ARE THOSE PAINKILLERS KILLING YOU?

While painkillers may be necessary for people with pain and chronic pain, many people have a habit of popping pills for every minor ache. Image credit: *ENGINAKYURT* on Pexels.

By AAMINAH NAJMUS SAHAR

Painkillers are the most commonly used over-the-counter (OTC) drugs. Though they are considered safe enough to be dispensed OTC without needing a prescription, they certainly have side effects and long-term toxicity.

Painkillers, also known as analgesics, belong to the class of drugs known as nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs treat fever and pain and reduce inflammation in the body.

NSAIDs/painkillers work by preventing the body from producing prostaglandins that cause inflammation and pain by dilating blood vessels and raising temperature.

Many people wonder how painkillers know where the pain is. Painkillers block the Cox enzyme, thereby blocking the prostaglandins that send signals of pain to the brain. Thus, by blocking prostaglandins, pain signals to the brain are blocked, and all kinds of pain is reduced.

Other types of drugs used for pain include narcotics and anesthesia. These drugs change the brain’s perception of pain. In this column, we are discussing only NSAID, the most commonly used painkillers. This may be due to their easy availability over the counter, low cost, effectiveness, and being a comparatively safer option among other painkillers.

The most commonly used painkillers are Paracetamol/Acetaminophen (Tylenol), Ibuprofen (Motrin, Advil), and Naproxen (Aleve). For adults, the maximum per-day dose of Acetaminophen is 4000mg, Naproxen is 750mg, and Ibuprofen is 1200 mg.

The adverse effects of NSAIDs include NSAID-induced stomach ulcers, risk of bleeding, diarrhea, nausea, vomiting, indigestion, heartburn, headache, dizziness, fluid retention, and allergic reactions. Consumption of alcohol along with NSAIDs increases the risk of bleeding. The adverse effects of NSAIDs on the stomach can be reduced by taking them with food or milk or drugs that reduce acid production (antacids). Long-term use of NSAIDs can cause liver and kidney damage. Thus, it is essential to take NSAIDs only when necessary to avoid vital organ damage.

NSAIDs like Diclofenac increase the risk of Angina, and patients with conditions such as Unstable Angina are at greater risk for Myocardial Infarction (MI) while taking NSAIDs.

Aspirin is used as a blood thinner at lower doses (75mg) when used daily and as a painkiller at higher doses (325mg, 350mg, 500mg). Use of aspirin is not recommended in children below 18 years of age as there is a risk of Reye syndrome. Reye syndrome is a rapidly worsening condition of the brain. It causes swelling in the brain and liver. Symptoms include vomiting, personality changes, seizures, confusion, and loss of consciousness. It may lead to permanent brain injury or death.

Use of NSAIDs should be avoided in pregnancy unless it is essential; even then, the lowest possible dose should be used for the shortest duration. Acetaminophen is safe for use in pregnancy and lactation. NSAIDs should be particularly avoided in early pregnancy and the third trimester. NSAIDs can increase the risk of early pregnancy loss, fetal renal dysfunction, and other fetal risks.

Most NSAIDs pass in the breast milk, thus, the lowest possible dose of NSAIDs should be used while lactating. Ibuprofen is considered safe to use while lactating.

While NSAIDs may be necessary for people with pain and chronic pain, many people have a habit of popping painkillers for every minor ache. It is important to remember the adverse effects of NSAIDs and their effects on the liver and kidneys. NSAIDs should be used only when necessary. Other forms of pain relievers like pain balms, topical pain patches, sprays, ointments, hot water, and ice bags should be used to manage pain. Even though these drugs are OTC, safe and conscious use of NSAIDs is necessary to avoid adverse effects and ensure healthy living.

HEALTH FILE

ARE THOSE PAINKILLERS KILLING YOU?