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The first non-opoid painkiller

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Re: The first non-opoid painkiller

#171

Post by padjo »

DougN7 wrote: post #164
padjo wrote: post #124

Earlier quoted context omitted.

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

I’ve never heard of this particular overdose. In the US it’s completely unmonitored and I’ve never heard of an overdose. I’m genuinely surprised.

“A study of cases of acute liver failure between November 2000 and October 2004 by the Centers for Disease Control and Prevention in the US found that paracetamol was the cause of 41% of all cases” from https://en.m.wikipedia.org/wiki/Paracetamol_poisoning

Re: The first non-opoid painkiller

#172

Post by cadamsdotcom »

One thing people barely notice is how well the FDA is working.

A government agency with very high trust that partners with companies and helps to get things approved but only when they’re safe and has gotten more efficient since Covid is a rare and precious thing.

Re: The first non-opoid painkiller

#173

Post by laughing_man »

dghlsakjg wrote: post #153
Marazan wrote: post #136

Earlier quoted context omitted.

As annoying as it is (and I agree it is fantastically annoying) much to my surprise admissions for paracetamol overdose to UK hospitals absolutely plummeted after purchasing restrictions were introduced. Score one for the nanny state.

Not sure what "plummeted" quantifies to in this context, but the US saw meaningful reductions in overdose treatments and calls to the poison control line after changing the labeling rules and a public education campaign. The cited study was even conducted before the full labeling rules change came into effect. Teach a man why not to over-fish fish vs giving him a smaller amount of fish... or something. https://pmc.nc…

The US doesn't have a significant problem with deliberate acetaminophen overdose as part of a suicide attempt, which is the problem the UK rules are meant to address.

Re: The first non-opoid painkiller

#174

Post by dghlsakjg »

laughing_man wrote: post #173
dghlsakjg wrote: post #153

Earlier quoted context omitted.

Not sure what "plummeted" quantifies to in this context, but the US saw meaningful reductions in overdose treatments and calls to the poison control line after changing the labeling rules and a public education campaign. The cited study was even conducted before the full labeling rules change came into effect. Teach a man why not to over-fish fish vs giving him a smaller amount of fish... or something. https://pmc.nc…

The US doesn't have a significant problem with deliberate acetaminophen overdose as part of a suicide attempt, which is the problem the UK rules are meant to address.

Strictly speaking, if you wanted to solve intentional overdoses of acetaminophen, it appears that you could do it by presenting more appealing means of self-harm, like in the US. I'm pretty certain the availability of other lethal products (guns, really) directly correlates with whether OTC drug overdosing is a popular means of harm.

I'm willing to bet that handing out cyanide pills OTC would effectively eliminate intentional acetaminophen poisonings in the UK. Surprised the boffins at the NHS didn't think of it first if they really want to eliminate intentional overdoses! /s

Re: The first non-opoid painkiller

#175

Post by oakwhiz »

delusional wrote: post #138
dspillett wrote: post #108

Earlier quoted context omitted.

> 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, …

Worse in what ways? I think it's a pretty neat feature of the design. If you just need some, you don't get a lot, and you don't get to buy a lot "just in case". If you truly need a lot, you can go though the hassle of going to multiple stores. It's essentially just raising a barrier for (under normal circumstances) undesirable behavior.

I think being able to buy a lot of medicine just in case is an amazing feature that makes me less dependent on the supply chain.

Re: The first non-opoid painkiller

#176

Post by ck2 »

Traubenfuchs wrote: post #106
ck2 wrote: post #68

Earlier quoted context omitted.

Oh ambroxol is very interesting! And a cheap generic Really appreciate you mentioning it https://pmc.ncbi.nlm.nih.gov/articles/PMC6494067/

Ambroxol has many interesting fringe applications. It potentiates antibiotic effect in lung infections, including tuberculosis, treats painful hyperacusis, trigeminal neuralgia, neuropathic pain, parkinson, gaucher disease... ...and what's this? We have a surprise guest! Ambroxol significantly reduces snoring and thus suddenly becomes a candidate for a medication half the population should take! https://www.researchg…

grain of salt with this because it's LLM and needs verification

https://images2.imgbox.com/e1/b7/YaB8gjLI_o.png

but apparently the problem with ambroxol vs suzetrigine

is it is not as selective on the ion channel and not as strong (needs megadose to do similar)

I cannot remember the drugs offhand but this is the same problem with other old generics for other kinds of targets

suzetrigine won't be generic for years which is a shame

Re: The first non-opoid painkiller

#177

Post by 4gotunameagain »

hn_throw2025 wrote: post #132
4gotunameagain wrote: post #70

Earlier quoted context omitted.

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.

I had open surgery for an inguinal hernia here in the UK. Was sent home with a box of Codeine, 15mg tablets, to go with the Paracetamol. Plus some sachets of laxative for any constipation.

I don't want to be that guy, but UK barely counts in these kind of things, even more so nowadays.

There has been a huge opioid epidemic there as well.

Re: The first non-opoid painkiller

#178

Post by atombender »

theoreticalmal wrote: post #82
billforsternz wrote: post #40

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.

I'm a big fan of paracetamol in terms of how well it works; does wonders for headaches as well as joint aches. My concern is about the relatively recent findings about potential Alzheimer risk [1]:

> During a median follow-up of 12.3 years, 6407 (3.0%) participants developed new-onset all-cause dementia. Participants who regularly used paracetamol had a significantly higher risk of new-onset all-cause dementia (adjusted HR, 1.18; 95%CI: 1.10-1.26), compared with non-users. However, there was no significant association between regular use of ibuprofen and new-onset all-cause dementia (users vs. non-users; adjusted HR, 1.06; 95%CI: 0.97-1.16).

I don't follow the research closely enough to know if this is reliable evidence, but there are other studies showing the same thing.

Paracetamol also well known as mood-altering, apparently inhibiting empathy [2], which may be part of why it has an analgesic effect. That isn't as scary on a personal level, but imagine a society full of millions of people on paracetamol whose ability to feel empathy has been blunted.

[1] https://pubmed.ncbi.nlm.nih.gov/37633120/

[2] https://pmc.ncbi.nlm.nih.gov/articles/PMC6455058/

Re: The first non-opoid painkiller

#179

Post by hinkley »

StochasticLi wrote: post #147
hinkley wrote: post #139

No. Not even the 100th. Wikipedia: > At least 100 distinct phytocannabinoids have been isolated from cannabis, although only four (i.e., THCA, CBDA, CBCA and their common precursor CBGA) have been demonstrated to have a biogenetic origin.[6] It was reported in 2020 that phytocannabinoids can be found in other plants such as rhododendron, licorice and liverwort,[7] and earlier in Echinacea. Cannibinoid receptors are s…

They give me massive anxiety.

Well then I hope the 111th non opioid painkiller works for you. I know people in chronic pain (my body isn’t exactly a picnic) and so far none of them have gotten hooked on oxy but it’s always looming.

Re: The first non-opoid painkiller

#180

Post by atombender »

dcminter wrote: post #71
bravesoul2 wrote: post #29

Earlier quoted context omitted.

I also thought about epidural. Is that a non addictive way to give pain relief (extreme yes)

Epidural is surely just the method of administration (into the spinal fluid) where the actual painkiller administered is opioids, though, right? Meanwhile my understanding of Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) was that they were exactly that by definition - Anti-Inflammatories with pain being reduced by reducing the immediate cause of it, inflammation, not by interfering with the actual mechanisms of pain…

Paracetamol/acetaminophen is not an NSAID, though.

NSAID is effectively a shorthand for COX inhibitor; the term NSAID was coined at a time when the mechanism wasn't fully understood, and all other anti-inflammatories were steroids.

Paracetamol does target COX-2, but does so in a way that doesn't really have any effect on inflammation. Its main mechanism of action is as an AM404 inhibitor.

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