Contents
A statistical Pole takes a painkiller nine times a month. We are at the forefront of Europe when it comes to taking pain relief preparations. In 1999, we purchased over 128 million packages of over-the-counter (OTC) painkillers. But do we know how to take them?
Most often, we take medications for headaches, and many people also suffer from migraine. Often the reasons for taking medications are menstrual pain, toothache, as well as various types of joint and spine ailments or fever in the course of bacterial and viral infections. However, we are not always able to choose the right medicine for a given ailment.
What is worth knowing about drugs?
The science of pain management is an important part of medical science. Although pharmacological relieving of ailments is best directed by a doctor, especially in a pain clinic, it is not necessary to consult all cases of pain in a specialist’s office. That is why it is worth knowing a few basic facts. According to the analgesic ladder (i.e. the regimen of the use of analgesics defined by the WHO in 1986), painkillers are divided into non-opioid drugs and weak and strong opioids. The weak opioid analgesics include, for example, tramadol, codeine and dihydrocodeine, and the strong opioids include oxycodone, methadone, morphine and buprenorphine. These drugs are used in the case of severe pains, often of cancer origin. However, among non-opioid agents, non-steroidal anti-inflammatory drugs (so-called NSAIDs) are used, e.g. acetylsalicylic acid (i.e. aspirin), ibuprofen, naproxen and separately classified paracetamol. They are available over the counter and can be used for mild to moderate pain relief. However, it should be remembered that painkillers differ in their effectiveness in various types of pain and side effects.
Drugs used in mild to moderate pain relate to the group of non-opioid painkillers. The division often used by scientists distinguishes only two groups: painkillers (combating pain and fever) and anti-inflammatory drugs (combating ailments in the course of rheumatic diseases). However, it should be remembered that the boundary between these groups is blurred, as some drugs, such as ibuprofen and naproxen, are used in both indications.
How To Treat Pain?
Most painkillers and antipyretics available on the market contain paracetamol, acetylsalicylic acid and ibuprofen, of which only paracetamol has no anti-inflammatory effect. The others are also anti-inflammatory, which is important in the case of pains with an inflammatory component.
These preparations are effective in pain of mild and moderate intensity, e.g. in the case of fever, menstrual pains and migraines. Aspirin in low doses is also used in the prevention of myocardial infarction, as well as in unstable coronary artery disease and ischemic stroke, secondary prevention of acute coronary and cerebral incidents as well as chronic coronary disease, after coronary artery bypass grafting, coronary angioplasty and in people with occlusive disease. atherosclerosis of peripheral arteries.
The mechanism of action of drugs
The basic mechanism of action of all non-steroidal anti-inflammatory drugs (NSAIDs), despite their different chemical structures, is similar. In addition to the central effect on the brain, they also have a peripheral effect (in the area of nerve endings, i.e. at the site of ongoing inflammation or trauma), inhibiting cyclooxygenases – primarily COX-2 and also COX-1. The mechanism of action of NSAIDs is primarily related to the inhibition of the synthesis of prostaglandins that mediate the development of inflammation, which may cause pain. What does it mean? The drug acts directly at the site of the pain – in the tissues of the body and brain.
It is known that the analgesic effect of drugs is also the result of reducing inflammation by acting on the peripheral nervous system – mainly nerve endings and receptors, i.e. removing the source of pain.
In turn, paracetamol acts on the central nervous system. It inhibits the activity of COX-3 cyclooxygenase, which is found in the central nervous system (brain). As a result, the reduction in pain perception decreases.
Which drug to choose?
Paracetamol is effective for headache, toothache, muscle aches, or menstrual pain. Paracetamol can also be used safely in children and, if necessary, it can be administered to pregnant women, it is worth remembering that its long-term abuse may lead to liver and kidney damage and a number of other complications.
In contrast, anti-inflammatory drugs are more effective in combating pain with an inflammatory component. Among the most frequently used representatives of this group, aspirin has a moderate analgesic effect. Due to numerous side effects, it should be replaced with drugs with a higher safety profile, such as ibuprofen, which is considered the safest painkiller among NSAIDs. As a result, it is approved for wide use, both in adults and children. Ibuprofen is recommended by pediatricians as the first drug to treat fever in children. This is because a child’s fever is most often associated with existing inflammation.
In addition, in adults, ibuprofen can be used to alleviate inflammation caused by rheumatic diseases and pain in the muscles, head and spine, and also due to its inhibitory effect on uterine contractions in the case of menstrual pains [1,2]. The analgesic effect becomes apparent about 15 minutes after administration. The recommended dose is 200 mg every 4-6 hours and may be doubled if necessary.
Tekst: Lidia Banach
1. Slap G. Menstrual disorders In adolescence. Best Pract Res Clin Obstet Gynaecol. 2003, 17; 75-92.
2. Rees M., Anderson A., Demers L. et al. Prostaglandins in menstrual fluid in menorrhagia and dysmenorrhoea. Br J Obstet Gynecol. 1984, 91; 673-680.