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To provide guidance to health care providers and their patients in their clinical decision-making, researchers from Florida Atlantic University's Schmidt College of Medicine have published a review in the Journal of Cardiovascular Pharmacology and Therapeutics addressing cardiovascular risks and beyond, which include gastrointestinal and kidney side effects of pain relievers. They examined the benefits and risks of over-the-counter and prescription drugs for pain relief such as aspirin, ibuprofen (Motrin or Advil), naproxen (Aleve), and prescription drugs such as diclofenac (Voltaren), a non-aspirin NSAID [Non-Steroidal Anti-Inflammatory Drugs], and selective cyclooxygenase-2 inhibitors such as celecoxib (Celebrex) as well as acetaminophen (Tylenol).
NSAIDs include aspirin, traditional non-aspirin NSAIDs such as ibuprofen, (Motrin or Advil), naproxen, (Aleve) and diclofenac, (Voltaren) as well as selective cyclooxygenase 2 inhibitors (COXIBs), such as celecoxib (Celebrex), and acetaminophen (Tylenol).
All of these drugs have benefits and risks. Aspirin decreases inflammation as well as coronary events and stroke, but increases gastrointestinal symptoms and bleeding, however, without adverse hepatic or renal consequences. Non-aspirin NSAIDs decrease inflammation, but have been associated with adverse major coronary events and stroke with long-term use as well as major upper gastrointestinal and kidney side effects, as well as electrolyte imbalances such as high sodium or potassium and even heart failure.
Cyclooxygenase 2 (COX2) inhibitors were developed primarily because of their more favorable gastrointestinal side effect profile relative to aspirin and traditional non-aspirin NSAIDs, but confer adverse cardiovascular as well as hepatic and renal effects. Acetaminophen has no clinically relevant anti-inflammatory properties and accounts for more than 50 percent of drug overdose related liver failure and about 20 percent of liver transplant cases, as well as kidney disease.
[...] "The factors in the decision of whether and, if so, which drug to prescribe for relief of pain and inflammation, should not be limited to risks of cardiovascular or gastrointestinal side effects. These considerations should also include potential benefits including improvements in overall quality of life resulting from decrease in pain or impairment from musculoskeletal pain syndromes," said Charles H. Hennekens, M.D., Dr.P.H., corresponding author, first Sir Richard Doll Professor and senior academic advisor in FAU's Schmidt College of Medicine.
Journal Reference:
Manas A. Rane, Alexander Gitin, Benjamin Fiedler, Lawrence Fiedler, Charles H. Hennekens. Risks of Cardiovascular Disease and Beyond in Prescription of Nonsteroidal Anti-Inflammatory Drugs$. Journal of Cardiovascular Pharmacology and Therapeutics, 2019; 25 (1): 3 DOI: 10.1177/1074248419871902
(Score: 0) by Anonymous Coward on Tuesday February 11 2020, @08:51PM (38 children)
Reduces pain and has no negative gastrointestinal, hepatic or renal effects.
(Score: 4, Touché) by Anonymous Coward on Tuesday February 11 2020, @08:57PM (23 children)
No, just diarrhea, nausea, constipation, dry mouth, somnolence, confusion, muscle weakness, sweating. abdominal pain, headache, fatigue, anorexia and weight loss, dizziness, nervousness, hallucinations, anxiety, depression, flu-like symptoms, indigestion, shortness of breath, hypoventilation, apnoea, and urinary retention.
(Score: 4, Informative) by Freeman on Tuesday February 11 2020, @09:05PM (9 children)
You forgot death, as Fentanyl is that oh happy of substances that has been reported as contributing to the death rate. Since, it's super potent.
CDC Report Says That Fentanyl is the Deadliest Drug in America [soylentnews.org]
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 3, Informative) by fustakrakich on Tuesday February 11 2020, @09:32PM (5 children)
You forgot death
Well, after that all your problems are solved.
Unfortunately the AC beat me to it, but the safest thing is still aspirin and weed, and at least one shot of Don Julio as often as needed.
La politica e i criminali sono la stessa cosa..
(Score: 2) by Booga1 on Wednesday February 12 2020, @03:44AM (2 children)
I know you referred to aspirin, but don't combine acetaminophen/paracetamol with alcohol. That multiplies the side effects and liver damage from acetaminophen.
References say regular dose acetaminophen(325mg) can be used with up to three drinks per day, but it just doesn't seem worth risking your liver.
(Score: 1) by fustakrakich on Wednesday February 12 2020, @04:00AM
Precisely why I stick with aspirin. A little hole in my stomach will close up with some sodium bicarbonate in my drink
La politica e i criminali sono la stessa cosa..
(Score: 5, Informative) by takyon on Wednesday February 12 2020, @04:05AM
If you're taking a painkiller other than alcohol, lose the alcohol for a while.
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @04:21PM (1 child)
Unless you're driving. I'd rather not be killed because you had a headache and were driving buzzed.
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @04:31PM
Welp, just make sure to stay out of the way then, and you're golden.
(Score: 2) by dry on Wednesday February 12 2020, @06:46AM (2 children)
Yes, it is poisonous if not taken as recommended, usually caused by not knowing exactly what you are taking. Aspirin kills quite a few people too, usually by not taking as directed, Acetaminophen is consistently one of the top killers of kids, usually due to thinking the pills are candy.
Drug store drugs can be deadly
(Score: 2) by Freeman on Wednesday February 12 2020, @04:47PM (1 child)
The difference is the amount it takes to kill. As far as Fentanyl is concerned it's such a tiny amount extra to be a fatal overdose. Whereas something like Aspirin / Acetaminophen, it's not likely to be an adult accidentally overdosing and killing themselves that way. It's the parents' job to raise their kids to adulthood. Keeping medicine in places your kid can't get to it and making sure they know never to take medicine without mommy/daddy is a given. Accidents happen and that's a sad thing, but has nothing to do with the extreme danger of something like Fentanyl.
https://www.oxfordtreatment.com/substance-abuse/fentanyl/lethal-dose/ [oxfordtreatment.com]
Contrast that with something like Acetaminophen.
https://www.answers.com/Q/How_much_Tylenol_is_lethal [answers.com]
While that last quote isn't from an authoritative source, it's generally correct.
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 2) by dry on Thursday February 13 2020, @02:31AM
My understanding is that the people ODing on fentanyl are actually buying, or rather attempting to buy, heroin and such. It would be much the same if you were buying aspirin etc from some shady guy on the street corner who was cutting the aspirin with fentanyl to make sure it was effective.
Legalization or at least decriminalization, along with regulation is the solution to the people accidentally poisoning themselves with fentanyl or other street drugs. As a bonus, many a junkie will turn into a productive member of society when they don't have to spend all their time struggling for the next fix.
(Score: 2) by RS3 on Tuesday February 11 2020, @09:35PM (11 children)
Awesome list. And in the elderly, especially if they have any other medical problems, fragility, etc., Fentanyl, Tramadol, and all opioids and synthetic opioids cause brain damage, sometimes life and personality-altering permanent brain damage.
(Score: 4, Interesting) by Freeman on Tuesday February 11 2020, @09:43PM (10 children)
Definitely sounds like something best left untouched. Even with all the stigma around weed, it does seem to be at least within the ballpark of alcohol trouble. Perhaps even less trouble than Alcohol, in which case, it should definitely be legalized. At least, I've not heard of a weed addict becoming horribly violent while under the influence. Then again, perhaps, it's just due to sample size and/or the fact that people don't want to get in trouble for partaking in an illegal substance. Still, would at least be worth it to do major studies to decide whether or not to make it legal.
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 3, Funny) by RS3 on Tuesday February 11 2020, @10:07PM (7 children)
Weed addicts can get aggressive when they get the munchies, and only get violent if you take away their pizza.
(Score: 0) by Anonymous Coward on Tuesday February 11 2020, @11:27PM
https://soylentnews.org/comments.pl?noupdate=1&sid=36001&page=1&cid=956954#commentwrap [soylentnews.org]
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @08:57AM (1 child)
The problem with Weed, at least, locally, is that there's a sizeable percentage of the population here using the stuff, and a number of them are innately violent shitheads, coming from families who have been innately violent shitheads for generations (verifiable, in some cases, at least back to early Victorian times through court records and newspaper archives).
The local strain of choice is Skunk [wikipedia.org], and that really seems to bring out the 'best' in these stabby little fuckers..the sooner they all graduate to becoming spice [wikipedia.org] zombies, the better for the rest of us..
It's disconcerting, to say the least, to travel on a bus where the driver stinks strongly of skunk, in fact, when you see someone lighting up on the streets it's more common for it to be skunk, any very uncommon now for it to be a plain old tobacco cigarette...
(Score: 0) by Anonymous Coward on Wednesday February 12 2020, @09:26AM
Chances are that flat screen TVs, video games, smartphones, weed and other decadence are pacifying the population.
(Score: 2) by Freeman on Wednesday February 12 2020, @04:23PM (3 children)
Same can be said for someone that's hypoglycemic.
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 2) by RS3 on Wednesday February 12 2020, @06:01PM (2 children)
Interesting, but that has not been my experience.
I had a brother who was an extremely "brittle" type-1 diabetic. He would often become hypoglycemic. He only got silly, goofy, giddy, etc. Convincing him to eat or drink anything was difficult. Many times he went into shock and became unconscious. Fortunately EMTs got there in time to give him IV dextrose. At least one time I had to give him a glycogen shot that saved his life, although he ended up in coma for 2 weeks. They said his blood sugar was 15, and likely much lower just before I administered glycogen.
(Score: 2) by Freeman on Thursday February 13 2020, @12:38AM (1 child)
I don't doubt your experience and perhaps, the irritability is only in some people or in less severe cases, but it's definitely a possible symptom.
https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685 [mayoclinic.org]
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 3, Interesting) by RS3 on Thursday February 13 2020, @02:27AM
Always remember the 2 words before that symptom list: "may include".
With my brother we didn't know anything about his heart rhythm.
Not sure about fatigue- his episodes came on very suddenly- he would go from normal to unconscious in a few minutes.
Didn't notice pale skin (maybe happened too fast for color flush?)
He would get shaky, but again, with him acting silly it's not easy to see shaky.
Didn't notice anxiety- quite opposite- giddy.
He would get sweaty- even his face would sweat.
No change in hunger- had to convince him to drink something, like OJ, soda, dextrose tablet, etc.
Not really irritable, mostly silly / giddy.
Again, his hypoglycemic attacks were sudden, fast, and hard.
(Score: 3, Interesting) by dry on Wednesday February 12 2020, @06:50AM (1 child)
Weed when mixed with other drugs, especially alcohol, can lead to violence and likely occasionally on its own. Some people who are border line insane really shouldn't take weed. It has been known to kill people too, usually when a ton of it hits you in the head.
(Score: 2) by Freeman on Wednesday February 12 2020, @04:26PM
Well, I'd think it's quite likely for someone to die when a ton of anything hits you in the head.
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 2) by DeathMonkey on Wednesday February 12 2020, @09:37PM
So....just another Wednesday, then?
(Score: 0) by Anonymous Coward on Tuesday February 11 2020, @08:58PM
It also mindfucks you. Weed is better.
(Score: 2) by DannyB on Tuesday February 11 2020, @10:40PM (12 children)
Hydrocodone is a great pain reliever. It's just not the first thing I reach for. If I were to take it all the time, that story does not have a happy ending.
Prescription nsaids are great if your stomach doesn't have trouble with them. Fortunately I've been able to take all kinds of nsaids for decades. Pity the poor soul that can't take them.
Doctor asks: do I get constipated from hydrocodone? I say: no, because I don't take enough of it in a single dosing, and also not frequently enough.
The lower I set my standards the more accomplishments I have.
(Score: 3, Informative) by Azuma Hazuki on Wednesday February 12 2020, @03:19AM (11 children)
I've seen histamine-H2 antagonists (*tidine) and proton-pump inhibitors (*prazole) prescribed along with NSAIDs in the pharmacy I work at. Those come with their own issues, especially the PPIs, but it may be worth it to prevent GI lesions in susceptible patients.
The one that really surprises me is that Cele-frickin'-coxib is still on the market. Remember Vioxx? That was the brand name for Rofecoxib, and the entire drug class name "coxib" means "Cyclooxygenase inhibitor." Apparently "studies show" Celecoxib is no more dangerous than diclofenac etc, but I would not be surprised if said studies were biased or slanted...
I am "that girl" your mother warned you about...
(Score: 2) by DannyB on Wednesday February 12 2020, @04:40PM (10 children)
I do remember the name Vioxx. Never took it. But it was headline news.
I've taken Indomethacin (nsaid) for over 15 years now. My arthritis Dr worked with me to try a number of different nsaids until I found one that (1) I liked and (2) I could take three times a day. Some others, like Celebrex could only be taken 2x a day. By the time for the 2nd dose I would already be in a lot of pain again.
I've taken hydrocodone for over 11 years now and haven't gotten into any trouble with it yet. Both primary care and specialist don't have any concerns about my use of hydrocodone.
At this point, those work, and if it ain't broke, as programmers say: then fix it till it is broke.
Also, programming in Java can help put one into a catatonic state. :-)
Humor is also good medicine.
The lower I set my standards the more accomplishments I have.
(Score: 2) by RS3 on Wednesday February 12 2020, @05:46PM (9 children)
Any knowledge of or experience with meloxicam?
(Score: 2) by DannyB on Wednesday February 12 2020, @06:12PM (8 children)
Not me.
The lower I set my standards the more accomplishments I have.
(Score: 2) by RS3 on Wednesday February 12 2020, @06:19PM (7 children)
Me neither, but I don't have problems that need it. It was prescribed to my father, but I don't know why, and he's not with us anymore to ask him about it... Might be something for you to look into- my dad's doctor was voted best doctor in a major metropolitan area many years.
(Score: 2) by DannyB on Wednesday February 12 2020, @06:25PM (6 children)
A weird drug, IMO, is Tramadol. My arthritis dr had me try it instead of hydrocodone in, about, 2010. Take it every day he said.
I got jittery. Couldn't keep my limbs and extremities still. Had to always be shaking of moving them. Had some trouble sleeping. It was like an electric current almost. Also it was definitely addictive. Withdrawal symptoms were no fun either. I quit it and never looked back. I don't find hydrocodone addictive, but I'm sure it can be from all I hear. I hated Tramadol. Have no problem of any recognizable kind with hydrocodone.
The lower I set my standards the more accomplishments I have.
(Score: 4, Informative) by Azuma Hazuki on Thursday February 13 2020, @01:55AM (5 children)
Tramadol is a well-known serotonergic. That sounds like low-grade serotonin syndrome, and it's a major reason tramadol is not recommended to be mixed with SSRIs, triptans, or other serotonin agonists.
Fun story: about 5 years ago I was prescribed tramadol and cyclobenzaprine (Flexeril), the latter of which is a muscle relaxant that looks almost exactly like a tricyclic antidepressant like amitryptiline. I remember just staring at the bottles and asking if they were trying to kill me. They looked like the carpet had just leapt off the floor and bitten them; they were evidently not expecting a "civilian" to know one end of a vial from another! This is the event that got me really interested specifically in pharmacology, as opposed to my generalized organic-chem nerdistry from elementary school: it was self-defense.
I am "that girl" your mother warned you about...
(Score: 2) by RS3 on Thursday February 13 2020, @02:37AM (2 children)
So, I have to ask, have you looked into going to med school?
(Score: 2) by Azuma Hazuki on Friday February 14 2020, @01:21AM (1 child)
With no money, almost 40K in student debt, and having been lifelong poor? Hah. Not in this country. One of the reasons I'm trying to get into Soviet Canuckistan is the possibility of perhaps going to pharmacy school there. This country? The US wants me and all the other poors dead.
I am "that girl" your mother warned you about...
(Score: 2) by RS3 on Friday February 14 2020, @02:13AM
GoFundMe?
Cuba?
(Score: 2) by DannyB on Thursday February 13 2020, @02:52PM (1 child)
Another thing about Tramadol I forgot to mention: I was in a really good mood all the time.
That's just not natural. I distinctly recognized it, that I was always in a good mood on that drug. I didn't like it. It's not normal to always be in a good mood constantly.
The lower I set my standards the more accomplishments I have.
(Score: 2) by Azuma Hazuki on Friday February 14 2020, @01:22AM
I had Tramadol once. *Once.* It made everything all better. I didn't feel numb or disconnected; for the first time in decades, I felt *safe.* And I knew, right then and there, that I could never ever have it again. That kind of thing hooks people.
I am "that girl" your mother warned you about...