Painkillers

Well, after a few thoughts, i decided to talk about medicines on Tuesday, which are something i am more familiar with. Also, it might help me to refresh my memory on the stuff i learnt in school. I guess i can treat it as a revision session haha.

Anyway, i'm gonna talk about painkillers today, which is one of the Top 10 medicines people buy in pharmacies. There are many types of painkillers available, including the well known Paracetamol and NSAIDs (Non-steroidal anti-inflammatory drugs).

Paracetamol is more known as Panadol, which is actually it's brand name. It's like laptop, you have Acer, HP, Toshiba etc while Paracetamol, you have Panadol and a lot of other brands. Well, i normally tell the customers that they all do the same thing because they are the same medicine, just with different names produced by different pharmaceutical companies. This applies to most of the other medicines. Some medicines are extremely pricey because of the fact that it is imported from overseas, however you can actually get a relatively cheaper version that is produced locally. They are generally the same medicines. If the brands do make a difference, they will specify it. But for most of the over-the-counter (OTC) medicines, the brands just indicate the companies that produced them.

NSAIDs on the other hand, is a class of medicine. And a lot of medicines are under this class, including Ibuprofen, Naproxen, Mefenamic acid, Diclofenac Sodium/Potassium etc. They are all painkillers. However, there are some differences in effect among these medicines. In this case, the doctor might give you different types of painkillers according to your situations.

Today, i'm gonna tell you guys how to choose between painkillers at different situations.

Situation 1: You had a cold and is having muscle ache. 
Paracetamol is probably the first choice as you might have a fever as well. As most people might know, paracetamol is very effective in fever. Well actually, i would say that Paracetamol is mainly for fever rather than pain. However, due to the lesser side effects, people normally use it first and only look for other options when it doesn't work.

Situation 2: You have tooth ache. Your gum is red and inflammed.
In this situation, we will say that your gum is having a inflammatory reaction. Probably due to the growth of wisdom tooth if you are a teenager. The inflammatory reaction includes 3 main symptoms: RED, PAIN, SWOLLEN (RPS). In this case, NSAIDs will be more useful as it will help to reduce the inflammation therefore resolving the pain. I myself used to take Ibuprofen and it takes about 1-2 hours for the effect to kick in. Very effective.

Situation 3: You have a gastric pain.
Ok, this is one of the situation that you DO NOT take painkillers especially the NSAIDs class. The reason that you have gastric pain is normally because you skip your regular meals or you have gastric problem in the past. In this case, you have too much gastric acid in your stomach that irritates the lining of the stomach. So you will need something to neutralize the acid or reduce the production of the acid. Neither paracetamol nor NSAIDs help. You will need something like Antacids or PPIs or H2 Antagonist which i will discuss other time. The point here is that you should not take painkillers as they will not help and might even exaggerate the pain.

The main counselling points for both medicines are summarized as below:

Paracetamol
1. Take 2 tablets (each 500mg) every 4-6 hours for adult. Do not take more than 8 tablets (4 grams) a day.

It is very important to not exceed the amount taken a day as paracetamol is metabolised in the liver. And as some of you might know, overdose can cause liver problem even death.

2. Take it only when you have fever or mild to moderate pain.

3. Do not take the medicines if you have history of allergy to this medicine.

This is important as well. Allergy can be life-threatening. Watch out for any swollen lips or eyes, rashes, itchiness, breathing difficulties etc after taking the medicines if you have never take it before.

4. Consult the doctor/pharmacist if you have other medical condition or is currently taking other medicines such as Warfarin.

This is to prevent the incidents of drug interactions.

NSAIDs
1. Take it AFTER food and do not take more than directed.

This is because NSAIDs can cause gastric irritation which is commonly known as gastric pain. As all the medicines, overdose can make the medicine becomes poison which is a serious medical issue.

2. Take the medicines only when necessary for moderate to strong pain.

3. Do not take the medicines if you have allergy to any drugs from NSAIDs class. Consult a doctor/pharmacist if you are not sure.

4. Do not take the medicines if you have gastric, kidney or heart problem. Also consult a doctor/pharmacist if you are taking any other medicines, including Aspirin, warfarin and even some of the supplements which help with blood flow.

This is a crucial point for people who want to get NSAIDs medicine. I have explained about the relationship between gastric problem and the drug. As for the kidney problem, NSAIDs are cleared by kidney which means if your kidney is not functioning well, the medicines will accummulate in the body which will cause serious problem. 

Also some of the NSAIDs they are marketed as Selective COX-2 inhibitor, e.g. Celecoxib and Etoricoxib, which claims they have minimal gastric side effects. That is actually reasonable as they selectively not acting on the receptor that is responsible for the gastric effect. However, studies have shown that this type of NSAIDs might induce heart attack or stroke in people who have heart problem. Therefore consultation with the doctor or pharmacist is very crucial to avoid using Celecoxib or other similar medicines in people who have heart problem.

Wow, this is totally like writing for an assignment even though i just briefly introduce the medicines. I think this is the longest post i have ever written haha. Anyway hope you guys find it helpful and please do leave comments if you need any clarification or other informations =)