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Dear List readers,

I'd like to explain what I can about anti-inflammatory drugs.  Both
prednisone and NSAIDs (non-steroidal anti-inflammatory drugs) like
naprosyn, aspirin, ibuprofen, ect.

stop the inflammatory process by stopping the production of prostaglandins
which are mediators in our bodies cascade of inflammation in response to
insult or injury.  They work at different sites in the cascade but the
result is the same.  Stop prostaglandin synthesis and stop the inflammatory
process.  Unfortunately the stomach lining is made with the help of
prostaglandin "E" and this is knocked out with all the other prostaglandins
lead to inflammation in our joints that make us hurt.  There is another
drug Cytotec that supplies prostaglandin E to help keep ulcerations from
occuring in the stomach  from NSAID use.  I don't see it used much in my
pharmacy practice.  A good practice for those that have to use these drugs
is to use them in spurts if possible.  For example 10 days on NSAIDS and 20
days off, or 1 week on , 2 weeks off, if possible.  Steroids, like
prednisone, also have the side effect of suppressing the adrenal gland
function if taken in high doses over extended periods of time.  That is why
patients should be weaned off these doses and not taken off abruptly.  When
the adrenal gland is suppressed, the body stops making natural,self-made
hormones that normally come from there - the adrenal-corticoids.  We fight
infections among other things with our own adrenal gland hormones and this
supression can lead to major illnesses and problems.  Again, for those that
have to be on these drugs, varying the dosing schedule has proven to
prevent some of the worst side effects, as always the lowest dose effective
is always the best.  Hope this has been some help.

Cindy Fisher, RPh in Texas.