Pain is the result of damaged cells in any area of the body. The human body makes two different types of cyclooxygenase enzymes, where COX-1 is responsible for protecting the stomach lining, and COX-2 causes inflammation.
The damaged cells excrete large amounts of an enzyme called cyclooxygenase-2. This stimulates the production of chemicals known as prostaglandins that are responsible for sending pain messages to the brain, which creates pain for the patient.
These chemicals also stimulate the release of fluid from the blood. This creates a cushion to protect the damaged cells from further damage, which causes swelling and inflammation on the surface of the patient's skin.
Since there are different types of painkillers, they all work in different ways to prevent the message of pain from being interpreted. NSAIDs are non-specific, which means that they can affect both these chemicals.
They work in the body by inhibiting the production of COX-2, which in turn prevents the excretion of prostaglandins. This reduces pain and inflammation. Although the damaged cells are still present, patients will not feel the pain.
Opioid analgesics work by joining to opioid receptors in the brain, which prevents the signal of pain from being interpreted at all. Anti-depressants and anticonvulsants affect advancing of the chemical, GABA, which plays a role in pain control.
Different painkillers take various activation times to work in the body. This is attributed to the medication's active ingredients and general pharmacology and structure. The various forms that pain medications are available in, also play a role in the time it takes to work.
Generally, it takes 20 to 30 minutes to see notable effects after taking analgesics. They will usually reach their peak concentration in one hour. These are normally immediate-release tablets. The long-acting preparation pain tablets release active ingredients slowly, generally over a timeframe of 12 hours. This provides a long-lasting period of pain relief.
Longer-acting or slow release analgesics are considered ideal for patients with chronic conditions. This is of-course due to the tablets' characteristic of providing a longer duration of pain control. Most often, opioid medications such as tramadol painkiller pills are available in this form as well as fast-acting / immediate release tablets. Another commonly available medication for treating chronic nerve pain is pregabalin.
Medications such as anti-depressants and anticonvulsants require a few days to a week or two, before showing their full effects after commencement. However, if a medication does not offer any noteworthy relief within two to three weeks, patients should consider another option.
Painkillers should only be administered when the patient has unbearable pain. It is not advised to take pain medications of any type for no valid reason, as this may cause unnecessary side effects. Since there are many analgesic medication types and strengths, patients should read their medication leaflets to note any interactions or contraindications.
Anyone over a certain age can use over-the-counter pain medications, unless they are allergic to a specific ingredient in the pharmaceutical. Patients with an affinity for misuse, kidney or liver problems and alcohol dependence should visit their doctor before taking any painkiller.
More potent analgesics have much more interactions and contraindications, as their composition and effects are more prominent in the body. Understanding a medication's history and prior health conditions are significant in preventing prescription errors and risks. This information is also useful in deducing the possible reasons for the pain and the correct way to approach it, in terms of addressing underlying issues.
Patients often have the misconception that alcohol is an effective 'painkiller'. However, this is a fallacy. The use of alcohol, in fact, has the potential to make the pain more severe than it already is. Although it does not directly provide pain relief, the inebriation of liquor causes the CNS to be temporarily dulled, so pain sensations are thus interpreted less intensely.
This is why mixing analgesics while having alcohol is a common, albeit misguided, practice. The risk of this combination depends on the classification of the particular medication being taken. However, combining any pain relief pills with alcohol is not recommended.
Even mixing alcohol with over-the-counter painkillers could potentially yield dangerous risks or side effects, such as extreme drowsiness or kidney and liver problems. Patients are at greater risks if they combine prescription pain medications with alcohol as the effects can be more debilitating.
Patients who take prescribed opioid analgesics for pain management are usually at risk of dependency and this risk is heightened further when alcohol is used in conjunction with these medications. A patient's health can rapidly decline with continued use of the combination, and the tolerance can exacerbate unwanted effects.
The use of alcohol and prescription medications can pose the following risks:
Certain prescription pain medications can, however, be safely combined with paracetamol. Nevertheless, this can increase the possibility of liver damage, when combined additionally with alcohol consumption. Due to these dangers, it is strongly advised never to mix any analgesic with alcohol.
The feeling of pain and discomfort goes hand-in-hand with pregnancy. However, most women hesitate to use medications for pain relief. They often do not know what analgesics are safe for them and their babies. Luckily, there are safe painkillers on the market, but careful timing and caution is still necessary when using these medications for optimum results.
Adequate rest and a cold compress can assist with muscle pain and headaches during pregnancy, but if additional relief is needed, doctors usually recommend the use of paracetamol. By following the exact dosage, pregnant women can treat their pain without harming their baby.
Other pain relievers such as naproxen and ibuprofen should be avoided as they have been associated with a decrease in amniotic fluid levels. This puts more pressure on the umbilical cord, which is the lifeline of the baby.
The use of opioid painkillers should be avoided entirely during pregnancy. Opioids can cause a condition called neonatal abstinence syndrome (NAS), which is where a baby has withdrawal symptoms from the presence of opioids. This can be distressing for both mother and child. For the treatment of chronic pain conditions, it is important to seek medical advice for the safe use of prescription medications.
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Updated: 27th January 2021
Review Due: January 2022
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