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Acetaminophen vs. ibuprofen

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Re: Acetaminophen vs. ibuprofen

#441

Post by antirez »

xen0 wrote: post #438
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…

Didn't expect that, my feeling was that the situation in most continental Europe was like in Italy and the UK, and even more in France! (I believe they have the record of use), in such places paracetamol is very strong.

Re: Acetaminophen vs. ibuprofen

#442

Post by the_real_cher »

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…

I dont know if that tracks. Medicine is a science after all.

Re: Acetaminophen vs. ibuprofen

#443

Post by alphager »

isoprophlex wrote: post #72
justinc8687 wrote: post #66

I lived with an ICU nurse for years and one of the things he emphasized was the risk of acetaminophen overdose. He's more than once treated the liver failure (and death) from it and by his words, it's one of the worse ways to go. The positive of it is it got me in the habit of logging whenever I take it, either in a note on my phone or just a sheet of paper I place on my dresser under the bottle. This helps make sure…

I'm not disagreeing with you or trying to be disagreeable, but how do people accidentally exceed 3-4 grams daily? That's 6-8 pills!

It's in all kinds of medicine. People take some pills and then add a cough syrup, not noticing that the syrup also contains it as an active ingredient.

Re: Acetaminophen vs. ibuprofen

#444

Post by throwaway27448 »

AnthonyMouse wrote: post #233
kakacik wrote: post #132

Earlier quoted context omitted.

Whenever people here mention to my critique of US healthcare how its now mostly solved problem now, its 'good' to see the other side and reality. It certainly doesn't seem solved unless you have a million or two just laying around on the account, while mortgages and kids tuitions are paid. And I can easily imagine a long term condition or 10 which, if unlucky in terms of treatment cost coverage can wipe out that sum…

The problem with the US system is that it doesn't know what it's trying to be. If you did a socialist system then everything is "free" but possibly slow and expensive on the back end when the government isn't efficient. If you did a libertarian system then everything is cheap but it's caveat emptor because nobody is stopping you from buying morphine for $10 from Amazon. The US system isn't either one. It pretends to…

I think you're trying to apply ideology where it doesn't belong. Nobody on earth would advocate for such extensive spending to facilitate agreement on financing. It's extremely, extremely inefficient. (But it does produce jobs, which makes politicians super horny.)

The market also won't assist us, as we can't exactly compete future treatment costs against unknown illnesses.

Merely providing emergency rooms and "free clinics" will ensure that people only use these services.

A public option eliminating profit margin seems to at least be sane, and ideally would starve private funding from existence. Any remaining options would highlight deficiencies in the existing system.

A schumpeterian system, if you must slap an ideology on it.

Re: Acetaminophen vs. ibuprofen

#445

Post by drdaeman »

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…

> Clean layering.

We’d all wish it’d be so, doctor. Sometimes it’s as clean as biological systems - touch something somewhere, a different seemingly completely unrelated thing elsewhere breaks.

Even in the dawn of the era, where accumulated complexity was a while lot lower, we have tales of 500-mile emails and “magic/more magic” switch ;-)

Inferring things in a legacy codebase old enough to drink can be quite a challenge. And the way I get it, you folks are dealing with a multimillenia-old mess of layering violations - so no surprise first principles are tricky.

Re: Acetaminophen vs. ibuprofen

#446

Post by beAbU »

Insanity wrote: post #300
beAbU wrote: post #266

Earlier quoted context omitted.

> the amount of painkillers used and prescribed here seems much lower than what Americans tell me is normal in the US. Americans' relationship with painkillers is absolutely unhinged.

Might just be an artifact of the broken healthcare system. Painkillers are cheap and over the-counter. Going to a doctor is not. Additionally, in EU you can just take a sick day to rest and recover pretty much any time you need it. In the US you have limited “sick days”. E.g I now only have 6 “sick days” per year.. (and I’m fortunate to work in tech, I just WFH when I’m under the weather. But people who are less well…

Im in Ireland and I have 6 sick days... More and I take unpaid leave which I can probably claim from welfare.

Re: Acetaminophen vs. ibuprofen

#447

Post by nfw2 »

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…

It seems both true that 1. intuitive-sounding explanations about medicine can be extremely misleading for laypeople and 2. reasoning about mechanisms of action, supplemented with empirical science, is important and useful in medical science.

I'm not sure saying to not try to reason at all about mechanisms of actions is a good idea. If someone knows Tylenol is metabolized into chemicals that are toxic to liver, that is simple enough to understand and reason about

Re: Acetaminophen vs. ibuprofen

#448

Post by KaiserPro »

Jach wrote: post #379
KaiserPro wrote: post #142

Earlier quoted context omitted.

wait, how are you getting naproxen? Whenever its prescribed here, its paired with some sort of intestine protection medicine to stop it burning holes in your stomach/intenstines Ibuprofen is much safer, so long as you eat with it. Paracetamol is also safer, so long as you don't OD. BUT! so long as you stay below 4 grams a day, you'll be safe. (yes yes, in some situations you can take double, but unless you are under…

In the US, Aleve is the name-brand pill for naproxen, available in grocery stores next to everything else. I have a bottle of 160 gelcaps. Each pill is 220mg naproxen sodium or in parentheses 200 mg of naproxen. The advertised effect is 12 hours / all day, getting anywhere near 4g would only happen in a suicidal "swallow bottle of pills" situation.

So its a bottle, not a blister pack?

wild.

I know that blister packs are a pain, but in the places that they are introduced they reduce pill based suicide by up to 40%[1]

Sorry I should have been more clear about the 4g, that was for paracetamol. I have no idea what it would be for naproxen

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC526120/

Re: Acetaminophen vs. ibuprofen

#449

Post by tristor »

Interesting, I've always preferenced ibuprofen because I was concerned with long-term liver effects from acetaminophen as a casual drinker and someone who is a bit overweight (both things negatively impact the liver). I think one thing that's hard to understand as someone with no medical background is the long-term impacts of medications, it sounds like once it's processed there's no long-term negative impact for acetaminophen, where-as alcohol does have long-term negative impacts on the liver even after processing. Also, there's not enough information placed on the label or known how important not being dehydrated is to having good outcomes with ibuprofen. Obviously dehydration is bad, but it's also very commonplace.

Re: Acetaminophen vs. ibuprofen

#450

Post by gardnr »

thepryz wrote: post #434
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 specia…

I wouldn't label that arrogance. In my experience outside the USA, my GP has been unaware of new research / advice / guidelines published by the MoH. They generally respond to new info from reputable sources when you print it out and bring it to them.

I would expect specialists to be subscribed to journals and reading the latest articles in their field. When I saw a specialist at UCSF this was definitely the case; while my GP still has gaps where their current knowledge on a specific subject is from their time at med school.

An equivalence would be a front-end engineer being naive to the happenings on the Linux kernel mailing list. They could likely understand what's going on if they took the time to read it, but that is not their focus.

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