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Acetaminophen vs. ibuprofen

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Re: Acetaminophen vs. ibuprofen

#431

Post by Forgeties79 »

tshaddox wrote: post #426
vanderZwan wrote: post #245

Earlier quoted context omitted.

I feel like this is one of those things where Europe and the US are very different, culturally speaking - I've lived in the Netherlands, Germany and now Sweden, and the amount of painkillers used and prescribed here seems much lower than what Americans tell me is normal in the US. Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. If I sprain my ankle it onl…

> Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. That's a pretty apt explanation for why pain probably evolved via natural selection, but you can't therefore conclude that all or even most pain is a genuinely actionable warning sign. Presumably the vast majority of OTC painkiller usage is for short-lived and low-severity pain. I don't think it's a hubris…

>but you can't therefore conclude that all or even most pain is a genuinely actionable warning sign.

I didn't read their comment that way at all. It seems they're critiquing the default action that many people take, which is "pain = pop an aleve/tylenol/advil/etc. and get back to it."

Re: Acetaminophen vs. ibuprofen

#432

Post by Barrin92 »

tshaddox wrote: post #426
vanderZwan wrote: post #245

Earlier quoted context omitted.

I feel like this is one of those things where Europe and the US are very different, culturally speaking - I've lived in the Netherlands, Germany and now Sweden, and the amount of painkillers used and prescribed here seems much lower than what Americans tell me is normal in the US. Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. If I sprain my ankle it onl…

> Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. That's a pretty apt explanation for why pain probably evolved via natural selection, but you can't therefore conclude that all or even most pain is a genuinely actionable warning sign. Presumably the vast majority of OTC painkiller usage is for short-lived and low-severity pain. I don't think it's a hubris…

>Presumably the vast majority of OTC painkiller usage is for short-lived and low-severity pain

which is far from harmless given how many people use them as a replacement for treating underlying symptoms and changing their life. Case study my dad. Kept taking ibuprofen to get rid of 'harmless' headaches and back pain because he was 'too busy', few years later he couldn't ignore it any more, turns out he had completely messed up disc in his cervical spine from years of physical stress, bad posture, no treatment or exercise etc.

just look at the sheer amount of back pain diagnoses. About a third of Americans report back pain at any given time, IIRC 10-15% of the population go to the doctor any given year for back pain. There's likely millions, if not tens of millions preventable cases if you replaced the liberal use of OTC drugs with actually solving the lifestyle problems.

Re: Acetaminophen vs. ibuprofen

#433

Post by Forgeties79 »

Barrin92 wrote: post #432
tshaddox wrote: post #426

Earlier quoted context omitted.

> Pain a warning signal from the body. It's something one should listen to, not just try to ignore and overrule. That's a pretty apt explanation for why pain probably evolved via natural selection, but you can't therefore conclude that all or even most pain is a genuinely actionable warning sign. Presumably the vast majority of OTC painkiller usage is for short-lived and low-severity pain. I don't think it's a hubris…

>Presumably the vast majority of OTC painkiller usage is for short-lived and low-severity pain which is far from harmless given how many people use them as a replacement for treating underlying symptoms and changing their life. Case study my dad. Kept taking ibuprofen to get rid of 'harmless' headaches and back pain because he was 'too busy', few years later he couldn't ignore it any more, turns out he had completely…

Hopefully no kidney issues too :\

Re: Acetaminophen vs. ibuprofen

#434

Post by thepryz »

KacharKhan wrote: post #417

Doc here. One thing every single member of the general public needs to get drilled into them: Medical science is NOT intuitive. You cannot just read the mechanism of action of a drug and infer a dozen things from it. A drug's mechanism of action, its indication (when it ought to be used) and its adverse effects CANNOT simply be inferred logically from each other. Biology is orders of magnitude more complex than SE/CS…

While I don’t disagree, the problem I often have with medical professionals is that they tend to be arrogant and unable to take in new information to adapt and evolve their frameworks.

I was married to a doctor, helped them study for board exams, etc and was surrounded by other doctors within our social circle. What most people don’t realize, and most doctors themselves refuse to acknowledge, is how limited by specialization their knowledge can be and how the education of most doctors stops after med school and residency. Nutrition, for example, is barely covered at all.

Yes, there are continuing education requirements and countless journals but most doctors do the bare minimum and don’t keep up. I’d even argue that most physician knowledge tends to be updated more often through drug and instrumentation reps promoting their products by taking them out to dinner and entering them into referral programs, etc.

Re: Acetaminophen vs. ibuprofen

#435

Post by magicalhippo »

mghackerlady wrote: post #332
gregoryyy wrote: post #131

Earlier quoted context omitted.

Yup - in the UK, paracetamol is usually recommended for general pain relief before Ibuprofen. Additionally, Ibuprofen and NSAIDs have a lot of interactions which can make them unsafe - SSRIs or blood thinners for example.

Ibuprofen interacts with SSRIs? Anecdotally I've never had any problems with my Escitalopram and the Wikipedia page doesn't mention any interactions

The Norwegian pages I linked to states you should be careful with Ibuprofen and anti-depressants. I did a quick search and these[1][2] articles came up, suggesting increased risk of brain hemorrhaging and 10x increased gastrointestinal adverse effects due to the combination.

[1]: https://www.cam.ac.uk/research/discussion/antidepressants-an...

[2]: https://pmc.ncbi.nlm.nih.gov/articles/PMC1884970/

Re: Acetaminophen vs. ibuprofen

#436

Post by ViktorRay »

KacharKhan wrote: post #417

Doc here. One thing every single member of the general public needs to get drilled into them: Medical science is NOT intuitive. You cannot just read the mechanism of action of a drug and infer a dozen things from it. A drug's mechanism of action, its indication (when it ought to be used) and its adverse effects CANNOT simply be inferred logically from each other. Biology is orders of magnitude more complex than SE/CS…

The above two core properties make it possible to more or less reliably reason about bit SE/CS systems from first principles. The complete absence of above two in medicine means you cannot do the same there.

I'm a doctor as well and I think your statement here is too broad. Plenty of specialists such as cardiologists, orthopedic surgeons, radiologists, etc are able to reason things from first principles. The issue is that many non-doctors may not know several key details about these systems that would let you reason through them. And even many doctors well versed in one specialty would be unable to reason about another specialty since they may not know in detail several key pieces of information from that other speciality.

Re: Acetaminophen vs. ibuprofen

#437

Post by ahepp »

KacharKhan wrote: post #417

Doc here. One thing every single member of the general public needs to get drilled into them: Medical science is NOT intuitive. You cannot just read the mechanism of action of a drug and infer a dozen things from it. A drug's mechanism of action, its indication (when it ought to be used) and its adverse effects CANNOT simply be inferred logically from each other. Biology is orders of magnitude more complex than SE/CS…

This seems like a classic "rationalism vs empiricism" issue, and it was interesting for me to learn that Galen (famous / influential ancient Roman physician) wrote a lot about that.

0: https://plato.stanford.edu/archives/win2021/entries/galen/#M...

Re: Acetaminophen vs. ibuprofen

#438

Post by xen0 »

antirez wrote: post #227

In the article it is mentioned but it is worth stressing that N-acetylcysteine is a trivially available antidote for paracetamol overdose (and you may have it at home without knowing, Fluimucil, Mucomyst, NAC or alike). Also: in Europe everybody normally takes paracetamol and not FANS as a first reach to minimize adverse effects. So this article looks like very US centric. AFAIK liver failure because of paracetamol i…

> Also: in Europe everybody normally takes paracetamol and not FANS as a first reach to minimize adverse effects. So this article looks like very US centric.

This is not my experience. After moving to Germany from the UK, I feel like people take and expect Ibuprofen far more often than Paracetamol. It seems like the first port of call for colds and general headaches, with Paracetamol being treated with some suspicion, despite it being far more effective in my experience for certain things (I've taken a lot of Ibuprofen and other NSAIDs in my time so am quite familiar with how they affect me).

Re: Acetaminophen vs. ibuprofen

#439

Post by mcoliver »

pavlov wrote: post #429
KacharKhan wrote: post #417

Doc here. One thing every single member of the general public needs to get drilled into them: Medical science is NOT intuitive. You cannot just read the mechanism of action of a drug and infer a dozen things from it. A drug's mechanism of action, its indication (when it ought to be used) and its adverse effects CANNOT simply be inferred logically from each other. Biology is orders of magnitude more complex than SE/CS…

One of the greatest Silicon Valley tropes is when boring software guys get rich, lose the plot, and start reinventing physics from first principles because they think the universe is like computer science. The solace of made-up physics is there for every mediocre dude, from Uber founder Travis Kalanick down to any random guy who made $10M as the CTO of a third-rate video conferencing app and immediately broke up with…

Oddly specific. The interactions and variables in biology and physics create way more permutations than many (perhaps all?) people can wrap their heads around but that doesn't mean the possibility of reasoning from first principles doesn't exist. There are very well defined pathways in both medicine and physics. The ones we haven't discovered are most likely much more complex and may contain recursive loops that make tradeoffs inevitable. Or not. The rapid improvement in pattern recognition and processing leads me to believe we are in for a wild time over the next 10 years with a ton of breakthroughs in both physics and medicine.

Re: Acetaminophen vs. ibuprofen

#440

Post by tedd4u »

pavlov wrote: post #429
KacharKhan wrote: post #417

Doc here. One thing every single member of the general public needs to get drilled into them: Medical science is NOT intuitive. You cannot just read the mechanism of action of a drug and infer a dozen things from it. A drug's mechanism of action, its indication (when it ought to be used) and its adverse effects CANNOT simply be inferred logically from each other. Biology is orders of magnitude more complex than SE/CS…

One of the greatest Silicon Valley tropes is when boring software guys get rich, lose the plot, and start reinventing physics from first principles because they think the universe is like computer science. The solace of made-up physics is there for every mediocre dude, from Uber founder Travis Kalanick down to any random guy who made $10M as the CTO of a third-rate video conferencing app and immediately broke up with…

"Billionaires Want You To Know They Could Have Done Physics" - Angela Collier (actually has a Physics PhD)

https://www.youtube.com/watch?v=GmJI6qIqURA

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