We are afraid of pain and therefore, analgesics are as important at home as water. They are used as if it were a caramel but the truth is that they are not harmless: Our kidneys and liver can pay the consequences of misconduct.
What is Analgesics?
Painkillers are medicines that are used to decrease or eliminate pain, from a scrape to severe pain caused by diseases such as cancer. They are not dangerous for most people if taken at the doctor’s recommended dosages, but consuming them regularly for long periods of time, exceeding doses or using them poorly can cause serious problems in the liver and kidneys. They may also hurry prior heart disease or delay with treatment by decreasing the effectiveness of certain medications, such as antihypertensive.
Classification of Analgesics
They are classified according to the chemical families to which they belong and function by different mechanisms. There are many types and the stronger, the more delicate is their use.
According to the National Institutes of Health and the US Food and Drug Administration, more than 50% of cases of liver failure in that country is due to characteristic, i.e. unexplained, damage or reactions caused by approved drugs and 37% are related to acetaminophen.
Types of Analgesics/antipyretics
They are the most common commercial analgesics and have long been considered the safest in the market. Within this group, the most famous is paracetamol or acetaminophen (Dolex, Dolofán, Tempora, Panadol, Tylenol, among others). Its mechanism of action is not well defined although it is known that acts weakly inhibiting the production of prostaglandins, mediator substances pain. It has an analgesic effect, antipyretic, but not anti-inflammatory and therefore is not part of NSAIDs. Unlike these, it has fewer effects on the digestive system. It is easily achieved in the market, at low cost, has few interactions with other medicines and is quite effective.
However, reaching an overdose is easy because the maximum dose in adults (4 g or less per day, according to recent research) is on the border with the amount that begins to be toxic and can lead to hepatotoxicity. Its danger is also increased by continuous use over long periods of time and when consumed with alcoholic beverages.
Another commonly used analgesic is metamizole or dipyrone (Novalgina, Fisalgil, Conmel) whose use is associated with hematological disorders (decreases the production of white blood cells) that can become severe.
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Non-steroidal anti-inflammatory drugs
They are commonly referred to by their acronym, NSAID, and refers to most of the painkillers that we buy in the market and that are obtained without medical formula. In this category are acetylsalicylic acid (Aspirin), diclofenac, ibuprofen, meloxicam and naproxen, among others.
They act by inhibiting the production of prostaglandins, mediators of pain. Apart from being analgesia, they are usually anti-inflammatory and antipyretic (decrease fever).
They can affect the digestive system, cardiovascular and renal. They do not create physical dependency (addiction), but there can be psychological dependence that requires help from a therapist. As with analgesics/antipyretics, they are often abused because of the ease with which they are available in the market. Taking them daily can lead in the medium or long term to analgesic nephropathy (kidney disease) or to hepatotoxicity. Also, by inhibiting the production of prostaglandins, they can produce fluid retention and decrease the effects of antihypertensive drugs. Therefore, they are not recommended for people with cardiovascular problems, heart failure or hypertension.
Acetylsalicylic acid useful for the heart is not the same as that used against pain, it has a higher dose than the one used as antiplatelet.
They can be natural or synthesized and act on the opioid receptors of neurons of the nervous system reinforcing or simulating the effect of endogenous opioids (eg endorphins). They are the most potent painkillers known, but they generate constipation, drowsiness, mood swings and can create dependence, so they are only obtained with medical formula.
Drug poisoning can be the multi organ and lethal, usually due to errors in drug administration, lack of understanding of the risks of drug users and pharmacological abuse. Because of their difficult handling and the risks associated with their use, opioid analgesics should always be used under medical supervision.
Terms and Conditions
Also called toxic drug-induced liver disease and refers to anatomical or functional liver damage. It can be caused by chemical compounds (medicines) or organic (nutritional supplements, among others). It can occur by overdose, idiosyncratically or by regular intake and for long periods (more than two months) of a medication.
In the case of analgesics, it is produced by direct toxicity, overdose or by an idiosyncratic reaction. Like that, a kind of “allergic reaction” to the drug that causes the kidneys to stop working or to do so improperly. If handled promptly and properly, kidney damage may be reversible.
It develops by taking daily painkillers for many years. It is a chronic kidney disease that gradually leads to kidney failure that may be irreversible. According to the American National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), four out of 100,000 people develop analgesic nephropathy, being more common in women over the age of thirty.