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The first non-opoid painkiller

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Re: The first non-opoid painkiller

#121

Earlier quoted context omitted.

You don't need to take that much. LD50 is surprisingly close to the normal dose, and possible to do if you don't realise that cold remedies contain it (or that aminocetophen and paracetamol are the same thing!)

I avoid it at all costs because of the possibility of liver damage. Ibuprofen seems to have the same effect without potentially serious side effects.

The drawback of Ibuprofen is that it tends to cause damage to stomach and intestinal linings. That's why you are advised to take with food and/or lots of water. You don't want it absorbing all in one place. Long term use exacerbates the effect, making it more likely to cause ulcers and eventually internal bleeding. My partner ended up in the hospital with a serious internal bleed caused by taking Ibuprofen daily for chronic pain. I'm not saying don't use it, just be aware of the risks.

https://pubmed.ncbi.nlm.nih.gov/9715832/

Re: The first non-opoid painkiller

#122

Earlier quoted context omitted.

My wife and I got colds while vacationing in Edinburgh and had a heck of a time before realizing to ask for paracetamol rather than acetaminophen. Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid.

> the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid Worse than that: it is effectively per day per shop. In a very short space of time I can buy two packs in Boots, two in Tesco, two in Sainsbury, ooh look another small Tesco I'll get two there as well, two from Savers, two from SuperDrug, …

And yet the policy appears to have been effective in reducing overdoses.

Re: The first non-opoid painkiller

#123

Earlier quoted context omitted.

My wife and I got colds while vacationing in Edinburgh and had a heck of a time before realizing to ask for paracetamol rather than acetaminophen. Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid.

> Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid. Yes, but: > Responsible for 56,000 emergency department visits and 2600 hospitalizations, acetaminophen poisoning causes 500 deaths annually in the United States. Notably, around 50% of these poisonings are unintentional, often resulting from patients misinterpreting dosing instructions or unknowingly…

There's an interesting thing too about metamizol. It's very popular here in Spain for some types of pain (for example, teeth related stuff or post-surgery) and it's used widely without much problem. In fact, it was the most sold medication in Spain in 2023 (sold under the Nolotil brand) [0]. But it's forbidden in places like the UK.

Thing is, as we are a popular destination with British tourists or even pensioners that live in the Mediterranean, we've found in the last years that British population is genetically more likely to have a very dangerous side effect, agranulocytosis, that could result in death.

Can't find the exact source (I'm on my phone), but seems like at least half of the metamizol related agranulocytosis cases in Spain have been of British origin, and several deaths have been reported. There's a ongoing legal process where at least 40 deaths are being investigated [1] and doctor have stopped providing metamizol to persons of British origin, and do it carefully for other persons.

So what was perfectly safe around here, was found quite dangerous for certain subset of the British population (no jokes about balconies, please).

Edit for some sources:

From 1998 to 2003, out of the 13 agranulocytosis cases from a hospital in Marbella, 8 were foreigner, and of those 5 were from the UK [2]. According to the ADAF association, out of the 45 deaths attributed to metamizol in Spain since 1996, only 8 of them were Spanish (they don't tell their sources in that article) [3]

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  0: https://fefe.com/wp-content/uploads/2023/05/Obs.-marzo23ok.pdf
  1: https://guardian.pressreader.com/article/281857238286709
  2: https://www.sciencedirect.com/science/article/abs/pii/S0014256509713104
  3: https://www.elespanol.com/ciencia/salud/20231128/denuncian-sanidad-muerte-decenas-britanicos-espana-tomaron-nolotil/812919101_0.html

Re: The first non-opoid painkiller

#124

Earlier quoted context omitted.

Off topic complaint: I am guessing an absolutely massive amount of (admittedly minor in each instance) grief has been caused by the most widely deployed simple, inexpensive, useful and familiar drug unnecessarily having two different names acetaminophen / paracetamol. Finally figured this out this year (aged 64) after previously being confused why I couldn't find any damn paracetamol in pharmacies on my occasional vi…

My wife and I got colds while vacationing in Edinburgh and had a heck of a time before realizing to ask for paracetamol rather than acetaminophen. Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid.

Given how common accidental paracetamol overdose is I think it’s perfectly reasonable.

Re: The first non-opoid painkiller

#125
post #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.

Is that true? That ibuprofen is only reducing my pain via reduced inflammation? I'm sure I've taken it for pain that isn't caused by inflammation.

Re: The first non-opoid painkiller

#126
I think the medical community needs to take more seriously that different people have different pain tolerances.

My wife, daughter and I are very pain tolerant. Out of curiosity, I've turned down freezing for fillings and I even turned down some of pain meds before abdominal surgery. I've never taken the post op opioids, including when I had my impacted wisdom teeth removed.

My other kid, on the other hand, is a whimp. She gets anxious simply if I replace her earrings.

My use case for anesthesia is very different from my kid. I struggle to appreciate why anesthesia is even necessary beyond the need to restrain the patient.

My kid could go into a full blown panic attack from pain.

Yet I don't see anesthesiologists ever asking "how good are you with pain?"

Re: The first non-opoid painkiller

#127
post #110

Earlier quoted context omitted.

I was under the impression that a lot of overdoses of acetaminophen are due to it being included in many different multiple-medicine cold/flu remidies, like cough syrup, NyQuil, decongestants, etc. So people end up exceeding the max dose accidentally when they take acetaminophen along with some of those other things. Does the UK have rules that prevent mixing acetaminophen with other drugs? Its getting so its sometim…

I think it's less mixed in with other products than in the US (?)

My wife has negative reactions to it, which is extremely rare at normal doses (to the point many doctors don't believe her).

Trying to find medicine for her when she's sick is surprisingly time consuming as it is in so many things even vaguely related to treating cold / cough / flu symptoms.

Re: The first non-opoid painkiller

#128

Earlier quoted context omitted.

My wife and I got colds while vacationing in Edinburgh and had a heck of a time before realizing to ask for paracetamol rather than acetaminophen. Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid.

> the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid Worse than that: it is effectively per day per shop. In a very short space of time I can buy two packs in Boots, two in Tesco, two in Sainsbury, ooh look another small Tesco I'll get two there as well, two from Savers, two from SuperDrug, …

I did something similar when the whole household was coming down with Covid...

Re: The first non-opoid painkiller

#129

Earlier quoted context omitted.

>The term 'painkiller' is reserved for strong pain relief Having claimed it was cultural. It have been helpful of you indicated which culture you felt this applied to. In UK I'd say painkillers includes ibuprofen and paracetamol. I suppose with ibuprofen it's also referred to as an anti-inflammatory. Not sure how else one would refer to paracetamol other than with synonyms (analgesics) or euphemism (pain relief table…

Even in the UK it's not necessarily true. I wouldn't be surprised to hear it used that way, but I don't think my peer group in the UK would ever refer to NSAIDs as anything other than their brand or generic names. I particularly disagree with the parent comment that calls this click bait. The topic's intrinsically interesting to anybody who'd be lured in by that title; it doesn't need "bait" and we all know NSAIDs ex…

The title is at the very least ambiguous. I expected an essay on the historic invention of NSAIDs/paracetamol as I also understand painkillers to include NSAIDs.

Re: The first non-opoid painkiller

#130
post #109

Earlier quoted context omitted.

Off topic complaint: I am guessing an absolutely massive amount of (admittedly minor in each instance) grief has been caused by the most widely deployed simple, inexpensive, useful and familiar drug unnecessarily having two different names acetaminophen / paracetamol. Finally figured this out this year (aged 64) after previously being confused why I couldn't find any damn paracetamol in pharmacies on my occasional vi…

Tylenol also. Virtually all drugs and chemical products go under a bunch of somewhat confusing names. I guess for marketing?

Tylenol is slightly different in this case, as it is merely a brand name widely associated with their most commonly sold medicine. Tylenol does also make other medications, but the majority of it contains acetaminophen/paracetamol.

Acetaminophen and paracetamol are two names for the same generic chemical composition drug, which is why it is especially confusing. You can ask for aspirin or ibuprofen in any English speaking country, and they'll know what it is, but the world is divided on which of the two generic names to use: some acetaminophen, some paracetamol.

FWIW, acetaminophen was coined a year earlier than paracetamol, much like soccer was the accepted term far prior to football, but the Brits and a fair few other countries choose the later versions of the words.

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