Over-the-Counter Drugs - Analgesics (pain relievers)
Pain relievers, or analgesics, are familiar products found in most medicine cabinets. These products help consumers relieve headaches, muscle aches, fever, and other pain-related symptoms. With so many brand name products and different strengths and formulas, today's consumer has a variety of pain relieving products from which to choose. What follows are descriptions of the various pain-relieving agents available as OTC drugs.
Acetylsalicylic acid is known by a much more familiar name—aspirin. It is a common analgesic, or drug that alleviates pain without affecting consciousness. In the fifth century B.C. , Greek physician Hippocrates, considered "the father of medicine," used powder extracted from willow tree bark to treat pain and reduce fever. The active ingredient, sodium salicylate, was discovered centuries later. This ingredient was the predecessor to aspirin.
IN 1897, GERMAN CHEMIST FELIX HOFFMAN DEVELOPED ASPIRIN WHILE TRYING TO FIND A WAY TO RELIEVE THE PAIN OF HIS FATHER'S ARTHRITIS. HE WORKED FOR A COMPANY CALLED BAYER.
Aspirin works by inhibiting the release of a hormone-like substance called prostaglandin. This chemical affects blood vessels and the functions of blood platelets and sensitizes nerve endings to pain. By limiting the prostaglandin, aspirin affects blood clotting, eases inflammation, and prevents the nerve ending at the site of the pain from becoming stimulated. It is used for headaches, muscle pain, arthritis, and to reduce fevers.
ASPIRIN FOR THE HEART?
The Bayer Company ran an advertisement for its aspirin in the 1920s that read, "DOES NOT AFFECT THE HEART." But Bayer was wrong; aspirin does affect the heart. Fortunately, aspirin has been found to be beneficial to the heart, and some of today's aspirin advertisements feature the American Heart Association's seal of approval.
It is estimated that Americans use 80 million aspirin tablets a day, and most are not taken for aches and pains. They are used to reduce the risk of heart disease. The FDA has approved the use of aspirin to treat serious cardiovascular conditions such as heart attack and stroke. It has been proven to reduce the risk of:
- Strokes and heart attacks in those who have already had one.
- Death or complications from a heart attack if taken at the first signs of one.
- Recurring blockage in those who have had heart bypass surgery to clear blocked arteries.
The secret to aspirin's protective properties in relation to the cardiovascular system lies in aspirin's ability to reduce the body's production of prostaglandin, which causes blood platelets to stick together. This phenomenon can eventually lead to blocked blood vessels and clots. A blood clot in the brain causes stroke, while a blood clot in the heart causes heart attacks. By reducing the prostaglandin, the risk of heart attacks and strokes is reduced.
The American Heart Association believes that out of the nine hundred thousand lives lost each year to cardiovascular disease, five to ten thousand could be saved if more people used aspirin at the first signs of a heart attack (intermittent chest pain, shortness of breath, and fatigue). In the important first moments of a heart attack, aspirin provides "head start" therapy and a better chance for survival.
Because of its possible serious side effects, aspirin is not approved for daily use by healthy people who are not at risk for heart disease. For those who do need it, the recommended dose varies from 50 to 325 milligrams daily. Above all, aspirin should never replace a healthy lifestyle.
While it seems like a wonder drug, aspirin does have certain drawbacks. It can irritate the stomach lining, causing heartburn, pain, or nausea. Coating aspirin capsules helps reduce this irritation by preventing the release of the aspirin until it has passed through the stomach and into the small intestine; however, coating also slows the absorption of aspirin and increases the amount of time before it starts to work. Buffered aspirin reduces the acidity of the stomach's contents to lessen irritation. Taking aspirin with an antacid or after a meal will also reduce the stomach irritation. Because of these possible adverse effects, people should not take aspirin if they have a bleeding disorder, stomach ulcer, or gout (a painful disease of the joints, especially legs, hands, and feet).
Other side effects include the fact that high doses of aspirin may cause ringing in the ears. Furthermore, if children or adolescents infected with chicken pox or influenza (flu) are given aspirin, they could develop Reye's Syndrome, a sudden loss of consciousness that may cause death. Allergy sufferers should also watch their aspirin intake. If people are allergic to aspirin, they may have difficulty breathing or develop hives, itching, or swelling. Also, aspirin should not be given to someone directly before or after surgery because it decreases the blood's ability to clot, which could cause excessive bleeding.
People who consume a lot of alcohol need to be careful, too—liver damage and stomach bleeding can result when heavy drinkers use aspirin. Finally, aspirin should not be given to children under the age of twelve or to pregnant women, especially during the last three months of pregnancy since it could cause complications during delivery.
Acetaminophen is the generic (non-trademarked) name for the pain reliever found in brand name products such as Tylenol and Excedrin. It is also used to treat fever, headaches, and minor aches and pains. Acetaminophen works by affecting the brain and spinal cord, altering the perception of pain. Acetaminophen is similar to hormones that the brain produces called endorphins. These hormones stop the pain sensation from being transmitted from cell to cell. It reduces fevers by affecting the area of the brain that regulates temperature. Like aspirin, acetaminophen limits the production of prostaglandin in the brain. Aspirin affects prostaglandin production in the rest of the body as well, but acetaminophen only affects the brain. For this reason, acetaminophen does not reduce inflammation. It cannot affect swelling from arthritis, sprains, or muscle pain. It does have fewer side effects than either aspirin or ibuprofen (see below). Therefore, people with blood clots, ulcers, chicken pox, influenza, or gout can safely take acetaminophen instead of aspirin.
Individuals with liver disease should not take acetaminophen; in fact, an overdose of this drug can cause serious liver and kidney damage. Like other pain relievers, this drug should not be taken with alcoholic beverages. A risk of liver damage exists from combining large amounts of alcohol and acetaminophen. It should not be taken for more than ten days or by children under the age of twelve.
Originally available only by prescription, this drug has been available in lower strength as an OTC pain reliever since 1984. Ibuprofen can be used to treat headaches, muscle aches, arthritis, swelling, menstrual pain, and to reduce fevers. Like aspirin, it works by inhibiting production of prostaglandin, which aids blood clotting and makes nerve endings sensitive.
The possible side effects of using ibuprofen include drowsiness, heart-burn, upset stomach, nausea, vomiting, or dizziness. Taking the drug with food or milk often helps to avoid these problems. Pregnant women and people with diabetes or congestive heart failure should not take ibuprofen.
Ibuprofen is a stronger analgesic than either aspirin or acetaminophen and a better anti-inflammatory than aspirin. It can be found in brand name products such as Advil, Motrin IB, and Nuprin.
Ketoprofen and naproxen are pain relievers similar to ibuprofen. Ketoprofen has had OTC status since 1994; naproxen has been available over the counter since 1995. Ketoprofen and naproxen share side effects similar to those of ibuprofen, including heartburn and upset stomach.