Preety shah of Lahan doesn’t consult a doctor for relief from minor ailments. Shah, who works in an manager in business firm, relies on her local chemist for medicines to tackle headaches, stomach cramps, back pain and even sore throat. “I have really crazy deadlines and by the time I come home it is late to see a doctor,” she says. “So I just call up my chemist and he sends me the medicine I need.” From painkillers to medicines for minor aches, Shah, 31, finds relief over the counter.
Her mother, Rita Shah, too, does not seek expert advice before popping painkillers. The 55-year-old homemaker says she doesn't have the time for rest in case of a headache or body ache and so she pops painkiller Nims or Niko to keep up with the household work. Kamal Thapa, 50, has chronic knee pain. So he relies on painkillers to stay on his feet. “When the pain becomes uncontrollable, I take four painkillers a day,” says Thapa, who lives in Butwal.
Most of us are guilty of popping over-the-counter drugs when we suffer from minor ailments. The common belief is, why would anyone go to a doctor when a Rs.5 tablet can take care of headache, backache, body ache, menstrual cramps and even migraine attacks? Most people rely on their chemist to suggest a drug during times of need. Analgesics or painkillers like aspirin, paracetamol, diclofenac, naproxen and ibuprofen are easily available and we pop them without batting an eyelid.
If these drugs are widely available and have been in use for so long, there could be nothing wrong in taking them, right? Wrong. Painkillers, like all other drugs, have side effects and popping them regularly and for a long time without consulting a doctor could lead to severe long-term damage. The most common side effects are heartburn, nausea and vomiting, but it could also lead to serious complications like liver and kidney failure or even stroke. The side effects usually depend on the type of painkiller.
“There are two major types of painkillers—opioid analgesics and NSAIDs (nonsteroidal anti-inflammatory drugs),”. “Opioids act on the central nervous system and include drugs like morphine, pethidine and pentazocine. NSAIDS act peripherally and decrease the mediators of inflammation ie, substances that accumulate in the part of the body where we get an injury, and are responsible for producing pain and swelling."
The NSAIDs are further divided into selective and nonselective COX-2 inhibitors. Nonselective COX-2 inhibitors include drugs like aspirin, paracetamol, diclofenac, piroxicam and mefenamic acid though paracetamol is considered to be another category of drug because it reduces pain but not inflammation. Selective inhibitors include celecoxib, rofecoxib and valdecoxib.
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Pharmacy Practice