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The first non-opoid painkiller

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Re: The first non-opoid painkiller

#61
post #5

This is clickbait, there are at least two classes of non opioid painkillers in use since a long time. https://en.wikipedia.org/wiki/Analgesic

I don't feel the title is misleading, but it may be a cultural language difference. The term 'painkiller' is reserved for strong pain relief, and wouldn't include things like ibuprofen. That made me think immediately of a non-opioid pain blocker not just a pain reliever.

>The term 'painkiller' is reserved for strong pain relief

Maybe there's some very specific, limited medical context where this is the case but in common parlance it's not at all the case, search for "painkiller" in an online shop like Amazon and you'll find a whole lot of Paracetamol/Tylenol, and various NSAIDs (aspirin/ibuprofen) and manufacturers of those drugs actually use that specific term.

Re: The first non-opoid painkiller

#62

Earlier quoted context omitted.

The FDA interfering with informed consent between doctor and patient isn't something I find a source of complex feelings. The agency bears zero responsibility for the pain and suffering its caused by overcaution.

> The FDA interfering with informed consent between doctor and patient isn't something I find a source of complex feelings. Thalidomide. Patients (and often doctors) really don't have the skills or information to make an informed decision. They can however have 'feelings'. This is not the same thing.

I think your argument hinges on the implied idea that whoever makes up these entities (the FDA or otherwise) are intrinsically made of finer clay that the rest of us mere mortals.

Re: The first non-opoid painkiller

#63
post #42

> Another example involves nerve growth factor inhibitors like tanezumab. Although tanezumab alleviated inflammatory pain from conditions like osteoarthritis, Phase III trials revealed an unfortunate side effect: rapidly progressive osteoarthritis. Researchers hypothesized that because patients felt so much better, they overused their arthritic joints, accelerating damage. Although further trials were conducted at lo…

Well, pain exists for a reason for animals to pay attention to things that are harming the body. If you remove the flag (pain), harm will continue.

In that case maybe, but there are plenty of cases where pain is not indicating harm and may actually prevent people from reducing harm.

Re: The first non-opoid painkiller

#64
post #60

Earlier quoted context omitted.

> Was the vote against approval a move to "completely prevent a drug from entering the market and being used", or was it a desire to better understand it before saying "okay"? Why do you present this as an either/or? > Clicking "FDA" in the bit you quoted above takes you to a different page Indeed, where I found that... > That said, the article may not be fairly representing what happened in the first place, so... ..…

>Why do you present this as an either/or? >... your false dichotomy. I appreciate you giving me the opportunity to answer your first question before coming to the conclusion that I was using a false dichotomy. I didn't intend to present it as an "either/or", though I can see how it can be read that way. I simply read you saying that they "completely prevent[ed]" something from coming to market when, perhaps, they're…

> I appreciate you giving me the opportunity to answer your first question before coming to the conclusion that I was using a false dichotomy.

If I didn't already conclude that you presented a false dichotomy, why would I have inquired about why you did so? It's also not set in stone; from your reply I can just change my mind afterwards. But why do it in two rounds when I can do it in one?

I understand if I came across as hostile though, I admit it was sadly reflexive, and I apologize.

> perhaps, they're not "completely" doing anything and are open to doing it provided that they know more about it.

That's not a nuance I intended to disregard. Yes, I understand they can revisit the drug's approval later, didn't mean to suggest otherwise.

Gosh I hate natural language sometimes.

Re: The first non-opoid painkiller

#65

> Another example involves nerve growth factor inhibitors like tanezumab. Although tanezumab alleviated inflammatory pain from conditions like osteoarthritis, Phase III trials revealed an unfortunate side effect: rapidly progressive osteoarthritis. Researchers hypothesized that because patients felt so much better, they overused their arthritic joints, accelerating damage. Although further trials were conducted at lo…

Meanwhile, good old aspirin is not only an effective pain reliever but it has also been shown to reverse the effect of cartilage loss in osteoarthritis:

https://www.sciencedirect.com/science/article/abs/pii/S03785...

And that's not even taking into account its cardioprotective effects.

But hey, it can be hard on the stomach in SOME people so we developed alternatives with all sorts of nasty side effects, up to and including heart attacks and strokes (rofecoxib, valdecoxib, etc.) Hell, a decade ago, the FDA issued an advisory across the board that "Non-aspirin NSAIDS increase the risk of heart attacks and strokes":

https://www.fda.gov/drugs/drug-safety-and-availability/fda-d...

Some day we will look back on the attempted replacement of aspirin with these other drugs the same way we now look back on the replacement of butter with margarine (and the replacement of saturated fats with trans fats more broadly).

Re: The first non-opoid painkiller

#66
post #60

Earlier quoted context omitted.

>Why do you present this as an either/or? >... your false dichotomy. I appreciate you giving me the opportunity to answer your first question before coming to the conclusion that I was using a false dichotomy. I didn't intend to present it as an "either/or", though I can see how it can be read that way. I simply read you saying that they "completely prevent[ed]" something from coming to market when, perhaps, they're…

> I appreciate you giving me the opportunity to answer your first question before coming to the conclusion that I was using a false dichotomy. If I didn't already conclude that you presented a false dichotomy, why would I have inquired about why you did so? It's also not set in stone; from your reply I can just change my mind afterwards. But why do it in two rounds when I can do it in one? I understand if I came acro…

>Gosh I hate natural language.

Especially when it's sometimes hard to read tone, even moreso from a stranger whose communication style we're unfamiliar with. Even harder still, comments online generally don't lend themselves well to nuance and assumptions can easily be made, such as my leaning too heavily on your use of the word "completely"! Should we hug it out?

Hope you enjoy the rest of your day. :)

Re: The first non-opoid painkiller

#67
post #27

Earlier quoted context omitted.

> even the "pain relief" provided by sticking a knife through your skin to the bone is addictive > the side effect of addiction isn't going to go away While I agree with your conclusion itself, I disagree that the premise implies the conclusion. The main difference between suzetrigine and opioids, as explained in the article: Crucially, opioids don’t just kill pain: they also incite pleasure. When the mu opioid recep…

What is this thread? Sticking a knife through your skin to the bone kills pain and is addictive?

"There are more things in Heaven and Earth, Horatio, than are dreamt of in your philosophy."

And the Internet is the place where you get exposed to them at random.

Re: The first non-opoid painkiller

#68

Anyone better than me in pharmacology able to explain how suzetrigine compares to (high dosage?) ambroxol? They are both Nav1.8 blockers, but in Germany you can get lots of ambroxol for cheap and OTC.

Oh ambroxol is very interesting! And a cheap generic

Really appreciate you mentioning it

https://pmc.ncbi.nlm.nih.gov/articles/PMC6494067/

Re: The first non-opoid painkiller

#69
post #6

The title... Confuses me. Especially with a handful on non-opiod painkillers sitting in my history. Gabapentin? Heck, ibuprofen? Especially when the article itself compares it to ibuprofen: > If paracetamol and ibuprofen are inadequate for pain relief, Journavx can now be prescribed as the next alternative treatment, instead of mild- to moderate-strength opioids. "suitable for treating post-surgery pain" isn't someth…

Gabapentin is an anticonvulsants. Ibuprofen and paracetamol are anti-inflammatory. While they are effective at reducing pain, they are technically not "pain killers". The title is therefore correct.

Re: The first non-opoid painkiller

#70
post #2

Colloquially acetaminophen/paracetamol and ibuprofen are "painkillers" but this is in a different class, it's amazing to have something which performs like the opioid pain relief but without at least some of the side effects. It's the first non opioid painkiller applicable for situations like post operative use. I'd have loved this after my hernia op, the last thing you need with that is opioid induced constipation.

What kind of hernia ?

In the US it seems like they prescribe opioids like candy. I've never heard of opioids post hernia surgery in Europe.

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