Pain not only affects the quality of life, but also causes psychological disorders, especially cancer pain, due to the lack of effective treatment for long-term pain. However, taking painkillers for some pains may hide the real condition, especially the pain of internal organs. If you take painkillers blindly and prematurely, although it can temporarily relieve the pain, it is not conducive to the doctor’s observation of the disease and judgment of the disease site, and it is not conducive to the doctor’s correct diagnosis and timely treatment because the site and nature of the pain are concealed after taking painkillers. If ectopic pregnancy occurs with hemorrhage or appendicitis with necrosis and perforation, such temporary pain relief will cover up the real condition, which will aggravate the development of the disease and cause serious consequences. Therefore, in case of disease-induced pain or unexplained pain, patients should go to the hospital in time to find out the cause of pain.
Principles of painkiller use
Generally, non-opioid drugs should be used first. If the pain-relieving effect cannot be achieved even with the full dose of drugs used, weak opioid drugs can be added, and if the pain cannot be relieved after the combination of the two, strong opioid drugs can be used. Cancer pain should be treated in strict accordance with the World Health Organization’s three-step pain relief
Combined medication
For moderate and severe pain, it is better to use two or more pain-relieving drugs, which can reduce their dosage and complications and enhance the pain-relieving effect.
Alternating medications
Repeated use of the same pain medication for a long period of time will produce drug resistance in the body, so you should not rely on increasing the dose to achieve the pain relief effect, and should promptly switch to other pain medications instead.
Drug dosage
According to the actual needs, under the premise of ensuring safety, the drug dose should be from small to large until the patient stops pain. than
Classification
The first category, non-steroidal anti-inflammatory drugs. Aspirin, ibuprofen, anti-inflammatory pain, paracetamol, pautazone, rofecoxib, celecoxib, etc. The pain-relieving effect is relatively weak, without addictive properties, widely used, with precise efficacy, for general common pain. Such as cold, fever, muscle aches, flu, fatigue headache, neuralgia.
The second category, central painkillers. Tramadol, represented by synthetic central painkillers, belongs to the second category of psychotropic drugs. The pain relief effect of tramadol is stronger than general antipyretic painkillers, and its pain relief effect is 1/10 of morphine, mainly used for moderate acute pain and post-surgical pain.
The third category, narcotic painkillers. It is represented by codeine, morphine, dulcolax and other opioids, including weak opioids and strong opioids. The pain-relieving effect is strong, but long-term use can become addictive. These drugs have a strict management system and are mainly used for patients with advanced cancer. (1) Weak opioids: represented by codeine, which can cause respiratory depression. There are also dextropropoxyphene and oxycodone, strong painkillers; ② strong opioids: represented by morphine, commonly used are oral morphine regular and controlled-release tablets, as well as buprenorphine, fentanyl, methandienol, dulcolax, etc.
The fourth category, antispasmodic and analgesic drugs. Mainly used for the treatment of spasmodic pain of gastrointestinal and other smooth muscles, such as gastrointestinal, biliary, urinary tract colic representative drugs are atropine, probenecid, epilepsy tablets, scopolamine, etc.
The fifth category, anti-anxiety painkillers: headache patients are often accompanied by anxiety, tension and anxiety. Tension headache patients have more severe headache due to the tension and contraction of facial muscles, so anti-anxiety drugs can stabilize emotions and relax muscles, so they are also used in the treatment of headache. The representative drug is Valium.
Use of drugs
1.Non-steroidal anti-inflammatory and analgesic drugs should be preferred for common neck, shoulder, lumbar and leg pain, such as fentanyl and furosemide.
2.For fever accompanied by headache or toothache, antipyretic and analgesic drugs, such as aspirin, anti-inflammatory pain, etc. can be used.
3.For cancer patients with pain, various therapeutic measures should be taken decisively so that the patients can be relieved of their pain both mentally and physically.
4.Prevent drug tolerance: Patients who use analgesic drugs for a long time for chronic pain will have drug tolerance problems. At the same time, the longer the medication is used, the larger the required drug dose is, and various adverse reactions will follow. The methods to prevent or reduce drug tolerance include: applying adjuvant drugs as much as possible to enhance the analgesic effect; applying different types of analgesic drugs alternately instead of using one drug alone; gradually adjusting the drug dose after the patient’s pain is reduced, and the interval between drugs can be extended appropriately; and treating with other pain relief methods at the same time.
5.Don’t drink alcohol before and after taking oral analgesics: because alcohol can increase the toxicity of analgesic drugs, that can cause liver and kidney damage even in regular doses.
6, the occurrence of adverse reactions to countermeasures: some painkillers may produce some adverse reactions, especially narcotic painkillers, which can be manifested as nausea, vomiting, acid reflux, indigestion, constipation, headache, dizziness, rash, shortness of breath, etc. The use of such drugs should be stopped in time, and the physician should be consulted and replaced by other drugs to avoid aggravating the condition and causing other adverse consequences.
7. Use heroin or morphine only when you have severe pain.
The dangers of painkiller abuse
1, kidney function damage. Painkillers can cause chronic interstitial nephritis, renal papillary necrosis, renal insufficiency and so on. This is due to the inhibition of prostaglandin synthesis by painkillers. It is more common with anti-inflammatory pain.
2. Induced bleeding of gastric ulcer. Salicylic acid, aspirin, anti-inflammatory pain and other drugs can stimulate the gastric mucosa, causing serious gastrointestinal reactions, inducing gastric ulcers, and even gastric bleeding and perforation.
3. Bleeding tendency. Salicylic acid, aspirin and other drugs can inhibit the formation of prothrombin in the liver, so that the content of prothrombin in the blood decreased, but also affect the physiological function of platelets, so that the coagulation time is prolonged, coagulation function is affected, causing bleeding tendency.
4, resulting in leukopenia. Anacin, Protaxon, anti-inflammatory pain can inhibit the bone marrow and cause leukopenia, and even lead to granulocyte deficiency.
5, liver damage. Aspirin, Protaxon, and anti-inflammatory pain can cause liver damage and liver enlargement and discomfort in the liver area. Transaminases are elevated and other symptoms.
6, allergic reactions. Anacin, paracetamol can cause allergic reactions, rash, drug fever or aggravated asthma.
7.The use of anti-inflammatory pain can appear central nervous system symptoms, such as headache, vertigo, etc.
8.Masking of symptoms. Painkiller application can cover up the condition, misdiagnose and delay the treatment.
9, painkillers taken for a long time can lead to the phenomenon of addiction, if you do not eat, it is difficult to bear the pain, as with morphine, can be addictive. So take painkillers should be considered clearly, and not long-term use.
Common antipyretic and analgesic painkillers
Aspirin
It has analgesic, anti-inflammatory and anti-rheumatic functions, and is non-addictive. It is not only used to relieve pain, but also used to prevent coronary heart disease and stroke. Its main side effect is to cause gastrointestinal discomfort, and can be taken after meals to reduce the discomfort. However, aspirin should not be used for patients with stomach and duodenal ulcers, pregnant women and asthma patients should use caution, and it should not be taken before or after drinking alcohol.
Painkillers
It has antipyretic, analgesic and anti-rheumatic effects and is effective in the treatment of headache attacks.
Acetaminophen is the main active ingredient of Benadryl, Piriton, Tylenol, and Paracetamol; Acetaminophen is also the main ingredient of Xanax. These drugs have few adverse effects and are not irritating to the stomach, only occasional allergic reactions, such as rash.
Anacin
Anacin is an addition of aminopyrine and sodium nitrite, mainly used to reduce fever and various kinds of pain. However, this drug should not be taken continuously, because it may cause liver and kidney function damage; in addition, it may also cause drug rash, leukopenia, etc.
Anti-inflammatory pain
Anti-inflammatory pain is stronger than aspirin in relieving pain and reducing fever, and is effective for joint pain, muscle pain and headache. It can be used for headache caused by cold, fever, occipital neuritis and vasculitis. Its side effects are similar to aspirin, but heavier than aspirin, so it is used only when patients cannot tolerate aspirin.
Ibuprofen
Its pain relief effect is not as good as aspirin, but it is less irritating to the stomach wall and less likely to cause stomach bleeding. It can cause dizziness, tinnitus, and loss of vision. The extended-release version of ibuprofen, called fenbid, can prolong the duration of action of the drug and reduce the number of doses.
Loretine
Lorelodine is an alkaloid extracted from plants, which has pain-relieving and hypnotic effects. It can cause drowsiness, dizziness, and weakness during analgesia. It is a common narcotic analgesic.
Common Narcotic Painkillers
Narcotic painkillers are a class of painkillers represented by morphine. These drugs have the best pain relief effect, but their biggest drawback is that they are easily addictive and can form a vicious circle after use, so they should generally be avoided.
1, morphine morphine is an opioid (opium) in the extraction of drugs, in the existing painkillers in the best role after the application of headache or other parts of the pain disappears quickly, pain caused by restlessness, irritability, shortness of breath, panic, etc. also disappeared. It is often used for intractable headaches where other painkillers do not work. However, it should be noted that it should not be used for a long time, even in small amount for 1 to 2 weeks, it may be addictive, and withdrawal symptoms may occur if the drug is stopped, such as restlessness, insomnia, muscle tremor, vomiting, abdominal pain, dilated pupils, lacrimation, runny nose, profuse sweating, etc.
2, dulcolax Dulcolax is a synthetic morphine-like drug, also has pain relief, sedation and respiratory depression, but its effect is 8 to 10 times weaker than morphine, can also be used in intractable headache, but also has addictive, so can not be commonly used.
3, codeine is a semi-synthetic drugs, pain relief effect is much weaker than morphine, but the cough effect is stronger.
4.Prednisolone effect and dulcolax equivalent.
5.Dihydroetorphine has better pain relief effect, but it also has drug dependence, so care should be taken when using it.
Common anxiolytic painkillers
Valium
It has anxiolytic and sedative effects, and is used for tension headache, anxiety disorders in neurosis, plant nerve dysfunction and insomnia. Side effects include dizziness, drowsiness, nausea, hand tremors, etc. It should be used with caution in patients with liver disease (because the drug is mainly metabolized in the liver). The use of Valium for a long period of time may lead to tolerance, which may require an increase in dose and therefore should be controlled.
Sulforaphane
The sedative effect is stronger than that of Valium, and the duration of action is shorter. It is mainly used for patients with headache and dizziness the next day due to poor sleep.
Triazolam
It is mainly used for insomnia caused by anxiety and nervousness, and its effect is similar to that of Xanax, but without the common adverse effects of Valium such as dizziness and brain swelling.
Glaxoquine
It is mainly used for the treatment of tension headache, because the sedative effect is light, so the daytime application does not affect the work much. The side effects are drowsiness, dizziness, unstable walking, etc.