PAINKILLERS are scientifically known as analgesics. They are used in general to treat and relieve pain. There are various types of painkillers used for treatment in medicine.
Painkillers can be taken orally (in the form of tablets, capsules and liquids), through injections administered by doctors and via the anal route (using suppositories).
There are also painkillers in the form of creams and ointments that are applied onto the skin.
In general, painkillers that are commonly used or prescribed can be divided into three categories.
They are non-steroidal anti-inflammatory drugs or NSAIDs (popular examples are ibuprofen and diclofenac sodium); paracetamol or acetaminophen; and opioids (some examples are morphine and tramadol).
Most patients who use opioids usually suffer from chronic illnesses and are receiving ongoing treatment in hospital.
Certain medications are in combination with a few types of painkillers to ensure and achieve the desired efficacy.
In some countries, most painkillers can be obtained over-the-counter. These medications can be purchased without prescription from a doctor and some of them can even be found in grocery stores.
KEEP IN CHECK
In Malaysia, it is an entirely different situation. The majority of painkillers here are only available in pharmacies and clinics.
Although certain painkillers do not require a valid prescription from a doctor, only a registered pharmacist can sell it. This requirement is enforced in order to provide proper counselling and monitoring of side-effects.
Until today, paracetamol remains the only analgesic that can be purchased from local convenience stores in addition to pharmacies and clinics.
Paracetamol has a good safety profile and does not have any major side-effects, if taken according to the suggested dosage.
Most of the time, consumers will experience adverse effects when painkillers are taken without proper control and monitoring. One of the adverse effects is kidney injury.
There are two types of kidney injuries, the first being acute kidney failure. Acute kidney failure can result from taking high doses of painkillers in a short period of time.
Most patients who experience this type of kidney injury are usually dehydrated. On the other hand, patients who are old, are suffering from Systemic Lupus Erythematosus (SLE) or alcoholics have an increased risk of acute kidney failure as compared to others.
Another type of kidney injury is chronic kidney failure, which is also known analgesic nephropathy. This condition stems from prolonged usage of painkillers without any control and monitoring.
Kidney failure does not happen overnight. Studies have shown that if patients were to take painkillers on a daily basis for three to six years, it would result in kidney failure.
The most common group of people predisposed to this condition are those who take painkillers without any consultation from doctors or pharmacists.
STICK TO DOSAGE
To ensure safe and proper use of painkillers, consumers are advised to strictly adhere to the prescribed dosage.
For instance, when patients are prescribed paracetamol, some of them may be asked to take it up to four times a day, whereas others may be asked to take the medicine only when they experience pain.
The dosage depends on the current diagnosis and the type of painkiller prescribed.
NSAIDs like ibuprofen and diclofenac sodium should be taken with meals. This is to ensure that the patient will not experience any side-effects associated with the medicines such as gastritis. The key point here is to always follow the instructions given by the pharmacist when medicines are dispensed.
As with most acute conditions, painkillers are usually taken for a short period of time with the minimal dosage required to relieve pain. This dose regimen will help avoid or reduce the side-effects associated with the medicines.
DIFFERENT DURATION
Patients seeking treatment for conditions like toothache or headache will be prescribed painkillers for a few days whereas for conditions such as muscle cramps, the treatment may be for a few weeks.
On the other hand, patients diagnosed with osteoarthritis, rheumatoid arthritis or severe back pain may be given painkillers on a long-term basis.
Always be vigilant when taking painkillers by seeking medical advice from doctors or pharmacists. Painkillers are safe to be taken for acute and infrequent pain, provided they are taken according to the prescribed dose and duration.
For patients diagnosed with chronic pain, constant monitoring by their physician during treatment is vital to ensure the side-effects of painkillers can be managed or avoided.
For inquiries regarding painkillers and medicines, contact the National Pharmacy Call Centre at 1800-88-6722 (toll-free) during weekdays from 8am to 5pm.
*The writer is a pharmacist at the Ministry of Health, Malaysia.