Pain can occur almost all parts of the human body and on anyone. Different painkillers have different side effects. How should different individuals such as children, adults, pregnant women, and the elderly choose painkillers? Which option is more beneficial to your own health?
Pain can occur almost all parts of the human body and accompany a person's life. The most common pain relief drug is Nonsteroidal anti-inflammatory drug , and a further option is opioids.
Different painkillers have different side effects, and different individuals such as children, adults, pregnant women, and the elderly have different tolerances to the same painkillers. How to choose painkiller drugs that are more beneficial to health in the face of the needs of different individuals?
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choice of pain relief medicine for pregnant women
acetaminophen is considered to be a relatively friendly pain relief and fever-reducing drug for people of all ages. It is present in hundreds of drugs for the treatment of headache, toothache, joint pain, cold, flu , allergies and sleep.
It is not uncommon for pregnant women to take acetaminophen during pregnancy. Several reports indicate that about 65% to 70% of pregnant women use painkillers during pregnancy and about 40% use acetaminophen during pregnancy.
A recent study found that taking painkiller acetaminophen , also known as Tylenol, may cause children to have behavioral problems at the age of three after birth, and children's risk of attention and sleep problems increased by 20% or more .
Simply put, if pregnant women take acetaminophen during pregnancy, children after birth are more likely to develop withdrawal, sleep problems and attention deficit disorders.
acetaminophen has been shown to cross the placental barrier and therefore may directly affect fetal development.
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pain relief medicines for osteoarthritis pain selection
Nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen and naproxen , are the most commonly used drugs to treat pain symptoms of knee osteoarthritis, but they are not always effective and may have side effects.
A review study from BMJ in 2021 found that etocoxib 60 mg/day and diclofenac 150 mg/day appears to be the most effective nonsteroidal anti-inflammatory drugs for treating pain and function improvement in osteoarthritis patients. However, non-steroidal anti-inflammatory drugs are not suitable for long-term use, nor are they suitable for patients with comorbidities to avoid serious and potentially fatal toxic events such as gastrointestinal bleeding and myocardial infarction.
study also believes that opioid , such as tramadol and hydroxymorphone, does not have the harm to osteoarthritis patients, the clinical benefits of are greater than their treatment.
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Hearing medication selection for knee minimally invasive joint surgery
About three-quarters of joints after minimally invasive surgery patients will take opioids such as tramadol and hydroxymorphone to relieve pain. But this type of drug is very addictive.
A new randomized controlled study compared the effects of opioid pain medications and other pain medications, and the results showed that a method for treating minimally invasive surgical pain in the knee or shoulder joints could be as simple as combining three common drugs: anti-inflammatory drug naproxen, painkiller acetaminophen, and acid inhibitor pantoprazole .
study believes that the combination of the above three drugs reduces the side effects of non-steroidal anti-inflammatory drugs, and the analgesic effect of is similar to that of opioid , but greatly reduces the dependence of opioids.
The above research results were published in the well-known medical journal JAMA on October 4, 2022.
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Hearing-relieving medicine for spinal-related pain
Spine-related pain, such as Low-back pain caused by herniated discs and degenerative discs, Low-back pain , neck pain, and back pain, are becoming more and more common among the elderly. Although drugs play an important role in pain management, the use of these painkillers, especially in elderly patients, is limited due to concerns about impaired liver and renal function and the mutual influence under multi-drug treatment.
From a new study from Boston University in the United States found that ibuprofen may be more effective for spinal-related pain when taking nonsteroidal anti-inflammatory drugs to relieve pain, while acetaminophen is the safest for the elderly.
In addition, neuralgia drugs, such as gabapentin , pregabalin , may have some benefits for neck and back nerve pain in the elderly, but may cause dizziness or difficulty walking. Such drugs can be used to relieve pain in the elderly under cautious dosage and renal function.
Some newer antidepressants (duloxetine) can also help relieve spinal-related pain, but attention should be paid to possible sedation and dizziness.
Some muscle relaxants, such as baclofen and tizanidine, can also be used for pain relief in the elderly while monitoring liver and kidney function. However, in patients with hepatic insufficiency, tizanidine is strictly prohibited; in patients with renal insufficiency, the dosage reduction is required when using baclofen.
Opioids are limited in common spinal-related pain, and are at risk of sedation, stomach upset, constipation, etc., and are only used with caution if the above treatment is ineffective.
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Summary
(1) Balance the benefits and risks of using acetaminophen during pregnancy . Taking acetaminophen during pregnancy can increase the risk of attention and sleep problems in young children by more than 20%.
(2) Opioids are at risk of abuse worldwide. The addictive nature of opioids has become a huge challenge. should avoid using tramadol and hydroxymorphone and other opioids . The harm this type of drug may cause to patients than the clinical benefits of its treatment.
(3) In the pain-relieving treatment of osteoarthritis, etocoxib and diclofenac appear to be the most effective nonsteroidal anti-inflammatory drugs.
(4) In pain relief treatment after minimally invasive joint surgery, the combination of naproxen, acetaminophen and pantoprazole seems to achieve the same effect as opioids, with less side effects.
(5) In the treatment of spinal-related neck pain, back pain, and low back pain in the elderly, ibuprofen may be more effective, while acetaminophen is the safest.
Reference
JAMA. 2022 Oct
PLoS One. 2022 Sep
Drugs Aging. 2022 Jul
BMJ. 2021 Oct
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