In December 2022, the new ten national prevention and control articles were issued and implemented. It is clear that asymptomatic infections in and patients with mild symptoms do not need to go to designated hospitals or temporary hospitals for treatment, and can be directly quarantined and health monitoring.
Omickron currently mainly causes symptoms of upper respiratory tract infection . It is rare for invading the lungs, and is generally mainly caused by fever and fatigue. Fever is actually a stress response of to the human immune to fight viral infection. There is no need to reduce fever for low fever. If it exceeds 38.5℃, you can use some antipyretic drugs for the right symptoms.
So, how to choose antipyretic drugs has attracted great attention. Various recommendations have also appeared on the Internet, but the trickle of flow returns to the sea, and there are still two "title songs": acetaminophen and ibuprofen .
acetaminophen tablets
Both drugs are over-the-counter drug , and are also non-steroidal anti-inflammatory antipyretic and analgesic drugs. They are two relatively safe and effective antipyretic drugs in the front line of clinical antipyretics.
Let’s talk about acetaminophen first.
Acetaminophen was released earlier than ibuprofen and was the big brother in the world of fever reduction.
The third year of Guangxu in the Qing Dynasty, the lunar calendar Dingchou year , that is, 1877. This year, those who know a little about history know that this is a pain point in history, because the " Dingwu Qihuang " died in 1877 and 1878.
But acetaminophen was actually used in clinical antipyretics in 1955.
That year, the acetaminophen tablets of Johnson & Johnson, the United States, were launched. Our country has given a vivid and vivid translation of this hard-to-remember imported medicine: paracetamol.
Later, there are many drugs under the product name, including: Tylenol, Gankang, Kuaike, Baijiahei, Hutong and Sanlipu, etc.
Let’s talk about ibuprofen.
ibuprofen
Ibuprofen was later than acetaminophen, and he was the younger brother of the antipyretic world. It was only obtained a patent license in 1961.
Moreover, ibuprofen is not like acetaminophen, and has a high-end translation name. So far, ibuprofen is still called ibuprofen. Just like your dad, you still call it dad, you don’t have daddy, daddy, etc.
Even if the product name is only a few, the ones that can be remembered by most people are Fenbid and Merrill Lynch.
Moreover, the product name Fenbid also has two boats, including ibuprofen version and acetaminophen version. It is necessary to marry a wife and concubine. Eggs cannot be placed in the same basket, and all baskets are not placed in the same car. You see, Fenbid did a good job in this.
Of course, the main reason may also be that people are used to the impression that ibuprofen seems to be mostly used for pain relief, and not many people pay attention to it, it is actually a first-line medicine for antipyretics. In upper respiratory tract infections, people seem to care more about fever, and they are most afraid of the legendary brain burning and "confused" and do not care much about the pain of limbs and joints, headaches, etc. This is different from foreigners, and foreigners seem to care more about the feeling and experience of the whole body. This is reflected in the use of medicine, and there are great differences and differences. Therefore, it is more common for them to use ibuprofen and acetaminophen.
In addition to ibuprofen and acetaminophen, there is also a once-in-a-halfen that has been almost injected into the cold palace in recent years. The arrogant "queen to reduce fever": acetylsalicylic acid.
Many people are unfamiliar with this medicine name, but when I say his translation name, you know that it is the stranger you are most familiar with: aspirin.
This is an old antipyretic medicine.
I remember when we were young, we had a cold and fever, and the teacher asked us to go to the clinic to buy a tablet of "APC", which is oral aspirin.One cent per piece, it reduces fever for about an hour, and it tastes good and is not expensive. Therefore, aspirin has become a star antipyretic drug before and in the early 1970s and 1980s.
Drug metabolism
But now, aspirin has been almost a big brother in the world of fever reduction for many years, and has started a new business in the anticoagulant market and started its main business of cardiovascular and cerebrovascular.
Sometimes I think about it, the ups and downs of a medicine are like the ups and downs of life. After returning, I am no longer a teenager, and I am so changing that I don’t even know myself. Is this still the same as I used to be?
Back to the topic, acetaminophen is metabolized in the liver, and ibuprofen is metabolized in the kidney, so it should be safe to take two medicines in a safe dose.
But there is a phenomenon, which is very interesting.
is in my country. Most doctors do not advocate taking these two drugs at the same time, but in foreign countries, some professional doctors often use them together. Why can
be used in conjunction?
Because the two drugs ibuprofen and acetaminophen do not have an interactive component. The antipyretic effect of acetaminophen is to affect the temperature regulation center of hypothalamus and produce peripheral blood vessel dilation, sweating and heat dissipation. ibuprofen relies on controlling the fatty acid chains produced by the human body to exert its efficacy, so the drug strength of ibuprofen is slightly stronger than that of acetaminophen, and the efficacy will last longer.
However, in our country, it is not recommended to use these two drugs in combination. It is recommended to use alternately only if one drug has poor antipyretic effect.
In the "Evidence-based Guidelines for Diagnosis and Treatment of Several Issues of Unknown Causes of Acute Fever in Children Aged 0 to 5 Years (Standard Edition)" It is clear that acetaminophen combined with ibuprofen is not recommended for children to reduce fever, and it is not recommended to alternately use acetaminophen and ibuprofen for children to reduce fever.
fever
One more thing, recently there was a popular online article saying that some people took medicine at home to prevent new crown , which led to severe liver failure. I think it is probably caused by excessive oral administration of acetaminophen metabolized by liver. This is something that everyone should pay great attention.
Because individual differences are excluded, the amount of acetaminophen poisoning is 4 grams per day, and the lethal amount is 6 grams per day.
This may not be clear to you. What does
mean? Each tablet contains 0.25 grams of acetaminophen. One piece at a time, twice a day, which means up to 0.5g.
Tylenol is a little more vigorous, each tablet contains 0.65g of acetaminophen, one tablet at a time, three times a day, less than 2 grams.
Why do I say that Tylenol is more powerful?
Because the United States clearly stipulated that the acetaminophen content in each antipyretic drug should not exceed 0.325 g. Why do you have to make such a regulation?
Take medicine
This stipulates the purpose, which can minimize the risk of overdose.
In fact, one piece of Tylenol contains 0.65g. It is strictly used according to the instructions, and there is no problem at all. The problem is that in reality, many patients have poor compliance with medical advice, and even act smart and have increased their investment without authorization, using multiple drugs together, thinking that this will bring recovery faster. Many of our Chinese patent medicines, such as some compound cold spirit powders, actually contain acetaminophen. Invisibly, once mixed, it is easy to cause overdose of drugs. Turning the originally safe acetaminophen into a killer of the liver.
Speaking of this, some netizens may ask stupidly: Since the appearance of antipyretics will use acetaminophen and ibuprofen, and we are prone to mistakenly use traditional Chinese and Western medicines containing acetaminophen, why don’t ibuprofen be added to Chinese patent medicines instead of using acetaminophen?
The reason is very simple, just in one sentence: cheap.
Relatively speaking, acetaminophen is indeed cheaper than ibuprofen production.
Of course, more importantly, it can also be applied to maximize, because ibuprofen cannot be used for pregnant women and babies under June. Acetaminophen is relatively safe for pregnant women and babies over March.
Another point is what I haven't mentioned yet, that is the side effects of ibuprofen.
ibuprofen is mainly metabolized in the kidneys and is prone to renal failure and heart failure. I recently accepted a patient who was admitted to our internal medicine because of lumbar disc herniation compressing sciatica . He took me oral menstrual ibuprofen for a long time. This time he was nephritis and was admitted to our internal medicine department.
In addition, ibuprofen has the biggest and most common side effect, which is that it can easily cause gastrointestinal ulcers. There are gastric ulcers, , cerebral infarction, coronary heart disease, renal insufficiency, and even some rheumatoid arthritis and ankylosing spondylitis who are already taking some nonsteroidal drugs orally. These people cannot use ibuprofen.
Also, it is not recommended to use ibuprofen for elderly people over 60 years old and patients with various underlying diseases such as hypertension and hyperglycemia. Because ibuprofen has an interaction with a variety of antihypertensive and hypoglycemic drugs, it will affect the normal effect of these drugs.
Actually, if you look carefully at the instructions for ibuprofen, you will find that it clearly states:
When used together with antihypertensive drugs, the latter will reduce the antihypertensive effect;
0 reduces the effect of small doses of aspirin to prevent cardiovascular disease and stroke ;
1 The effect of low-dose aspirin to prevent cardiovascular disease and stroke ;
1 When is used together with oral hypoglycemia drugs, digoxin, and methotrexate , the blood concentration of these drugs can increase and should not be used together; when
is used together with furosemide, the latter's sodium discharge and antihypertensive effects are weakened; when
is used together with anticoagulants such as heparin , dicoumarin , bicoumarin , bicoumarin , tend to increase the prothrombin time and increase the tendency to bleeding.
In comparison, acetaminophen is much safer. Therefore, for this type of population, acetaminophen is preferred to reduce fever.
In this way, acetaminophen has a wider population of applicable people than ibuprofen and has a broader market value.
Finally, what I want to say is that just like the Japanese think cows are eaten, Indians think cows are worshipped, if the underlying logic is different, there is no consensus. Therefore, it is most important to believe in doctors and follow doctors’ advice. Professional things should be left to professionals. If you feel unwell, you must consult a doctor and follow the doctor's professional guidance. Never blindly take Baidu on your own and take medicine randomly.
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