Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
BRAND NAME: Amigesic, Salflex, Argesic-SA, Marthritic, Salsitab, Artha-G, (Note: Disalcid is no longer available in the U.S.)
DRUG CLASS AND MECHANISM: Salsalate is a
nonsteroidal antiinflammatory drug
(NSAID) that is used for treating fever, pain, and inflammation in the body.
Salsalate is converted in the body to salicylic acid which is its active form
and is closely related to aspirin. Other NSAIDs include ibuprofen (Motrin),
indomethacin (Indocin), nabumetone (Relafen), naproxen (Aleve) and several
others. They work by reducing the levels of prostaglandins, chemicals that are
responsible for pain, fever, and inflammation. Salsalate blocks the enzyme that
makes prostaglandins (cyclooxygenase), resulting in lower concentrations of
prostaglandins. As a consequence, inflammation, pain and fever are reduced.
Salsalate is as strong as aspirin in reducing inflammation but has less effect
on blood clotting than aspirin.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 500, 750 mg
STORAGE: Salsalate should be stored at room temperature 15-0 C (59-86 F).
PRESCRIBED FOR: Salsalate is used for treating rheumatoid arthritis and
osteoarthritis. It also is used for the treatment of inflammation and pain
resulting from soft tissue injuries,
tendinitis, bursitis, and similar
conditions.
DOSING: The usual dose of salsalate is 3000 mg daily given over 2-4 doses.
Salsalate should be taken with food to reduce stomach upset.
DRUG INTERACTIONS: Salsalate, like aspirin, is converted to salicylic acid.
Therefore, adding aspirin to salsalate can cause salicylic acid toxicity.
NSAIDs may increase the blood levels of lithium (Eskalith) by reducing the
excretion of lithium by the kidneys. Increased levels of lithium may lead to
lithium toxicity.
NSAIDs may reduce the blood pressure lowering effects of blood pressure
medications. This may occur because prostaglandins play a role in the regulation
(lowering) of blood pressure.
When NSAIDs are combined with methotrexate (Rheumatrex, Trexall) or aminoglycosides (for
example, gentamicin) the blood levels of methotrexate or aminoglycoside may
increase, presumably because the elimination of methotrexate or aminoglycosides
is reduced. This may lead to side effects from methotrexate or aminoglycosides.
PREGNANCY: There are no adequate studies of salsalate in
pregnant women.
NURSING MOTHERS: Salicylic acid appears in
breast milk at levels close to
maternal blood levels. This may cause adverse effects in the infant. Nursing
women should avoid nursing while taking salsalate or use alternate drugs.
SIDE EFFECTS: Most patients benefit from salsalate and other NSAIDs with few
side effects. However, serious side effects can occur and generally tend to be
dose-related (are more common at higher doses). Therefore, it is advisable to
use the lowest effective dose to minimize side effects. The most common side
effects of salsalate involve the gastrointestinal system and ringing in the ears
(tinnitus). It can cause ulcerations of the stomach and intestines, abdominal
pain, cramping, nausea,
vomiting, gastritis, and even serious gastrointestinal
bleeding and liver toxicity. Sometimes, ulceration and bleeding may occur
without any abdominal pain.
Black tarry stools, weakness, and dizziness upon
standing (orthostatic hypotension) may be the only signs of internal
bleeding.
Patients who develop tinnitus may need to reduce the dose of salsalate. Rash,
kidney impairment, vertigo, and lightheadedness also may occur. Fluid
retention, blood clots, heart attacks,
hypertension, and heart failure also have
been associated with the use of NSAIDs.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
The knee joint is composed of three compartments and ligaments which stabilize the joint. Causes of knee pain may include injury, degeneration, infrequently infection and rarely bone tumors. Although routine x-rays do not revel meniscus tears, they can be used to exclude other problems of the bones and tissues. The knee joint is the most commonly involved joint in rheumatic disease, as well as immune diseases that affect various tissues of the body.
Foot pain may be caused by injuries (sprains, strains, bruises, and fractures), diseases (diabetes, Hansen disease, and gout), viruses, fungi, and bacteria (plantar warts and athlete's foot), or even ingrown toenails. Pain and tenderness may be accompanied by joint looseness, swelling, weakness, discoloration, and loss of function. Minor foot pain can usually be treated with rest, ice, compression, and elevation and OTC medications such as acetaminophen and ibuprofen. Severe pain should be treated by a medical professional.
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.
Osteoarthritis is a type of arthritis caused by inflammation, breakdown, and eventual loss of
cartilage in the joints. Also known as degenerative arthritis. Osteoarthritis
can be caused by aging, heredity, and injury from trauma or disease.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Bursitis is inflammation of a bursa. A bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. There are 160 bursae in the body. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees.
Shoulder bursitis is inflammation of the shoulder bursa. Bursitis may be caused by injury, infection, or a rheumatic condition. Symptoms include pain, swelling, tenderness, and pain with movement of the shoulder joint. Treatment may involve ice compresses, rest, and antiinflammatory medications and depends on whether there is an infection.
Bursitis of the knee results when any of the three fluid-filled sacs (bursae) become inflamed due to injury or strain. Symptoms include pain, swelling, warmth, tenderness, and redness. Treatment of knee bursitis depends on whether infection is involved. If the knee bursa is not infected, knee bursitis may be treated with ice compresses, rest, and antiinflammatory and pain medications.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
A bursa is a closed
fluid-filled sac that functions as a gliding surface to reduce friction between
tissues of the body. Bursae is plural for bursa. The major bursae are located adjacent to
the tendons near the large joints, such as the shoulders, elbows, hips, and
knees. When a bursa becomes inflamed, the condition is known as bursitis.
Most commonly, bursitis is caused by local soft tissue trauma or strain injury, and there is no
infection (aseptic bursitis). On rare
occasions, the bursa can become infected with bacteria. This condition
is called septic bursitis.
What is knee bursitis?
The knee joint is surrounded by three
major bursae. At the tip of the knee, over the kneecap bone, is
the prepatellar bursa. This bursa can become inflamed (prepatellar
bursitis) from direct trauma to the front of the knee. This commonly
occurs when maintaining a prolonged kneeling position....
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