1. Be careful when taking painkillers.
Recently, the US Food and Drug Administration issued a safety warning that 2/kloc-0 non-steroidal anti-inflammatory and analgesic drugs, including fenbid, can cause gastrointestinal bleeding and cardiovascular diseases. Du, deputy director of the Shanghai ADR Center, pointed out that issuing a warning does not mean that painkillers can no longer be used. However, citizens should use painkillers reasonably and change the habit of taking painkillers when they feel a little pain.
Non-steroidal anti-inflammatory drugs have anti-inflammatory and analgesic effects, and are widely used to treat rheumatic diseases, inflammatory diseases, pain, soft tissue diseases and sports injuries, as well as to prevent cardiovascular diseases and tumors. According to statistics, about 30 million people around the world use NSAIDs every day. In China, the sales volume of non-steroidal anti-inflammatory and analgesic drugs is second only to anti-infective drugs. Relevant statistics show that 20%-25% of people who use non-steroidal anti-inflammatory drugs have different degrees of adverse reactions, and non-steroidal anti-inflammatory drugs account for 25% of all ADR reports.
Pain is a pathological symptom, and doctors diagnose it according to the symptoms. If the patient takes painkillers to suppress the pain, the doctor can't find out the cause. Therefore, if the pain lasts for 5 days, you should go to the hospital for examination. People who take drugs irregularly should go to the hospital to check whether it is neuropathic pain, psychological pain or physiological pain.
Repeated use of the same analgesic drug for a long time will lead to drug resistance, and the analgesic effect cannot be achieved by increasing the dose, but other analgesic drugs should be used in time. Under the premise of ensuring safety, the dosage of medicine should be from small to large until the pain is relieved. Patients should pay attention to the gradual use of painkillers.
Non-opioid drugs are usually used first. If the dosage and usage of the drugs used can not achieve the analgesic effect, weak opioid drugs can be added. If the pain can not be relieved after the two drugs are combined, strong opioid drugs can be added. For moderate and severe pain, more than two kinds of analgesic drugs can be used to reduce the dosage and complications and enhance the analgesic effect.
Can painkillers produce dependence? Du believes that this will not happen under normal circumstances. Patients who need long-term medication should choose appropriate drugs under the guidance of doctors. In addition to non-steroidal anti-inflammatory drugs, there are also central painkillers and narcotic painkillers. The central analgesic represented by tramadol has a weak analgesic effect, which is one tenth of morphine. Mainly used for all kinds of moderate acute pain and postoperative pain. Narcotic painkillers are represented by opioids such as morphine and demerol, which have strong analgesic effect, but they are addictive after repeated use and cannot be used casually.
Adverse reactions of non-steroidal anti-inflammatory drugs
● Gastrointestinal damage: sodium salicylate, indomethacin, aspirin, phenylbutazone, metronidazole, piroxicam, etc. Non-steroidal anti-inflammatory drugs can cause indigestion, mucosal erosion, gastric and duodenal ulcer bleeding, and even perforation in severe cases.
Note: People who can't tolerate NSAIDs or use NSAIDs in large doses, are old, have a history of gastrointestinal bleeding and ulcer, or use glucocorticoids and anticoagulants at the same time are all risk factors for gastrointestinal damage.
● Renal damage Ibuprofen and naproxen can cause nephrotic syndrome, ketoprofen can cause membranous nephropathy, and indomethacin can cause renal failure and edema.
Note: Long-term use of high-dose NSAIDs or compound NSAIDs may lead to heart, kidney, liver and other complications, diuretic users.
● Liver injury Most non-steroidal anti-inflammatory drugs can cause liver injury, and long-term high-dose use of acetaminophen can cause serious liver injury, especially liver necrosis; High dose of butazone can cause liver injury, jaundice and hepatitis; The use of salicylic acid in patients with specific reactions can lead to liver injury.
● Cardiovascular damage The latest research data shows that taking non-steroidal anti-inflammatory drugs can increase the incidence of cardiovascular diseases in patients.
Note: Patients who take such drugs for a long time should pay attention to monitoring cardiovascular diseases, and take timely measures if symptoms such as palpitation, angina pectoris and transient cerebral ischemia appear.
2. How to choose analgesic drugs
Joint pain Philip Cohen, a professor of musculoskeletal science at the University of Leeds in the United Kingdom, said that joint pain after middle age is often caused by osteoarthritis. When to take medicine is more important than what medicine to take. It is best to take medicine before the pain attacks. Professor Cohen suggested taking paracetamol once at lunch, once at dinner and once before going to bed.
lumbago
Martin Konerth, a famous British spinal surgeon, said that the best medicine to relieve long-term back pain is slow-release ibuprofen. Studies have shown that 8 tablets of paracetamol a day can provide a basic guarantee for relieving back pain, but ibuprofen takes effect faster and the sustained-release tablets take longer. They are slowly absorbed by the gastrointestinal tract and do not irritate the stomach.
migraine
Vasodilation and abnormal brain activity can induce migraine. Studies have shown that sumaputan can constrict blood vessels and effectively inhibit nerve activities that cause pain. When treating migraine, the initial dose should be slightly larger. Because migraine reduces the digestive ability of gastrointestinal tract and also affects the absorption of drugs.
Sinus pain
Andrew mccomb, an ear, nose and throat specialist, said that bacterial infection occurred in the sinuses, and the swelling of the nasal cavity would cause pain. Although ibuprofen or paracetamol have analgesic and anti-inflammatory effects, it is best to use nasal spray or decongestant in combination. It should be noted that the continuous use of decongestants should not exceed 2 weeks to avoid damaging the nasal mucosa.
have a headache
Common tension headaches can usually be solved by taking painkillers. Andrew Dawson, director of headache department at King's University School of Medicine, said that the trick is to use disintegrating tablets. Disintegrating tablets can be absorbed quickly, and can play an analgesic role 5- 10 minutes in advance. However, taking painkillers often makes the body prone to dependence and headaches become more and more frequent.
hangover
Sourdin Sid Dagani, a pharmacist of the Royal Society, said that hangover is actually a depression-like state, which is caused by the disorder of chemical signals in the brain caused by heavy drinking. Because a hangover hurts the stomach, taking aspirin and ibuprofen will induce vomiting. Dr. Dagani recommends quick-acting effervescent tablets or paracetamol disintegrating tablets. In addition, drinking some water and eating an apple before going to bed can relieve hangover symptoms very well.
dysmenorrhoea
Peter Owen Simpkins of the Royal College of Obstetricians and Gynaecologists said that dysmenorrhea was caused by excessive prostaglandin. Non-steroidal anti-inflammatory and analgesic drugs (such as ibuprofen) are effective, and the mechanism of this drug is to inhibit the secretion of prostaglandin. Aspirin and paracetamol are generally effective. In addition, diclofenac, naproxen and other drugs also have obvious effects on spasmodic pain and colic. Simpkins reminded women that it is best to take medicine before menstruation and limit the secretion of prostaglandin at the first time.
arthralgia
Philip Cohen, a professor of musculoskeletal science at the University of Leeds in the United Kingdom, said that joint pain after middle age is often caused by osteoarthritis. When to take medicine is more important than what medicine to take. It is best to take medicine before the pain attacks. Professor Cohen suggested taking paracetamol once at lunch, once at dinner and once before going to bed.
Sinus pain
Andrew mccomb, an ear, nose and throat specialist, said that bacterial infection occurred in the sinuses, and the swelling of the nasal cavity would cause pain. Although ibuprofen or paracetamol have analgesic and anti-inflammatory effects, it is best to use nasal spray or decongestant in combination. It should be noted that the continuous use of decongestants should not exceed 2 weeks to avoid damaging the nasal mucosa.