The Hazards of OTC Analgesics
September 9, 2012 at 4:01 pm
(This post was last modified: September 9, 2012 at 4:02 pm by Kayenneh.)
This is my topic for an oral presentation in my English class. It's a topic close to my heart, since every day at work I have at least one customer who wants to buy more OTC painkillers than are allowed. The most common phrase the frustrated ones spit in my face is: "Well, what's the harm?" Do you know, do you read through the package leaflet and are acquainted with the most common side-effects and what's the therapeutic dose? This will be a bit tl;dr, but I thought, if my classmates can benefit from this presentation, so could you.
Let's start with paracetamol (also known as acetaminophen). I won't go into the particulars of how it works or is metabolized, what you need to know is that the liver breaks it down. It hasn't got a wide therapeutic width (the gap from a dose that isn't effective to a toxic dose), so ODing on this particular substance is not hard to do. Many researches show that about 40% of all the ODs that end up in the ER is caused by paracetamol. And remember, this is the only painkiller that is recommended to children and pregnant women. (Actually, I read a disturbing article on how paracetamol can induce infertility in the unborn child, but I haven't found other sources that comfirms it yet.) Paracetamol is especially dangerous when drinking, the lethal dose is around 9 g, if you are a heavy drinker.
Now to move on to NSAIDs, e.g. ibuprofen. NSAID (non-steroidal anti-inflammatory drugs) are COX-enzyme inhibitors. The COX-enzyme is a vital part of the body's own process of making prostaglandins, that have a variety of functions in the body. Prostaglandins basically transmit the pain you feel when having inflamed tissue or a fever, thus NSAID is effective against pain and fever. Now, many know that prostaglandins have affect the stomach by acting in the parietal cells in the stomach wall to inhibit acid secretion. Stop this process and the likelihood of getting an ulcer increases. What people don't know is that NSAIDs can have an adverse effect on your whole cardiovascular system, leaving you vulnerable to heart failure and stroke.
When I tell my customers that I don't sell them more than 30x500mg of paracetamol and/or 30x400mg of ibuprofen (the amount pharmacies in Finland are allow to sell at one transaction by regulation) to ensure that abuse doesn't happen, they usually go monkey shit on my ass. To them abuse of drug is to get high, but abuse is when you use any substance in a way that it was not meant to be used. All (chronic) pain should be examined by a M.D., if ibuprofen or paracetamol is indeed the way to go, you'll get a prescription and get the drugs subsidized by the government.
You don't have to feel alarmed after this, even though OTC painkillers can be tremendously dangerous, when used in the right dosages, they are an effective way of taking care of pains and fever. If you work through a package of painkillers like candy, you are doing a disservice to yourself. So please, use medication with care and thought.
Let's start with paracetamol (also known as acetaminophen). I won't go into the particulars of how it works or is metabolized, what you need to know is that the liver breaks it down. It hasn't got a wide therapeutic width (the gap from a dose that isn't effective to a toxic dose), so ODing on this particular substance is not hard to do. Many researches show that about 40% of all the ODs that end up in the ER is caused by paracetamol. And remember, this is the only painkiller that is recommended to children and pregnant women. (Actually, I read a disturbing article on how paracetamol can induce infertility in the unborn child, but I haven't found other sources that comfirms it yet.) Paracetamol is especially dangerous when drinking, the lethal dose is around 9 g, if you are a heavy drinker.
Now to move on to NSAIDs, e.g. ibuprofen. NSAID (non-steroidal anti-inflammatory drugs) are COX-enzyme inhibitors. The COX-enzyme is a vital part of the body's own process of making prostaglandins, that have a variety of functions in the body. Prostaglandins basically transmit the pain you feel when having inflamed tissue or a fever, thus NSAID is effective against pain and fever. Now, many know that prostaglandins have affect the stomach by acting in the parietal cells in the stomach wall to inhibit acid secretion. Stop this process and the likelihood of getting an ulcer increases. What people don't know is that NSAIDs can have an adverse effect on your whole cardiovascular system, leaving you vulnerable to heart failure and stroke.
When I tell my customers that I don't sell them more than 30x500mg of paracetamol and/or 30x400mg of ibuprofen (the amount pharmacies in Finland are allow to sell at one transaction by regulation) to ensure that abuse doesn't happen, they usually go monkey shit on my ass. To them abuse of drug is to get high, but abuse is when you use any substance in a way that it was not meant to be used. All (chronic) pain should be examined by a M.D., if ibuprofen or paracetamol is indeed the way to go, you'll get a prescription and get the drugs subsidized by the government.
You don't have to feel alarmed after this, even though OTC painkillers can be tremendously dangerous, when used in the right dosages, they are an effective way of taking care of pains and fever. If you work through a package of painkillers like candy, you are doing a disservice to yourself. So please, use medication with care and thought.
When I was young, there was a god with infinite power protecting me. Is there anyone else who felt that way? And was sure about it? but the first time I fell in love, I was thrown down - or maybe I broke free - and I bade farewell to God and became human. Now I don't have God's protection, and I walk on the ground without wings, but I don't regret this hardship. I want to live as a person. -Arina Tanemura
