaminophen experience few, if any, side effects. But the drug can cause liver damage, especially when taking too much or if taken with alcohol.
Opioids
Opioid analgesics commonly cause drowsiness, dizziness, and respiratory depression. However, these side effects usually disappear with continued use. However, constipation, another common side effect, tends to persist. In addition, opioid use may lead to addiction or dependence. Other possible side effects of opioid analgesics include:
Euphoria, dysphoria, agitation, seizures, hallucinations
Lowered blood pressure and heart rate
Muscular rigidity and contractions
Nausea and vomiting
Non-allergic itching
Pupil constriction
Sexual dysfunction
Urinary retention
Mixed opioid agonist-antagonists
Patients can experience symptoms of opioid withdrawal if a straight opioid analgesic, such as morphine, is taken at the same time as an opioid agonist-antagonist drug. Some of these medications include pentazocine (Talwin Nx, Talacen, Talwin Compound), butorphanol, and nalbuphine (Nubain).
Muscle relaxants
The main side effect of muscle relaxants is drowsiness. This may be how they work to ''relieve'' pain. In addition, carisoprodol (Soma) use may lead to dependence because in the body it is converted into a drug similar to barbiturates; cyclobenzaprine (Flexeril) can cause dry mouth, constipation, confusion, and loss of balance; methocarbamol (Robaxin) discolors the urine to green, brown, or black; both metaxalone (Skelaxin) and chlorzoxazone (Parafon Forte, DSC) should be used with caution in those with liver problems.
Anti-anxiety agents
Anti-anxiety drugs also carry the risk of sedation, particularly if combined with certain other medications (such as opioid analgesics) or alcohol. Other possible side effects include psychological changes, headache, nausea, visual problems, restlessness, and nightmares. Chest pain and heart pounding are also possible.
Antidepressants
Some of the antidepressants used for pain relief are the older tricyclics. These come with numerous side effects classified as anticholinergic, including dry mouth, difficulty urinating, blurred vision, and constipation. Other possible side effects include lower blood pressure, fast heartbeat, palpitations, weight gain, and fatigue.
A few of the newer antidepressants also reduce pain -- and with less risk of anticholinergic issues. Still, the serotonin norepinephrine reuptake inhibitors (SNRIs) may cause the following common side effects:
Anorexia
Asthenia
Constipation
Dizziness
Dry mouth
Ejaculatory difficulties
Headache
Insomnia
Nausea
Nervousness
Sweating
Antiseizure agents
Side effects associated with the anticonvulsants used for pain management commonly disappear over time. They include dizziness, drowsiness, and swelling of the lower extremities.
Corticosteroids
In general, short-term and/or low-dose corticosteroid use results in few side effects. But taking corticosteroids long-term can result in severe side effects, including:
Adrenal insufficiency -- a condition in which the body cannot adequately respond to physical stress
Atherosclerosis
Bone death
Cataracts and glaucoma
Elevated blood pressure
Elevated blood sugar
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