Painkillers are medicines that are used to treat pain. There are a large number of painkillers available and they all come in various different brand names.
There are three main types of painkiller: non-steroidal anti-inflammatory drugs (NSAIDS), paracetamol and opioids. Each works in a different way. Most people only need to take painkillers for a few days or weeks at most, but some people need to take them for a long time. You can buy some painkillers from pharmacies; this includes some NSAIDs, paracetamol and some weak opioids (codeine or dihydrocodeine). If you buy painkillers that contain weak opioids and you need to take them for more than three days you must discuss this with your pharmacist or doctor.
How do painkillers work?
NSAIDs work by blocking (inhibiting) the effect of chemicals (enzymes) called cyclo-oxygenase (COX) enzymes. COX enzymes help to make other chemicals called prostaglandins. Some prostaglandins are involved in the production of pain and inflammation at sites of injury or damage. A reduction in prostaglandin production reduces both pain and inflammation. Not all NSAIDs are exactly the same, and some work in slightly different ways from others. See the separate leaflet called Anti-inflammatory Painkillers for more details.
Paracetamol – no one really knows for sure exactly how paracetamol works. But it is also thought to work by blocking COX enzymes in the brain and spinal cord (central nervous system). Paracetamol is used to treat pain and to lower a high temperature. However, it does not help with inflammation.
Opioids work by binding to certain receptors (opioid receptors) in your central nervous system, your gut and other parts of your body. This leads to a decrease in the way you feel pain and your reaction to pain, and it increases your tolerance for pain. See the separate leaflet called Strong Painkillers (Opioids) for more details.
How should I take painkillers?
People who are in pain all the time are usually recommended to take painkillers regularly. For example, if you have been prescribed paracetamol you will normally take it four times a day, every day until the pain is better. Otherwise, you only need to take painkillers when you need them.
If you are taking an NSAID such as ibuprofen or diclofenac, you will need to take this with or after food. This is because they can irritate the lining of your stomach and sometimes cause bleeding in
What painkillers can I take together?
Some people need to take more than one type of painkiller at any one time. If you need to do this, you need to be aware of drug combinations that are safe and unsafe.
The following combinations are generally considered safe:
– aspirin with paracetamol
– NSAID (such as ibuprofen) with paracetamol
– aspirin with an opioid
– NSAID (such as ibuprofen) with an opioid
– paracetamol with an opioid.
The following combinations are unsafe and shouldn’t be taken together:
aspirin with an NSAID (such as ibuprofen)
– paracetamol with a compound painkiller that contains paracetamol.
– Speak to your doctor if you have any questions or concerns about the types of painkillers you have been advised to take.
Can I take other medicines alongside painkillers or NSAIDs?
Many people with arthritis and related conditions will need to take painkillers or NSAIDs, along with drugs that treat the underlying cause of their condition. The combination you take will depend on your condition.
For inflammatory types of arthritis, such as rheumatoid arthritis, your doctors should recommend disease-modifying anti-rheumatic drugs (DMARDs). These types of drugs change how your condition develops. An example of a DMARD is methotrexate (mee-thoh-trex-ate).
DMARDs won’t stop your pain straight away, but once they start to work, you should be able to reduce or stop your pain relief medicines.
If you have gout, you may need NSAIDs or colchicine (coal-chuh-seen) to deal with the pain and swelling from an attack. You may then need another drug, such as allopurinol (al-oh-pure-ri-nol) or febuxostat (fe-bucks-oh-stat), in the longer term to reduce the risk of having more gout attacks.
If you have pain as a result of nerve damage, or fibromyalgia (fie-bruh-my-al-juh) your doctor may suggest drugs such as amitriptyline (am-ee-trip-ter-leen), gabapentin (gab-a-pen-tin) or pregabalin (prey-gab-a-lin). Although these are not classed as painkillers, they can be helpful for some types of pain.
If you have osteoarthritis of the hand or knee, topical capsaicin (cap-say-sin) applied several times daily can be used alongside other painkillers.
If you’re taking any other medications speak to your doctor or a pharmacist about possible interactions.
Can I drink alcohol if I’m taking painkillers or NSAIDs?
Most people who take painkillers or NSAIDs will be able to drink alcohol in moderation.
It’s best for all of us to stick within government guidelines of not drinking more than 14 units of alcohol per week, and to spread them through the week. Having two or three days each week when you don’t drink alcohol is good for you.
Alcohol can increase the risk of side effects of some painkillers and NSAIDs. It’s a good idea to read the leaflet that comes with your drug to see what it says about drinking alcohol. Talk to your doctor or a pharmacist if you have any concerns.
Who cannot take painkillers?
It is very rare for anyone not to be able to take some type of painkiller. The main reason why you may not be able to take a painkiller is if you have had a serious side-effect or an allergic reaction to a particular type of painkiller in the past. Even if this happens, your doctor will usually be able to choose a different type of painkiller, which you will be able to take.
Aspirin cannot be taken by children under the age of 16 years, because there is a risk of the child developing Reye’s syndrome (very rare).
PAIN KILLER and overdose .
What causes an overdose?
An overdose occurs when a person uses more of a substance than their body can handle. No one can tell exactly how much of a drug it will take to push someone to the point of an overdose. Different people have different thresholds, but risk factors for an overdose include poor physical health, mental illness, using alone, or having a history of a previous overdose. Whether it occurs accidentally or intentionally, an overdose can often be fatal.
Users of prescription painkillers report a sensation of euphoria when the drug first hits their brains. This is why people become addicted: to continually chase the feeling of being high. Eventually, though, your brain will develop a tolerance to painkillers, and you’ll need to take larger doses of the drug to achieve the same high – and that puts you at risk of an overdose.
What happens to your body during an overdose?
During an overdose, the drug overwhelms the parts of your brain that control your respiratory and circulatory functions. Neurological signals are suppressed, leading to slowed breathing and heart rate. Sometimes, people who overdose may experience abnormal heart rhythms; sometimes they will enter full cardiac arrest.
As heart and lung function ceases, your organs become deprived of oxygen. At this point, kidney and liver damage can occur, and the longer your brain goes without oxygen-rich blood, the higher your chances are of developing severe seizures and irreversible brain damage.
Signs of a painkiller overdose
People in the midst of an overdose may experience disorientation, hallucinations, severe headaches, or overheating. However, in the moment, they usually don’t have the self-awareness to realize what’s happening. It’s often up to outside observers to identify the signs of an overdose, which include:
– Cold, clammy skin
– Blue or grey lips and nails
– Slow or absent breathing
– Gurgling sounds or snoring
– Tiny pupils
What to do during an overdose
If you suspect someone is experiencing a painkiller overdose, it’s crucial to call 911 immediately. Timely medical attention can mean the difference between life and death. Emergency first responders are equipped with naloxone, a drug that can reverse the effects of an opioid overdose and potentially save lives. Administered via nasal spray or injectable syringe, naloxone works by blocking the opioid receptors in the brain, enabling lung and heart function to resume almost instantaneously.
Risk Factors for Overdose
Risk factors for overdosing on prescribed painkillers include:
– A history of substance use disorders.
– Dependence on painkillers.
– A high prescribed dose (over 100 mg of morphine or the equivalent daily).
– Male gender.
– Older age.
– Mental health conditions.
– Lower socioeconomic status.
The use of multiple prescriptions, including benzodiazepines.
Certain groups are more likely to abuse or overdose on prescription painkillers:
– Middle-aged persons.
– Rural dwellers.
– Whites and American Indian or Alaska Natives.
– People who inject painkillers. –
– People who use painkillers with other substances that depress the central nervous system, including alcohol.
People who use painkillers and have medical conditions such as HIV, -liver or lung disease, or depression.
Painkiller Overdose Treatment :
Monitoring vital signs after painkiller overdoseOnce at the hospital, the person may receive the following treatments for painkiller overdose:
– Close monitoring of vital signs
– Breathing support, including oxygen or a breathing tube
– Intravenous (IV) fluids
– A dose of naloxone to reverse the effects of the opioid (if not already given en route, or should additional doses be necessary)
– Other medicines as needed, including acetylcysteine (Mucomyst) administration in cases of associated acetaminophen toxicity
Because the effect of naloxone is often short-lived, the health care team will monitor the person for 4 to 6 hours in the emergency department. The person may receive a psychiatric evaluation if he or she exhibits suicidal behaviors.
Factors that may determine the outcome of an opioid overdose include:
– The timeliness with which emergency services were obtained.
– Use of any other substances in addition to the painkiller.
– Any injuries sustained as a result of the drug overdose (e.g., anoxic brain injury, acetaminophen-induced liver injury, bodily harm secondary to falls or accidents, etc.).
– Any complicating medical conditions (e.g., hepatic insufficiency).
An overdose can also lead to permanent lung damage, hepatic necrosis (when opioid/acetaminophen combinations are involved), seizures, trouble walking, tremors, and reduced cognitive ability.
Can You Die From a Painkiller Overdose?
People can and are dying from painkiller overdoses at alarmingly increasing rates each year. The Centers for Disease Control and Prevention (CDC) reports that nearly 15,000 people die every year from prescription painkiller overdoses. Nearly half a million emergency department visits in 2009 were related to misuse or abuse of opioid medications.