What Ibuprofen Does to the Body

this video is sponsored by brilliant find the link in the description below what does ibuprofen or medications like it do to the human body this is a very common medication that i'm sure many of you have probably used for things like pain inflammation a fever or maybe even something like period or menstrual cramps but could this medication cause any harm or potential side effects maybe you've heard it could affect the liver the stomach or other organs throughout the human body so in this video we're going to take a look at those organs by utilizing the bodies behind me and of course talk about how this medication works on you so let's do this so at some point we're going to need to take this and get it into the various digestive system structures so that eventually the medication can get absorbed into the body so that it can take its effect but first what is ibuprofen ibuprofen commonly known as some other brand names like advil or motrin is classified as a non-steroidal anti-inflammatory drug or an nsaid now there are some steroidal anti-inflammatories maybe you've heard of things like prednisone or dexamethasone but those steroidal anti-inflammatories work a little differently and so we'll save those for a different video and focus on these non-steroidal anti-inflammatories like ibuprofen now ibuprofen has some pretty common uses it's commonly used as an analgesic which is a pain reliever an antipyretic which is a fever reducer and obviously as an anti-inflammatory now is ibuprofen the only inset out there absolutely not some of you have probably used some others or heard of them things like aleve also known as naproxen some of my patients have also used a topical one called voltaron gel or diclofenac gel that's kind of this generic versus brand name thing and there are a variety of prescription strength nsaids and for the most part they all have this similar mechanism of action or in other words how they work in the body and so we'll focus on ibuprofen as kind of our baseline and said because it's one of the most commonly used so let's finally get this thing into the body to figure out how it works so i've got my 200 milligram tablet of ibuprofen which you probably can't see very well so i'll put in my tweezers here and we'll trace it into the body here's a sagittal cut of a head so essentially like so and most of us first put the pill in the mouth or the oral cavity here now we often say the oral cavity or the mouth is where digestion begins but this pill isn't going to spend a lot of time in there we pop it in there put some water in and swallow it quickly down into the pharynx here and then to the next part of the tube would be the esophagus here the esophagus is the food tube or posterior to the windpipe or the trachea here and that tablet would then move down the esophagus and i can show you on an anterior or front view of the esophagus on this dissection moving down into the stomach here now many of you have probably heard that ibuprofen can be harmful to the stomach and there's definitely truth to that but first let's get it absorbed into the body and figure out what it's supposed to do and then we can talk about its potential side effects so in the stomach it's going to start mixing with the gastric juices those gastric juices essentially include things like the stomach acid digestive enzymes and even some of the stomach mucus now that's where the pill or the tablet is actually going to start to dissolve and its active ingredients are going to be released or to a point where they can start to be absorbed now some of it can get absorbed into the stomach or through the bloodstream through that mucosal lining that we'll show you later in the video but the majority of it's still going to pass into the small intestine and this is where the majority of the medication will actually be absorbed small intestine has tons and tons of blood vessels to absorb nutrients or in this case a medication and this whole timeline of where absorption can start to take place is about 30 to 60 minutes depending on things like the contents of the stomach but now that we're in the bloodstream we essentially can think or say that the medication is going to be distributed to potentially everywhere and now we can talk about how it takes its effect so ibuprofen works by inhibiting certain enzymes called cyclooxygenase 1 in cyclooxygenase 2 or cox-1 and cox-2 but what in the world does that mean well these enzymes cox 1 and cox 2 normally get involved in synthesizing other substances called prostaglandins prostaglandins are extremely important to this discussion because these prostaglandins are involved in multiple physiological processes throughout the body some of these include things like inflammation another is they're involved in pain and essentially stimulating certain pain receptors you find a lot of prostaglandins in areas of infection and tissue damage they're also involved with interacting with this structure in the central core of the brain called the hypothalamus the hypothalamus does a lot of things but one of the things that gets involved in but with is body temperature and even the fever response we also see prostaglandins influencing uterine contractions say like during menstrual cramping it can cause that smooth muscle in the uterus to contract other things are influencing blood flow into these cool little organs that we call the kidney you can see this artery right here blood would go in but it really influences some of these microscopic vessels that you'd find on the cortex or the outer portion of the kidney here and the last thing that i want to mention that the prostaglandins get involved in if i take this other dissection of the stomach is the prostaglandins also get involved in aiding in the mucosal lining of the stomach or the inside lining of the stomach here producing mucus and also helps to regulate stomach acid so i want you to kind of think about the huge list that we just created of all the things that the prostaglandins are involved in and if i can take a medication like ibuprofen that inhibits cox-1 and cox-2 these enzymes that produce prostaglandins i'm going to lower the number of prostaglandins that are circulating throughout the body and so therefore i could help potentially reduce inflammation help reduce pain help reduce the fever and even help reduce like menstrual cramping and a lot of you've probably used these medications with some level of success with varying degrees depending on the pain levels and what was actually going on with your body but what about the potential side effects let's discuss those by going to another cadaver so let's talk about some of the potential side effects of ibuprofen whenever we take a medication we kind of have to do this pros versus cons the pros of the therapeutic benefits of the medication versus the cons or those side effects of the medication so with ibuprofen could it affect the liver the stomach or other organs throughout the human body well let's start with the liver if you take a look at this dissection here i've got the diaphragm in my hands here and if i reflect this diaphragm or this muscle back or upwards you can see this huge organ that we call the liver the liver is the second largest organ in the human body second to the skin and it's located in the right upper quadrant of the abdomen now the liver does a ton of amazing things for the human body one of which is to metabolize a lot of different drugs or medications and what do we mean by metabolized drugs and medications well let's think about the ibuprofen circulating throughout the bloodstream eventually that ibuprofen is going to pass through the liver and when it passes through the liver the liver contains certain enzymes that are going to actually convert the ibuprofen into more of an inactivated form and what they would refer to as metabolite and that metabolite that converted form of ibuprofen will then continue on its merry little way through the bloodstream but eventually make it to the kidneys get filtered out and we'll just pee it out hopefully into the toilet but the question is during that conversion process in the liver does that cause any potential harm to the liver for the most part no ibuprofen is relatively safe for the liver you can always find cases where there are certain situations where people have had some harm to the liver from taking ibuprofen but again for the most part it's relatively safe but if we compare that to the potential side effects of the stomach that might be a little bit of a different story so let's take a look at this other dissection here so i've actually got two stomachs here i've overlaid two thirds of a stomach because we cut it right here as you can see and i just wanted to kind of give you the comparison of the full stomach but the reason we show people this stomach is we love to show people the amazing inside lining of the stomach this inside lining that i'm touching with my thumbs here is called the tunica mucosa called the tunica mucosa because it helps produce mucus now one of the reasons why our stomach doesn't eat itself alive with its own acid or irritate itself is because we have that coating or that protective barrier of mucus between the acid and the actual lining of the stomach so you think here's the inside lining of the stomach mucus and then we've got that acid but remember our discussion about prostaglandins and what they could do earlier prostaglandins also got involved in helping the stomach produce mucus and even regulating the stomach acid so if i take a medication that reduces the amount of prostaglandins ibuprofen then i reduce the potential amount of stomach mucus on that inside lining and so i could thin out that protective barrier and make it more risky or at least create a situation where the acid could irritate the stomach more easily because that mucus being thinner or less produced and so that's essentially how ibuprofen could affect the stomach or cause stomach irritation now in general people who take ibuprofen every once in a while even if you take ibuprofen for a few days to help with a fever from like the flu or some other illness for the most part you're not going to have major stomach issues we're more concerned about those who may be on ibuprofen every single day to help manage a chronic condition say like maybe arthritis or we might be more concerned with patients who have a history of gastritis which is inflammation of this inside lining or maybe somebody who has peptic ulcer disease but what about other organs like the kidneys i mentioned the kidneys a little bit earlier when we talked about the ibuprofen passing through the liver getting converted to a more inactive form that we referred to as a metabolite and then those metabolites eventually made it to the kidneys and got excreted in the urine let's talk a little bit more about the details of that process and see if ibuprofen can have an effect on the kidneys so here's a really cool dissection that we briefly saw earlier in the video but more context this is a frontal cut so we could see the internal anatomy of the kidneys and the first thing i want to mention is this structure here called the renal artery renal just mean kid means kidney and this renal artery is going to take blood into the kidney and it'll branch multiple times but go back to that story of that metabolite of the ibuprofen eventually it's going to enter through this blood vessel and then get distributed throughout the kidneys and like i mentioned those blood vessels will continue to branch and branch and branch until the point where when they get into the cortex here the outer portion of the kidney they're microscopic can't see them with the naked eye so if we zoomed in and zoomed in to the renal cortex we'd see these awesome functional units referred to as a nephron and nephron is a combination of urinary tubules as well as some tiny little blood vessels and this is where we're going to see this filtration process between the cardiovascular system and the urinary system in essence we're going to create urine here so there's going to be a fluid component from the cardiovascular system that's going to pass into these urinary tubules and it'll take these waste products including some of these metabolites into the urinary tubules so we've moved from the cardiovascular system now into the urinary system and if we come back to this really cool kidney dissection you can see these areas right here that i'm highlighting with the probe here and these are referred to as renal pyramids now these are full of tiny tiny little collecting tubules that are collecting essentially urine and they're going to take them out and funnel them into this process or i should say this larger tube here called the renal pelvis which then goes and becomes the ureter down to the bladder and hopefully again out into the toilet so it's a really cool process that's happening 24 hours a day seven days a week but does that process of that metabolite from ibuprofen passing from the cardiovascular system into the urinary system cause a problem not so much but there is a potential side effect with the kidneys and ibuprofen it doesn't have to do with the process that i just went through and mentioned it weird has to do with again what the prostaglandins do last thing we'll refer to back to the beginning of the video remember the prostaglandins they did have an effect on the kidney a vasodilatory effect or in other words they helped the tiny little blood vessels in that renal cortex vasodilate or stay open a little bit and if you take ibuprofen and suppress prostaglandin synthesis you no longer have quite as much influence to vasodilate those blood vessels and they can start to vasoconstrict now in what context would that be a problem somebody again who's taking ibuprofen every once in a while or for short periods of time who's staying well hydrated isn't going to have a much much of a problem with that kind of vasoconstrictive effect of taking the ibuprofen but let's say again we go back to that example somebody who's taking it multiple times a day every day to help try to manage arthritis or in the senses maybe somebody has kidney disease if somebody already has kidney disease and you vasoconstrict those blood vessels you might exacerbate that problem even further so when i'm in the clinic and i'm talking about managing people's pain or inflammation or fevers with ibuprofen we often will have a discussion around what their kidney status is do they have a history of kidney disease sometimes they'll even pull up their lat previous labs and see what their kidney function looks like so those are some considerations that we have to do with say ibuprofen and if i run into some of those problems i may have to consider using some other pain medication to help manage their pain or their inflammation or their fevers so that's probably enough detail on ibuprofen and its potential therapeutic effects versus its potential side effects now granted there are some side effects we didn't discuss but we really wanted to focus on the main or the most common side effects in this video those others we can talk about in a future video but i do want to mention one last thing about a really cool phrase that one of my favorite pharmacology professors mentioned when i was still in medical training and that was in regards to us giving medications to patients and she would often say this phrase start low and go slow in other words start at the lowest therapeutic dose and slowly titrate up till you get the therapeutic response and then you can stop there in other words you don't necessarily have to say jump like to 800 milligrams of ibuprofen if say someone's pain and inflammation could be controlled with two to four hundred milligrams now granted everyone's situation's different the pain levels the condition you're treating all of that matters when you're picking a medication as well as dosing but i thought that was a really cool phrase at least that could be used as a general rule for clinicians and even for people who are going to manage their own health with over-the-counter medications now in this video we put so many little puzzle pieces together we put the pieces of human physiology and how they would interact with ibuprofen if you like puzzles and problem solving like that you're probably going to also like the sponsor of this video named brilliant brilliant is an interactive online learning platform for stem subjects that is math logic science and computer science there's some really cool courses on scientific thinking which we did a lot of in this video and they're very interactive they're fun and those are great combinations when you're trying to learn something and make it stick and problem solving and applying those skills and those details to real world situations is one of the best things you can do in education that's one of the things i've loved to see students do when they've come through the anatomy lab apply that knowledge to everything they're going to be doing in their future and their profession and brilliant offers all of these courses to help with this if you're interested i'll put the link in the description but you can also go to brilliant.org iha and they're going to give the first 200 people percent off to their yearly subscription again that links in the description and we'll see in the next video [Music] you

Channel: Institute of Human Anatomy

Views: 13,106,964

Keywords: ibuprofen, what is ibuprofen, what is ibuprofen used for, what is ibuprofen good for, is ibuprofen dangerous, does ibuprofen reduce swelling, does ibuprofen harm the liver, is ibuprofen bad for you, ibuprofen on an empty stomach, does ibuprofen cause ulcers, peptic ulcer disease, stomach anatomy, what does ibuprofen do to your body, what does ibuprofen do, what does ibuprofen do to your stomach, cox 1 and cox 2 inhibitors, cox 1 and cox 2, advil, aleve, ibuprofen headaches, ioha

Id: Zeem6k2bDFk

Length: 16min 34sec (994 seconds)

Published: Fri Nov 05 2021