Sunday, 15 July 2012

Pain management - A basic idea of symtoms and drugs

Pain management is an art, You have to learn it and go through multiple cases and experiences. I have tried many drugs on myself, my colleagues and my family members as an experiment sessions and through all those experiments I kept learning. I know it's a vast topic but I can assert few basic things which are primitive to understand and quite safe to try.

First thing, we should know the origin and the level of pain. 
1. Muscle and Spasm pain 
2. Joint pain
3. Headache
4. Body ache
5. Stomach pain/Bowel syndrome
6. Back pain

A little bit of idea about class of drugs related to pain management.

1. NSAID (non-steroidal anti-inflammatory drugs - All the NSAIDs differ in structure but they all have similar antipyretic, anti-inflammatory and analgesic properties. NSAIDs work by blocking the cyclo-oxygenase (COX) enzyme, so inhibit production of prostaglandins and thromboxanes, which are produced as part of the inflammatory response. Some classes of NSAIDs are:

  • Aspirin, ibuprofen, naproxen, ketoprofen
  • Dicelofanac family of drugs - used to treat pain or inflammation caused by arthritis or ankylosing spondylitis
  • Mefnomic acid drug family - It works by reducing hormones that cause inflammation and pain in the body

2. Acetaminophen/Paracetamol - One of the finest invented drug in medical science which works for almost everything without knowing how exactly it works.

3. Antispasmodics/Anticholinergics - Antispasmodic agents inhibit the action of acetylcholine. They stop the transmission of parasympathetic nerve impulses therefore lessen the spasms of smooth muscle, such as in the gastrointestinal tract and in the bladder. They are used to treat spasms or conditions with disturbances in the bladder or gastrointestinal motility.

4. Muscle relaxants - They are agents that reduce tension in muscles. Centrally acting muscle relaxants work by reducing the tone of skeletal muscle causing muscles to relax. These are generally used to relieve skeletal muscle spasms due to spastic conditions, and can be used to relieve musculoskeletal pain.

Now you just need a mapping which drugs is suitable for what kind of pain.

1. Normal muscle pain, minor headache, minor sore throat - Aspirin is good enough (Don't give it you kids, it may induce Reye's syndrome)

2. A littel bit more muscle pain, fever, body ache, sore throat, flu, headache - Paracetamol is awesome (marketed as Crocin, Dolo650, Calpol), Dolo650 and Calpol is better in terms of usages and safty for adult and as well as to kids.

3. Muslce pain - ACECLO-MR, ACENT-MR, ASOACT FORTE  (aceclofenac + chlorzoxazone + paracetamol)

4. Stomach pain - For common cause and stomach irritation,  You need an antispasmodics, like Cyclominol or Cyclopam, both contains Dicycloverine which is antispasmodics

4. Abdominal pain/Menstrual cramp - You need "mefenamic acid" drug, like MEFTAL-P is too good.

5. Joint pain - Required is something like non-steroidal antiinflammatory and antirheumatic products, which can be found in drugs which contains Diclofenac or Mefenamic acid,  like Meftal-Force (which contains paracetamol and Mefenamic acid), or Diclofenac + Paracetamol like Acetonac,  or Bindac by gsk, or Ibugesic plus, or Paracip plus by Cipla

6. Back painDiclofenac + Paracetamol works pretty well, if not then try Meftal-spas, if not then Mobizox (which contains Diclofenac + paracetamol + chlorzoxazone) which works extremely well, but these are not long term solutions

7. Headache 

First try Aspirin, then Paracetamol, then Ibugesic plus or Combiflam then try DART which contains caffeine also but don't take it much. If headache is persisting then you need to figure out root cause of it, don't just keep taking drugs.

Disclaimer: This post for your information only and not intended to replace your relationship with your treating physician.


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