What Is Pain Tolerance?

Analgesics refer to drugs that can partially or completely relieve pain. There are two types of non-steroidal anti-inflammatory drugs and central analgesics. Common analgesics include aspirin, Qutong tablets, paracetamol, butepine, rofecoxib and the like.

There should be moderation when taking painkillers. If you take painkillers blindly and prematurely, although the pain can be temporarily relieved, it will not be conducive for doctors to observe the condition and determine the affected area, because it will cover the painful area and nature after taking painkillers. Doctors diagnose correctly and treat promptly.

Chinese name: painkiller
Meaning: Drugs that partially or completely relieve pain.

Classification: NSAIDs, Central Analgesics
Attributes: drug

Significance of painkillers

Pain not only affects the quality of life, but also causes mental illness due to chronic pain not being effectively treated. Many pain patients are not treated in time, so that the local long-term general pain is transformed into complex local pain syndrome or central pain, which becomes a refractory painful disease. Therefore, pain should be relieved in time.

Misunderstanding of painkillers

Some pain taking painkillers will actually cover up the actual condition. Many pains, especially those of the internal organs, make it difficult for patients to discern what went wrong. If you take painkillers prematurely, although you can relieve the pain temporarily, it will not be conducive to the doctor to observe the condition and judge the affected area, and it is not conducive to the correct diagnosis and timely treatment of the doctor. In addition, after taking analgesics, the patient temporarily feels no pain, but the disease may actually worsen, such as major bleeding in the ectopic pregnancy, secondary necrosis and perforation of appendicitis. This temporary analgesia will mask the actual condition and make the disease develop. Aggravated with serious consequences. Therefore, once the pain caused by the disease or pain of unknown cause occurs, the patient should go to the hospital in time to find out the cause of the pain.

There is also a misunderstanding of the side effects of analgesics: Some people think that occasional, low-dose analgesics will not harm the gastrointestinal tract, but they are not. Studies have shown that healthy people can develop gastric mucosal damage 16 minutes after taking aspirin. Similarly, studies have shown that single or low doses of non-selective non-steroidal anti-inflammatory drugs can cause upper gastrointestinal bleeding and perforation. Some people think that taking analgesics or topical analgesics after meals will not damage the gastrointestinal tract, and this concept is also wrong. The non-steroidal anti-inflammatory analgesic damage to the gastrointestinal tract is divided into two parts. One is the local irritation caused by the drug staying in the stomach. This can be relieved by taking it after a meal or using an external analgesic. However, more than 80% of the effects of analgesics basically affect the gastric mucosa through blood circulation. This kind of harm cannot be avoided by taking medicine after meals and using external analgesics.

Analgesics use principles

Painkillers on time

Analgesics should be given on time according to the degree, regularity of the pain, and the first effective analgesic period to maintain the concentration of the drug in the blood and control the pain stimulus below the pain threshold.

Painkillers

Generally, non-opioids are used first. If the drugs, doses and usage do not achieve analgesic effects, weak opioids can be added. If the combination does not relieve pain, strong opioids can be used.

Analgesics

For moderate and severe pain, it is best to use more than two analgesics, which can reduce their dosage and complications and enhance the analgesic effect.

Painkillers alternate

Repeated use of the same analgesic drug for a long period of time will cause drug resistance in the body. You should not rely on increasing the dose to achieve analgesic effects. You should switch to other analgesic drugs in time.

Painkiller drug dose

According to actual needs, under the premise of ensuring safety, the dosage of the drug is from small to large, until the patient stops pain. For example, you can't wait for the illness to be healed immediately, and increase the amount of medicine without authorization; or don't take medicine seriously, think of it and eat it, forget it, or take the medicine twice and take it once, which is wrong.

Actively prevent and prevent the side effects of painkillers.

Analgesics classification

The first category: non-steroidal anti-inflammatory drugs. Aspirin, ibuprofen, indomethacin, paracetamol, butepine, rofecoxib, celecoxib, etc. The analgesic effect is relatively weak, not addictive, so

Medicine (2 photos)

It is widely used and has exact curative effect. It is used for common pain. Such as colds, fever, muscle aches, colds, fatigue headaches, neuralgia.

The second category: central painkillers. Tramadol is a representative, is a synthetic central painkiller, belongs to the second class of fine

God medicine. Tramadol's analgesic effect is stronger than that of general antipyretic and analgesic, and its analgesic effect is 1/10 of that of morphine. It is mainly used for moderate acute pain and postoperative pain.

The third category: narcotic analgesics. It is represented by opioids such as morphine and dulentin. These drugs have a strong analgesic effect, but long-term use can be addictive. These drugs have a strict regulatory system and are mainly used for patients with advanced cancer.

The fourth category: antispasmodic analgesics. It is mainly used to treat cramping pain in the gastrointestinal and other smooth muscles, such as gastrointestinal, biliary, and urinary angina. Representative drugs are atropine, probencin, belladonna tablets, and anisodamine.

The fifth category: anxiolytic analgesics. Patients with headache are often accompanied by anxiety, nervousness, and anxiety. Tension headache patients have more severe headaches due to facial muscle tension and contraction. Anti-anxiety drugs can stabilize the mood and relax the muscles, so they are also used for headache treatment. Typical drugs are diazepam.

Painkiller drug use

1, common neck, shoulder, waist and leg pain, various types of arthritis and other chronic pain, fever with headache, toothache, acute sprain and other acute pain should be the first choice of non-steroidal anti-inflammatory analgesics, such as Fenbid, Futalin, Celecoxib Cloth, etc.

2. For patients with painful cancer, various treatment measures should be taken decisively, so that the patient can reduce the pain both mentally and physically.

3. Prevent drug resistance: Patients who have been using analgesics for chronic pain will have drug resistance problems. At the same time, the longer the medication, the greater the dose of medication required, and various adverse reactions will follow. The methods to prevent or reduce drug tolerance include: comprehensively using auxiliary drugs as much as possible to enhance the analgesic effect; alternately applying different types of analgesics instead of using only one drug; gradually adjusting the drug dose after the patient's pain is relieved, The interval between medications can also be appropriately extended; at the same time, it can be treated with other analgesic methods.

4. Beware of gastrointestinal adverse events: Taking painkillers, especially non-steroidal anti-inflammatory analgesics, may cause gastrointestinal adverse events such as indigestion, nausea, ulcers and even perforation and bleeding. Patients who need to take non-steroidal anti-inflammatory analgesics for a long time and patients with gastrointestinal risk factors should choose as far as possible a selective COX-2 inhibitor that is relatively safe for the gastrointestinal tract, that is, selective non-steroidal anti-inflammatory analgesics , Such as celecoxib and so on.

5. Do not drink before or after oral painkillers: alcohol can increase the toxicity of painkillers, even regular doses can cause liver and kidney damage.

6, countermeasures for adverse reactions: some painkillers may produce certain adverse reactions, especially narcotic analgesics, which can show nausea, vomiting, acid reflux, indigestion, constipation, headache, dizziness, rash, shortness of breath, etc. The use of this drug should be stopped in a timely manner, and the physician should be instructed to replace other drugs to avoid aggravating the condition and causing other adverse consequences.

7. Only use heroin or morphine when you have severe pain.

Painkiller abuse hazards

People often experience a variety of pains, so painkillers are almost necessary, and patients often adopt a "stop and stop" attitude, so the abuse of painkillers is more common. Many consumers do not fully understand the dangers of painkiller abuse:

1. Damage the kidneys. Analgesics can cause chronic interstitial nephritis, renal papillary necrosis, and renal insufficiency. This is because painkillers inhibit the synthesis of prostaglandins. More common indomethacin.

2. Induced gastric ulcer. Salicylic acid, aspirin, indomethacin and other drugs can stimulate gastric mucosa, cause severe gastrointestinal reactions, induce gastric ulcers, and even gastric bleeding and perforation.

3, bleeding tendency. Salicylic acid and aspirin can inhibit the formation of prothrombin in the liver, reduce the content of prothrombin in the blood, and also affect the physiological functions of platelets, prolong the clotting time, affect the coagulation function, and cause bleeding. tendency.

4, lead to leukopenia. An Naijin, Baotaisong, and indomethacin can inhibit the decrease of white blood cells caused by bone marrow, and even lead to agranulocytosis.

5. Liver damage. Aspirin, Baotaisong, and indomethacin can cause liver damage with liver enlargement and discomfort in the liver area. Elevated transaminase and other symptoms.

6. Allergic reactions. Analgin, paracetamol can cause allergic reactions, rash, drug fever, or exacerbation of asthma.

7, the use of indomethacin can appear central nervous system symptoms, such as headache, dizziness and so on.

8. Cover up the symptoms. After the application of analgesics, the condition can be covered up, the diagnosis is delayed, and the treatment time is delayed.

Common painkillers

Aspirin

With analgesic, anti-inflammatory, anti-rheumatic and other functions, non-addictive. It is not only used for pain relief, but also for the prevention and treatment of coronary heart disease and stroke. Its main side effect is to cause gastrointestinal discomfort, which can be taken after meals to reduce the symptoms of discomfort. However, aspirin should not be used in patients with gastric and duodenal ulcers, pregnant women and asthma patients should be used with caution, and it should not be taken before or after drinking.

Pain Relief Tablets

Qutong Tablet is a compound tablet containing aminopyrine, phenacetin, and other ingredients. It has antipyretic, analgesic, and antirheumatic effects, and is effective for the treatment of headaches.

The active ingredients of Baifu Ning, Britton, Tylenol Analgesic, and Paracetamol are mainly acetaminophen; the main ingredient of Sanlitong is also acetaminophen. These drugs have few adverse reactions, and are non-irritating to the stomach, but only occasionally have allergic reactions, such as rashes.

Analgin

Analgin is an adduct of aminopyrine and sodium nitrite, which is mainly used for antipyretics and various pains. However, this medicine should not be taken continuously because it may cause liver and kidney damage; in addition, it may cause drug rashes and leukopenia.

Analgesic

Indomethacin has stronger analgesic and antipyretic effects than aspirin, and is effective for joint pain, muscle pain, and headache. Can be used for headaches caused by colds, fever, occipital neuritis, vasculitis, etc. Its side effects are similar to aspirin, but it is heavier than aspirin, so indomethacin should be used only when the patient cannot tolerate aspirin.

Ibuprofen

Its analgesic effect is not as good as aspirin, but it has less irritation to the stomach wall and less causes gastric bleeding. Can cause dizziness, tinnitus, and vision loss. Sustained release of ibuprofen is called Fenbid, which can prolong the action time of the drug and reduce the number of medications.

Celecoxib

It can effectively treat a variety of common acute and chronic pains. It is the first selective COX-2 inhibitor approved by the FDA and the largest non-steroidal anti-inflammatory analgesic in the world. Because it only inhibits the cyclooxygenase COX-2, it does not affect the protective effects of the prostaglandins produced by COX-1 on the gastrointestinal tract and platelets, so it has significant advantages in terms of gastrointestinal tract safety.

Luotongding

Luotongding is an alkaloid extracted from plants that has analgesic and hypnotic effects. Analgesics can cause drowsiness, dizziness, fatigue and other adverse reactions.

Other drugs

Common Narcotic Analgesics

Narcotic analgesics are a class of analgesics represented by morphine. This kind of medicine has the best analgesic effect. Its biggest disadvantage is that it is easy to addiction. After the medicine is used, a vicious circle can be formed. Therefore, it should be avoided as much as possible.

Morphine

Morphine is a drug extracted from opiates (opiates). After the best application of existing analgesics, headache or other areas of pain quickly disappear, and the anxiety, irritability, shortness of breath, and palpitation caused by pain also disappear. Commonly used for intractable headaches where other painkillers do not work. However, it should not be used for a long time. Even small doses may be addictive for 1 to 2 weeks. Withdrawal symptoms such as irritability, insomnia, muscle tremors, vomiting, abdominal pain, dilated pupils, tears, runny nose, etc. , Sweating a lot.

2. Du Lingding

Duolidine is a synthetic morphine-like drug that also has analgesic, sedative, and respiratory depression effects, but its effect is 8-10 times weaker than morphine. It can also be used in refractory headaches, but it is also addictive, so it cannot be commonly used.

3 Codeine

It is a semi-synthetic drug. Its analgesic effect is much weaker than morphine, but it has a stronger antitussive effect.

4 Strong pain

The effect is equivalent to that of Du Lunding.

5. Dihydroetorphine

The analgesic effect is better, but there are also drug dependence, you should pay attention to it.

Common Anxiolytic Analgesics

Stability

With anti-anxiety and sedative effects, it is used for tension headache, anxiety in neurosis, autonomic dysfunction, and insomnia. Side effects include dizziness, drowsiness, nausea, and hand tremors. Those with liver disease should be used with caution (because the drug is mainly metabolized in the liver). The stable use time is prone to tolerability. At this time, the dose needs to be increased, so it should be controlled appropriately.

Shule stability

Shule is stable, has a stronger sedative effect, has a shorter sedative effect, and has less side effects such as dizziness the next day after taking the drug. It also has a clear head the next day after taking it before going to bed. Mainly used for patients with headache and dizziness the next day due to poor sleep.

Triazolam

Triazolam, also known as "Haleshen" in foreign countries, is mainly used for insomnia caused by anxiety and tension. The effect is similar to that of sulbutamine, but there are no adverse reactions such as dizziness and brain swelling common to general tranquilizers. Be applicable.

4. Jiajing stability

Jiajing is stable and stable. The foreign name Shen Ning Shen has strong anti-anxiety and weak sedative effects. It is mainly used to treat tension headaches. Because the sedative effect is light, daytime application has little effect on work. Side effects include drowsiness, dizziness, and unstable walking.