body

body



analgesics



an analgesic is any drug that relieves pain, but does not cause unconsciousness.

there are two types of analgesics, narcotic and non-narcotic. narcotics relieve

severe pain, but are addictive. non-narcotics relieve minor pain, but are not

addictive. types of nonarcotic include aspirin and acetaminophen. narcotic includes

codeine,merphine,and,meperidine.





aspirin



aspirin help pains such as headaches, migraines, colds, flu, cramps, and dental

pain. aspirin, being used as early as the stone age, is the oldest known analgesic.

it was used by such cultures as the greeks, indians, and others. aspirin is found in

the bark of willow trees. it has analgesic, antipyretic, antiplatele, and in higher

dosages anti-inflammatory activities. it is a synthetic chemical compound

acetylsalicylic acid. aspirin is more effective than codeine, a prescribed analgesic.

it is not recommended for children under the age of 12 for the risk of reyes

syndrome. even one aspirin a day increases the chance of intestinal bleeding. it

irritates the stomach. half an aspirin a day can decrease the chance of stroke or

heart attacks. it also reduces blood clots. complications can be avoided by using

anteric-coated aspirin, which doesn’t dissolve until reaching the intestine.

americans consume about 40 million pounds of aspirin a year. that is about 300

tablets for every man, women, and child. some brand names include bayer,

bufferin, and ecotrin. the maximum dosage is 4 grams (4000 mg) a day.



ibuprofen



ibuprofen is a drug to reduce inflammation, fever, and sensation of pain. ibuprofen

is used for such pains as arthritis, muscle pains, headaches, cramps, fever and

menstrual pain. when ibuprofen is prescribed it is normally used for severe

symptoms associated with arthritis. when it is not prescribed it is usually to relieve

low intensity pain, inflammation, or fever. it has the widest use of drugs called

proplonic and cidderivatives. ibuprofen was developed during the 1960’s and was

only available by a prescription. in 1984 the fda approved it to be sold over the

counter. it has fewer side effects then aspirin. prolonged use of ibuprofen can

result in ulcers and internal bleeding because it blocks the production of the

stomach lining's protective mucous barrier. it can prevent the body from excreting

salt and water for people who suffer from kidney disease, liver disease, or high

blood pressure. the anticoagulant effect of ibuprofen can result in excessive

bleeding when taking prior to tooth extraction or minor surgery. alcoholic

beverages should be avoided while taking this medication. some brand names

include,advil,morin,andnuprin. The,max,dosageis,1.2grams(1200mg)a,day.

acetaminophen



acetaminophen is a drug that does not need a prescription. it is used for such

minor pains as headaches structional muscle aches, and fever. the difference

between this and the other two is it doesn’t reduce inflammation. yet it doesn’t

irritate the stomach lining as the other two do. an over dosage causes severe liver

damage.a,brand,name,includes,tylenol.







naproxen sodium



naproxen is a non-steroidal anti-inflammatory analgesic drug. it relieves such pain

as fevers, arthritis, muscle pain, menstrual, headaches, inflammation of joints,

gout, and backache. the fda approved it in 1994 to be able to buy without a

prescription. most common side effects include constipation, heartburn, abdominal

pain, nausea, dyspepsia, diarrhea, stomactitis, and headaches, ringing in your

eyes, vomiting, and swelling of fingers and ankles. it irritates your stomach. a

brand name is aleve. the maximum daily dosage is .66 grams or 660 mg.



analgesics



harmful effects of fever (for example, dehydration, changes in consciousness,

seizures, or coma) are most likely to occur at temperatures above 106 f. lower

fevers are dangerous in persons with heart disease, since fever increases the work

of the heart because the pumping of blood must increase. seizures occur in 2% to

4% of all children between the ages of 6 months and 5 years (usually before age 3)

with high fevers though these seizures generally last no more than 15 minutes.

children who experience febrile seizures have a higher risk of developing epilepsy

later in life.



What,are,the,different,classes,of,pain,relievers,and,fever,reducers?



the three classes of otc analgesic/antipyretic medications are:



 salicylates: aspirin (also called acetylsalicylic acid or asa), choline salicylate,

magnesium salicylate, and sodium salicylate;

 acetaminophen; and

 nonsteroidal anti-inflammatory drugs (nsaids): ibuprofen, naproxen sodium,

and ketoprofen. (aspirin is also an nsaid, but it is considered separately from

the other nsaids because it has some unique properties.) each of these

drugs is discussed in detail below.



in most circumstances, these medications all have very similar analgesic (pain-

relieving) and antipyretic (fever-lowering) abilities. their onset of action (the interval

from the time of ingestion to the start of pain relief) also are similar. naproxen

sodium may have a somewhat longer duration of pain relief (analgesia) than the

other nsaids or aspirin. at high doses, salicylates and nsaids suppress

inflammation and are, therefore, particularly useful in treating inflammatory

diseases such as arthritis. acetaminophen does not have anti-inflammatory

actions.



many otc analgesics are available in combination with other drugs. there is some

evidence that caffeine and antihistamines enhance the effects of analgesics. thus,

caffeine increases the pain-relieving effects of aspirin and ibuprofen, and the

antihistamines orphenadrine and phenyltoloxamine enhance the pain- relieving

effects of acetaminophen. combinations of decongestants with analgesics are

logical only when nasal or sinus congestion are present, for example, for sinus

headaches.



aspirin



formulations of aspirin: aspirin can damage the lining of the stomach and

duodenum, thereby causing abdominal pain, bleeding, and/or ulcers. as a result, 1

in 5 persons who take aspirin in a dose of 2.5 grams per day or more develops

ulcers and about 1 in 6 will lose enough blood from gastrointestinal bleeding to

develop anemia. in an attempt to reduce the potential for these complications,

some aspirin-containing tablets have been coated with a special coating that

prevents the tablet from dissolving until it is past the stomach and duodenum.

these "enteric-coated" aspirin products may reduce the frequency of abdominal

pain, but not the bleeding or ulcers. moreover, the onset of pain relief is delayed

with enteric-coated aspirin because it takes more time for the tablets to dissolve.



other attempts to prevent complications have included aspirin-containing products

that release the aspirin slowly over time (e.g., zorprin; measurin; verin). like enteric-

coated products, these products are not ideal when prompt relief of pain is needed.

they also do not prevent ulcers or bleeding. buffered (e.g. bufferin) and

effervescent (e.g. alka-seltzer) aspirin products are absorbed more quickly from the

stomach and intestine than aspirin, but they do not act more rapidly than regular

aspirin and do not reduce the risk of bleeding or ulcers. furthermore, effervescent

aspirin products contain large amounts of sodium (salt) and should be avoided in

persons with high blood pressure, heart failure, or certain kidney diseases.



side effects: aspirin prevents platelets from sticking together and forming blood

clots. on the one hand, this effect can be used beneficially, for example, to prevent

the blood clots that cause heart attacks or strokes. on the other hand, by

preventing blood clots, aspirin can have the detrimental effect of promoting

bleeding. therefore, aspirin should not be used by people who have diseases that

cause bleeding (e.g., hemophilia, severe liver disease) or diseases in which

bleeding may occur as a complication (e.g., stomach ulcers). moreover, since the

effect of aspirin on platelets lasts for several days, people should not take aspirin

for seven days before surgical or dental procedures because of the increased risk

of bleeding after the procedures. in patients at risk for bleeding, acetaminophen

can be an excellent alternative to aspirin since acetaminophen does not have an

effect on platelets, blood clots, or bleeding. like aspirin, other nsaids affect

platelets, but the duration of the effect is less than with aspirin. two aspirin-related,

salicylate-containing products (salsalate and choline magnesium trisalicylate) have

no effect on the platelets, but they are available only by prescription.



although many people claim to be "allergic" to aspirin, most describe their "allergy"

as abdominal pain or heartburn. these common side effects are not allergies, but

rather reflect the irritating effects of aspirin on the lining of the stomach. true allergy

to aspirin occurs in fewer than 1 out every 100 persons. true allergy may include

hives, itching, swelling, or difficulty breathing. allergy to aspirin is more common in

persons with asthma, allergic rhinitis, or nasal polyps. in such persons, the risk of

an allergic reaction to aspirin may be as high as 1 to 3 persons out of every 10.

people with true aspirin allergy also may be allergic to other compounds. one such

compound is tartrazine, or yellow dye #5. this dye is used in many medicines,

foods (such as soft drinks), and candy or desserts. in addition, people with an

allergy to aspirin often are allergic to other nsaids, such as ibuprofen.



pregnancy/lactation: regular aspirin consumption during pregnancy has been

associated with side effects in the pregnant mother, including bleeding and

complications during labor. it is unclear if aspirin taken in the first two trimesters

poses a risk to the fetus. however, when taken during the third trimester, aspirin

may increase the risk of bleeding in the newborn. although very little aspirin is

secreted into milk, most authorities recommend that nursing mothers avoid using

aspirin.



viral infections in children: because aspirin causes reye's syndrome (a potentially

fatal liver disease that occurs almost exclusively in persons under the age of 15

years), aspirin should not be given to children when a viral infection is suspected.



drug interactions: high doses of aspirin can increase the activity of valproic acid

(depakene; depakote), an effect which can cause drowsiness or behavioral

changes. high doses of aspirin also can enhance the effect of some sugar-lowering

medications used in diabetes, e.g. glyburide (diabeta), glipizide (glucotrol), and

tolbutamide (orinase), which can possibly lead to hypoglycemia (low blood sugar).

the effects of probenecid (benemid) are reversed by aspirin. aspirin can increase

the toxicity of methotrexate and the risk of bleeding with warfarin

(coumadin).,Salicylates,other,than,aspirin



there are three other otc salicylates; choline salicylate, magnesium salicylate, and

sodium salicylate. the advantage of these drugs over aspirin is their shorter effect

on the platelets that promote bleeding.



choline salicylate (arthropan) is available as a liquid. it is absorbed more quickly,

but its onset of action is no different than that of aspirin. some people find choline

salicylate fishy. fortunately, it can be mixed with juice or soda prior to ingestion. it is

less effective at reducing fevers in children than either aspirin or acetaminophen.

magnesium salicylate (arthriten; backache) is as effective as aspirin at reducing

pain. patients with chronic kidney disease should avoid magnesium salicylate,

since the magnesium may accumulate in their bodies.



sodium salicylate (scot-tussin original) and aspirin are equally effective in the long-

term treatment of rheumatoid arthritis, but sodium salicylate is less effective at

reducing pain or fever.



acetaminophen



formulations: acetaminophen comes in various oral formulations, including different

types (elixirs or syrups) and flavors of liquids, capsules, tablets, caplets, and

suppositories. the capsules contain tasteless granules that can be emptied onto a

teaspoon containing a small amount of drink or soft food, and can then be

swallowed. however, the granules should not be mixed in a glass of liquid since the

granules will stick to glass itself. the amount of acetaminophen that is absorbed

from rectal suppositories is about half that of the oral formulations.



side effects: acetaminophen generally is safe to use, and few people develop side

effects. in high doses, however, it can cause liver damage and doses of 4000mg (4

grams) per day should not be exceeded.



pregnancy/lactation: acetaminophen has no known harmful effects on the mother,

fetus, or infant and, therefore, can be used safely during pregnancy and during

lactation.



drug interactions: it has been reported that patients with hiv- related diseases (e.g.,

aids) who take azt (zidovudine; retrovir) and acetaminophen are at an increased

risk of developing suppression of their bone marrow. such patients develop lower

white and red blood cell and platelet counts and, therefore, are more susceptible to

infection, anemia, and bleeding.



Nonsteroidal,anti-inflammatory,drugs,(nsaids)



there are three otc nsaids--ibuprofen, naproxen sodium, and ketoprofen. all have

pain relieving (analgesic), fever reducing (antipyretic), and anti-inflammatory

properties. additionally, nsaids are more effective than aspirin or acetaminophen

for cramps associated with the menstrual cycle (dysmenorrhea).



formulations: ibuprofen is available in tablets as well as in a pediatric suspension.

naproxen sodium is available in tablets. ketoprofen is available as tablets and

caplets.



pregnancy/lactation: nsaids are safe for use during the first or second trimesters of

pregnancy, but should not be taken during the third trimester, since they can

prolong labor and delay birth, increase bleeding in the mother following birth, and

can cause cardiac (heart) and vascular (blood vessels) complications in the

newborn. ibuprofen and naproxen sodium also are safe for use by nursing

mothers. due to insufficient data, ketoprofen is not recommended for use by

nursing mothers.



side effects: the most frequent side effect of nsaids is damage to the lining of the

stomach and duodenum that can lead to abdominal pain, nausea, and loss of

appetite. nsaids also can cause ulcers and bleeding from the stomach and

duodenum, but less frequently and less severely than occurs with aspirin use.

nsaids, like aspirin, affect platelets and can inhibit the formation of blood clots, and,

therefore, they should be discontinued at least 24 hours before surgery or dental

procedures. because alcohol intensifies the effect of nsaids on bleeding, alcohol

should not be taken with nsaids. nsaids also can cause kidney damage, particularly

in the elderly or patients with high blood pressure, diabetes, atherosclerosis, or

who take diuretic medications ("water pills"). patients who are allergic to aspirin

should not take nsaids since they are likely to be allergic to nsaids as well. nsaids

may cause fluid retention in persons with congestive heart failure, and, therefore

should not be used in this setting.



drug interactions: ibuprofen may increase blood levels of digoxin (lanoxin);

however, it is unclear whether this interaction is important enough to recommend

that patients taking digoxin not take ibuprofen.



nsaids reduce the blood pressure-lowering effects of certain high blood pressure

(antihypertensive) medications, including: thiazide diuretics such as

hydrochlorothiazide (dyazide, maxzide); beta-blockers such as propranolol or

atenolol (inderal, tenormin), and metoprolol (lopressor); angiotensin receptor

antagonists such as enalapril (vasotec), lisinopril (zestril; prinivil), benazepril

(lotensin), quinapril (accupril), ramipril (altace), and captopril (capoten); and some

medications that act on the brain, such as clonidine (catapres).



nsaids can increase the levels of lithium in the blood, which can result in lithium-

related side effects.



nsaids can also increase the levels of methotrexate in the blood and have been

reported to result in methotrexate-related side effects.



what about overdoses of pain relievers and fever reducers?



the american association of poison control centers reported that of all overdoses of

otc products, 66% involved acetaminophen, 19% involved ibuprofen, and 15%

involved aspirin. aspirin overdose can occur with as little as 150 mg/kg (10,000mg

or 10 grams in the average sized male) as a single dose, or 90 mg/kg per day for

at least two consecutive days. symptoms of toxicity due to aspirin may include

tiredness, ringing in the ears, rapid breathing, seizures, vomiting, bleeding, and

coma. large doses of acetaminophen rarely cause serious problems in children. in

adults, as little as 10 grams can damage the liver and the kidneys. overdoses of

ibuprofen rarely produce important problems. nausea, vomiting, stomach pain,

tiredness, and dizziness are the most common symptoms of large doses of

ibuprofen. rarely, coma may occur.



pain is the most common reason for people to seek medical advice, and medicines

for pain are the most frequently purchased over-the-counter (otc) medications.

fever is one of the most common reasons for people to seek medical advice for

their children, and one in five emergency room visits for children is due to fever.

since otc medicines that are effective in treating pain also are effective at reducing

fever, they will be considered together.



what classifications of pain are there?



pain can be classified as acute, chronic non-malignant, or chronic malignant.

headaches, the most common cause of pain, can be considered a separate class

of pain.



acute pain usually is due to mechanical or thermal (usually heat) injuries. examples

of mechanical injuries include soreness of muscles due to overuse or strain (and

sometimes to viral infections), tears of the ligaments, broken bones, bruises, and

cuts. these types of acute pain usually respond well to otc medications for pain.

muscle soreness also may respond well to heat and massage.



chronic non-malignant pain is a type of pain associated with progressive,

debilitating diseases such as arthritis. otc medications for pain usually are effective

for this type of pain. however, because of the chronic nature of the pain, their use

often leads to excessive use of the medications and frequent side effects. the pain

of arthritis also may respond well to heat.



chronic malignant pain is pain associated with advanced, progressive diseases

(often fatal) such as cancer, multiple sclerosis, aids, and terminal kidney disease.

otc medications for pain may be useful for the management of chronic malignant

pain. however, stronger prescription medications usually are necessary.



what types of headaches are there?



headaches--most common reason that analgesic medications are taken-- can be

classified into three types: muscle contraction, migraine or vascular, and sinus.



a muscle contraction headache, the most common type, results from the

continuous tightening of the muscles in the upper back, neck, or scalp. this type of

headache often is described as a tight, pressing, or throbbing sensation of the

head. it can be brought on by emotional stress and anxiety ("tension headaches").

acute muscle contraction headaches generally respond well to otc analgesics, but

chronic muscle contraction headaches often require physical therapy or relaxation

techniques.

migraine or vascular headaches are due to dilation (expansion) of blood vessels in

the head. although many patients use the expression "migraine" to describe any

particularly painful headache, many of these are actually muscle contraction

headaches. otc medications for pain may be quite effective for treating migraine

headaches. however, prescription medications that are specifically formulated for

treating or preventing migraines often are necessary.



a sinus headache is caused by an infection or blockage of one or more sinuses in

the head. the pain often is limited to the area around the eyes or the forehead

where the major sinuses are located. the pain may occur upon awakening, and

may decrease in intensity after the person has been standing or sitting up for a

while. in addition to analgesics, otc decongestants can be effective by helping to

drain the sinus.



what is a fever and what is it's causes?



most fevers are transient (lasting only a few hours or a few days) and are not

dangerous, but they may cause a great deal of discomfort. a rectal temperature of

greater than 101.8 degrees f (38.8 degrees c), an oral temperature of more than

100 degrees f (37.8 degrees c), or an armpit temperature of greater than 99

degrees f (37.2 degrees c) is considered abnormal. fevers usually are due to

infections, either viral or bacterial, but they also can be due to cancers, injury to

tissue (for example, heart attacks), hyperthyroidism, other illnesses in which there

is inflammation, and dehydration. additionally, over 40 different drugs have been

reported to cause "drug fever."



stomach acid

gastric juices secreted by specialized cells lining pits in the wall of the stomach.

gastric juice contains an enzyme called pepsin that digests protein. it also contains

hydrochloric acid and water. the hydrochloric acid is very strong and is needed to

help kill bacteria that may cause illness and provides acid conditions in which

pepsin works quickly.

on a scale of acidity called the ph scale, the acid secretions from the stomach wall

are between ph 0.8 and ph 1.0. this makes the secretions so strong that, if bottled,

they would be too dangerous to have on an open shelf in a school laboratory and

would have to be labelled ‘corrosive’. this is strong enough normally to destroy

human tissues on contact. the stomach is protected against damage from the acid

by a lining of mucus, unless a person suffers from an ulcer.