Antibiotic resistance public health

What Is Public Health?

Public health is the science of improving health, preventing diseases, and prolonging life. It promotes ideas of how to remain healthy and happy through organized events, for instance, promoting breastfeeding, hand washing, the need to use vaccinations, distributing condoms, preventing suicides, etc.

Its main goal is to be aware of threats to human health based on data analysis and warn people about them, also giving ideas how they to improve the overall well-being. The population can be small as a several people to several continents. According to WHO, health is a state of social, mental, and physical well-being, and not just absence of infirmity or disease.

Public health needs to use help of health professionals and workers, such as physicians, psychologists, dentists, epidemiologists, microbiologists, etc. Public health promotes open and free information, which allows people to be aware of various threats and how they can deal with them, and that is why public health is so important.

What Is Antibiotic Resistance?

Humans have been living on Earth for about 200,000 years ago, and only for the last seventy years, we have been using synthetic antibiotics for the treatment of various bacterial diseases. The development of the first antibacterial agent called penicillin was a breakthrough for humanity. For many years, people were able to easily treat infections from which during previous thousands of years people would just die. Unfortunately, developing a potent drug is not enough because bacteria become able to resist the effects of medications. One of the reasons for that is the massive use of antibacterial agents.

Bacteria are able to reproduce, maintain internal conditions, and do other actions typical for all living things, including adapting to the changes in the environment. When bacteria experience the effects of antibiotics, they may use different mechanisms to survive, which is called antibiotic resistance. The major problem is that bacteria are able to share their successful experience with others through plasmids.

When antibiotic resistance occurs, other antibiotics should be used to treat bacterial infections, but, unfortunately, sometimes none of them works. There have been many cases of people dying from antibiotic resistance. It is important to develop new medications, and we should do it quicker than bacteria become resistant.

According to the CDC, at least two million people are infected with bacteria that resistant to antimicrobials agents in the USA annually and about 23,000 of them die. Unfortunately, according to forecasts, this number will grow year by year, unless people manage to prevent the occurrence of bacterial resistance and start developing potent drugs. In several years, we may face millions of people’s death because of antibiotic resistance. Public health has to be directed on warning people about the threat and letting them know how it is possible to help.

How Public Health Can Help Prevent Antibiotic Resistance

Although antibiotic resistance may occur even if you use the right medication for the treatment of certain bacterial infections, it is mostly has become such a major problem because of massive use of antibiotics, including cases when they should not have been really used.

Antibiotics really should not be used as they are used today, meaning that the use of antibacterial agents should be based on special tests, confirming the presence of a bacterial infection and informing about the type of bacteria causing it. Antibiotics are often prescribed based on “guessing” or “just in case” principle. This happens because people are not aware of the problem and it is easier and time-consuming to use antibiotics than undergo special tests.

The role of public health is to deliver to all people the information about the problem, and about the actions that they can do in order to prevent it. Public health should inform people that they should not use antibiotics for the treatment of viral infections. People should also know that it is also important to prevent the occurrence of bacterial infections by washing hands, using condoms, avoiding using things of other people, etc.

Basically, public health should deliver the needed information, so each person could be aware of what is happening, why it is dangerous, and how to prevent it.

What Can Medical Professionals Do in Order to Prevent Antibiotic Resistance?

Although the role of public health is really important, many people take their warnings as not necessary and do not pay much attention to them. Medical professionals are those who are dealing with people who got sick. They should avoid prescribing antibiotics if it is not necessary. Also, it is important to insist on taking specials test if the type of bacteria causing an infection is uncertain.

Healthcare providers should in details explain the need to follow all of their recommendations. Often, people do not take antibacterials for the needed time. Once they feel some relief, they think that the infection has been fought, and there is no need to continue using antibiotics. This is a big mistake, because in reality bacteria are not killed, and they will keep causing infections, and, moreover, they will become resistant to the antibiotic that has been used to treat them before.

Prophylaxis is one of the reasons why antibiotic are used. Almost all surgeries are accompanied by the use of antibacterial agents to prevent complications. As studies have shown, such an approach is not always necessary, and antibiotics for prophylaxis should be used only for people in a high-risk group.

All in all, public health can do a lot of useful things for preventing antibiotic resistance, and one of them is informing as many people as possible about the threat.

Antibiotic resistance evolution

How Antibiotic Resistance Evolves and Why This Happens

About Antibiotic Resistance

Antibiotic resistance means the ability of bacteria to withstand the effects of antibacterials (antibiotics). Infections caused by bacteria can be life-threatening, and even simple ones can only be treated with the use of antibacterials. Today, the production of antibiotics is massive, and it helps people from all over the world feel safer. These drugs are used for the treatment of bacterial infections in the urinary tract, strep throat, some pneumonia, and many others. Unfortunately, bacteria may become resistant to medications, which makes it impossible to use them for the treatment of even minor infections.

Bacteria are highly adapting species to the changing in the environment and attacks against them, using different mechanisms. They are constantly evolving, forcing people to develop new potent antibiotics and find other ways to be one step ahead.

Discovery of Antibiotic Resistance

Antibiotic resistance evolution is closely tied with the invention and uses of antibiotics. Bacteria were discovered in the late 19th century, which initiated the search for potent medications able to fight infections caused by them.

The first valuable breakthrough happened in 1928 when penicillin was discovered by Alexander Fleming, which became the inception of a new era in medicine.  Later, this discovery earned the inventor the Nobel Prize. After several years of the antibiotic use, Fleming warned people about antibiotic resistance. Since this time, many other antibiotics have been discovered, which saved a countless number of lives.

In 1937, sulfonamides were introduced, and soon people noticed the development of antibiotic resistance. Resistance to sulfonamide was reported in the late 1930s, and the same mechanisms of resistance work today. According to the recent database lists, there are over 20,000 potential resistance genes of about 400 types.

How Antibiotic Resistance Evolves

Antibiotic resistance evolution is a natural process occurred through mutation, but it can also be caused by an evolutionary stress. Bacteria are able to transfer the genetic information between individuals thanks to plasmid exchange. This means that once antibiotic resistance occurs, it becomes available to other strains. Bacterium with several resistance genes is called a superbug.

Several studies have proven that antibiotic resistance evolves due to the extensive use of antibacterials. That is why it is so important to eliminate the overuse of these medications.

According to researchers, LexA, the bacterial protein, may be important for creating mutants. Today, one of the major resistant pathogens is Staphylococcus aureus.

Researchers have managed to create a large culturing device that is able to track the evolution of bacteria and the way they mutate under the effects of antibiotics. It was surprising for the scientists to discover that not the fittest mutants were able to withstand the effects of higher antibiotic concentrations, but the bacteria “behind” them.

The results of the research have provided important information about the evolutionary mechanisms and patterns, which make bacteria resistant to drugs.

Michael Baym and colleagues and his team have created a MEGA plate, a model allowing observing the process of mutating bacteria. It has been revealed that descendants of mutants tend to migrate to new territories.

Initially, the low-resistance mutants occur, then moderately resistant species developed, and, finally, those that are highly resistant to antibiotics appear. It takes about 11 days for mutants to become resistant.

How to Prevent Antibiotic Resistance

In order to eliminate the threat of being unable to treat bacterial infections, the world’s leaders have to cooperate in term of financing and supporting by other ways the research on the topic, the development of new drugs, and increasing people’s awareness about the problems.

We can do simple actions in order to help in solving this problem, including the following:

  • Avoid using antibiotics for the treatment of infections caused by viruses, including common cold, influenza, a sore throat, or a runny nose;
  • Strictly follow recommendations of a healthcare provider regarding the use of antibacterials;
  • Do not use antibiotics that were not prescribed for you, and do not share your medications with other people.

Tylenol side effects

Despite the fact that one can buy Tylenol without a prescription, this analgesic may cause side effects. Risk of these effects is minimal, but it cannot be completely ruled out, especially if the drug is taken incorrectly.

This review is devoted to common and rare side effects of Tylenol. In this review, you can also find out more information about Tylenol and get answers to the following questions about adverse reactions:

  • What does contribute to their occurrence?
  • How to reduce their risks?
  • What to do if they arise?

It should be noted that Tylenol is well tolerated by patients and very rarely causes negative reactions. That is why this drug is available for sale without a prescription and is used to treat various types of pain in elderly, adults, adolescents and children. Low doses of this analgesic can be used to reduce soreness in toddlers and infants.

Side effects of Tylenol are mild or moderate, at least for most patients. Serious reactions are very rare. In general, adverse reactions are short-term, disappear on their own and do not imply termination of Tylenol use.

Side effects of Tylenol may occur in the following cases:

  • Use of the first dose
  • Use of an excessive dose
  • Change in dosing regimen
  • Increase of a daily dose
  • Use of a tablet less than 4 hours after the previous one
  • Concomitant use with other analgesics

Like most other analgesics, Tylenol is usually taken orally. After absorption from the gastrointestinal tract, Tylenol is relatively evenly distributed in the blood and in most other body fluids.

Tylenol contains an active substance Acetaminophen (Paracetamol) which can affect the lymphatic and circulatory systems. Commonly, such influence is insignificant, but sometimes thrombocytopenia or agranulocytosis occurs.

Thrombocytopenia is a state in which platelets level in the blood decreases. If the patient knows that he does not have enough platelets in the blood, it is best first to consult a doctor and after to start taking Tylenol.

Light side effects associated with a decrease in platelets or other blood constituents are difficult to self-detect. Typically, blood test is performed to detect thrombocytopenia. However, if there is bleeding gums and nosebleeds, as well as prolonged bleeding from cuts or wounds, this can be a sign of thrombocytopenia.

A term agranulocytosis is used when level of white blood cells decreases. These cells perform several functions the most important of which is protection of the body from infectious diseases.

Ordinarily, Tylenol is used as a short-term pain treatment. Therefore, even if this analgesic affects the blood composition, these changes are insignificant. After termination of using Tylenol, the blood composition quickly normalizes.

Besides agranulocytosis and thrombocytopenia, there is another adverse reaction that is often mentioned about – hepatic failure. Damage to the liver is difficult and long to treat. Therefore, people taking Tylenol should be warned about this adverse reaction.

Liver side effects may occur in the following situations:

  • use of a dose more than 4000 mg per day
  • combined use with other analgesics containing Acetaminophen
  • use of this analgesic in combination with alcohol

Despite a good safety profile, Tylenol cannot be used in patients with liver damage or in those who constantly consume alcoholic beverages. When using this this analgesic, consumption of alcoholic beverages should be completely stopped.

In addition to those mentioned above, a list of Tylenol side effects includes allergic reactions and bronchospasms. Such reactions are rare, but can be nuisance and affect your everyday activities.

Most of the allergic reactions of Tylenol are mild or moderate (e.g., sneezing, redness of the eyes, or runny nose). Sometimes severe allergic reactions occur that are called anaphylaxis or anaphylactic shock.

Bronchospasm is a state of acute respiratory failure caused by narrowing of muscles in the walls of the bronchioles. Bronchospasms usually occur in asthmatics using Tylenol.

Gastrointestinal symptoms are not included in the list of common Tylenol side effects. Stomach problems often occur when using other pain medications, such as NSAIDs. Therefore, Tylenol is recommended for people with digestive system diseases.

In order to minimize the risk of adverse reactions during pain treatment, the minimum effective doses of Tylenol should be used. The daily intake for adults should not exceed 4000 mg of Tylenol per day.

Children should take lower doses of Tylenol comparing to adults. The total dose for children depends on age and body weight. Children should not take Tylenol for more than 3 days without consulting a doctor.

The total daily dose should be divided into 3-4 doses at approximately the same intervals. If to take the maximum daily dose of Tylenol at a time, overdose may occur.

In case of overdose, it is necessary immediately consult a doctor, even if the patient is feeling well. Acute overdose of Tylenol may cause liver damage and other adverse reactions.

If side effects still arise and cause discomfort while using Tylenol, do not worry too much. Decrease in the daily dose and / or increase of the interval between doses intake makes it easy to control adverse reactions of this analgesic.

Benefits of using Tylenol for pain treatment should be compared with risks of adverse reactions. If undesired effects are mild and do not cause discomfort, it is not necessary to reduce the daily dose of Tylenol.

Sciatica pain relief

A correct approach to sciatica pain relief facilitates rapid relief and recovery of mobility. Sciatica is a neuralgia of the sciatic nerve, characterized by pain in the buttock and leg, tingling, burning and numbness of the hamstring. At that, sciatica is a pain symptom, and not an independent disease.

The most common cause of sciatica is an injury or trauma to the sacral spine. People, who suffer from sciatica, begin to limp, thus avoiding the transfer of their body weight to the aching leg. As a result, the load on the damaged intervertebral disc is distributed unevenly, which leads to its further destruction.

The nerve roots in the lumbar region form the sciatic nerve. Characteristic signs of sciatica are:

  • numbness of limbs
  • muscle spasms, muscle twitching
  • impaired control of the function of the bladder or intestine
  • partial or total loss of sensitivity on the foot and shin
  • pulling, piercing pain in the lumbar region, buttock, hamstring, shin and foot

When the nerve is compressed, the pain extends into the buttocks area, under the knee, sometimes in the calf or the heel. Symptoms of sensitivity loss in the legs are very persistent, and numbness can persist for a long time. If sciatica is not treated for, this increases the risk of pathologies in intervertebral discs and nearby internal organs.

The problem of sciatica pain relief is complicated by the fact that nerve entrapment can be located in different places separately or in several places at the same time. The first place in which the compression of the sciatic nerve can be formed is the ending of the spinal cord. Nerve roots that come off its bottom give rise to the lumbosacral plexus and the sciatic nerve itself.

The second place, in which people can have the compression of the nerve roots, involved in the formation of the sciatic nerve, is the lumbar region, on the sides of the spine. Nerve endings can be squeezed by the muscles and edges of the vertebrae. And the third place is the pelvic area, where separate roots and/or the sciatic nerve itself can be compressed by the muscles of the buttocks.

Methods of sciatica pain relief are:

  • analgesics
  • therapeutic gymnastics
  • physical and psychological relaxation
  • correction of habitual incorrect movement patterns
  • physiotherapy (including computerized reflexotherapy and cryotherapy)

Therapeutic gymnastics and physical activity are the first-line therapy for sciatica. The intensity of physical exercises is determined by the attending physician individually for each patient.

To ease the pain, people need to perform various exercises: mild, without sharp movements, tilt forward, backward, to the sides, so that the muscles of the lumbosacral section actively contract and stretch. Muscle activity improves blood circulation and gradually relieves pain.

To support the tone of the leg muscles, patient should make several squats daily. If a patient finds it difficult to balance, he can hold on to the back of the chair while making squats. Several slow squats per day are especially effective for sciatica pain relief during pregnancy.

For pharmacotherapy of sciatica, the drugs of choice are:

  • muscle relaxants
  • opioid analgesics
  • nonsteroidal anti-inflammatory drugs (NSAIDs)

If oral analgesics are ineffective in sciatica pain relief, the attending physician uses Novocain injections. Injections are made as close to the sciatic nerve as possible by the method of lumbar puncture, which allows to locally influence the inflamed nerve and achieve a rapid and strong analgesic effect.

One of the most advanced and modern methods of sciatica treatment is cryotherapy. The method consists in alternating exposure to heat and cold on the lumbosacral region. In outpatient practice, cryo chambers are used. However, patient can independently achieve sciatica pain relief at home.

For cryotherapy at home, people use plastic bags with basic salt solution. After freezing in a refrigerating chamber, patient should apply the bag to his low back and perform light slow rotational movements. The skin turns pale at first, and then starts to redden quickly.

Exposure to cold should be discontinued with intense skin reddening. Patient must put aside the package with ice, warm the reddened area and wait until the skin regains its natural color. The rest time is selected individually – 2 to 15 minutes. Then, the procedure can be repeated, again until the skin turns red. Two repetitions are sufficient for one cryotherapy session.

In addition to the use of analgesics, cryotherapy and physical activity, the auxiliaries for sciatica pain relief treatment can be:

  • special orthopedic pillows
  • creams and ointments for topical application
  • devices for computer reflexotherapy and percutaneous electrical neural stimulation (PENS)

Errors that patients make in sciatica pain relief treatment:

  1. Take analgesics for more than 3-4 days. There is no need to take painkillers for prevention or when the pain symptoms begin to decrease.
  2. They try not to move at all. Full immobility is necessary only when the pain is unbearable. However, if the pain symptoms are periodic, then moderate physical exertion is required to alleviate them.
  3. Independently perform exercises that they think can promote sciatica pain relief. Since many patients are not aware of all the features of the location of the muscles and ligaments relative to each other, they perform wrong exercises that can aggravate the pain symptoms.

Pain relievers

Minimum of unpleasant sensations and a fast analgesic effect are the two main criteria for choosing pain relievers. The main tasks of all painkillers are easing the pain and changing the emotional state from negative to neutral.

Safe and effective pain relievers should have the following characteristics:

  • fast start action onset;
  • low systemic toxicity and minimal risk of side effects;
  • adequate duration of pain relief, which should be at least 4 hours.

Analgesic effect is achieved by selecting pain relievers individually for each patient. There is no single dose or drug, which would be multi-purpose and would alleviate physical and emotional discomfort for all patients. In addition, for a variety of reasons (progression of the underlying disease, development of tolerance, etc.), previously used drugs may become ineffective for pain alleviation in repeated use.

As a rule, there are three dosage forms of pain relievers:

  • pills
  • injections
  • topical products

All drugs for facilitating physical and emotional sufferings should be used in the simplest, most effective and least painful way. Therefore, to ease the painful and unpleasant sensations, many patients prefer to use tablets because of the convenience and ease of their use.

Tablets for pain relief can be either of immediate or of sustained release of the drug substance. Pain relievers with an immediate release are used to relieve episodic and breakthrough pain (BTP).

Extended release tablets are used to alleviate chronic pain and provide a longer analgesic effect, than that of conventional tablets. Thus, using prolonged release tablets, patient can reduce the frequency of medication.

The main disadvantages of oral pain relievers are:

  • insufficiently rapid onset of the analgesic effect, compared to injectable preparations;
  • most of the drug substance is inactivated upon first passage through the liver;
  • impossibility to select the dosage necessary for adequate analgesic therapy with absolute accuracy.

Injectable pain relievers are first line drugs to alleviate physical and emotional suffering in outpatient practice. Parenteral administration of pain medication is necessary for fragile patients, who are unable to swallow tablets.

Injectable pain relievers should also be used by patients, who:

  • suffer from a gastrointestinal tract dysfunction
  • require very rapid onset of the analgesic effect
  • are incapable of using or tolerating the action of oral analgesics

The main advantage of injectable analgesics vs oral analgesics is the speed of action, since the drug substance is not absorbed from the gastrointestinal tract, and immediately enters the blood stream.

In outpatient practice, injectable drugs can serve not only for analgesia (loss of pain sensation), but also for anesthesia (loss of pain sensation, as well as motor activity and consciousness). Clinical efficacy of injectable pain relievers is determined by such indicators, as:

  • duration of anesthesia for therapeutic purposes;
  • active profile, that is, the duration of complete and incomplete anesthesia;
  • the onset of action, that is, the time to achieve an analgesic effect after injection;
  • the total duration of anesthesia, that is, until the sensitivity returns completely.

Of the parenteral ways of pain relievers administration, the subcutaneous way is the main one, while the intravenous way is used in need to quickly alleviate emotional and physical suffering. Intramuscular administration of drugs is only used for strict medical indications and mainly to alleviate severe pain.

Pain relievers of topical application can be ointments, creams, sprays and patches. Local analgesics should be used for symptomatic treatment of sore throat, as well as painful and unpleasant sensations, caused by injuries, bruises and sprains.

The effectiveness of the analgesic effect of topical drugs is the direct impact on the source of pain and inflammation. Other advantages of pain relievers for topical application vs oral and injectable medications:

  • no adverse effects on the liver and gastrointestinal tract;
  • decrease in the risk of side effects due to low systemic bioavailability of the drug;
  • ease of use, the possibility of using at home, the lack of the need for outpatient treatment.

The drawbacks of pain relievers for topical application that should be noted are inefficiency against chronic pain, the inability to achieve an immediate analgesic effect and an increased risk of allergic reactions on the skin.

By its effect on the body, all pain relievers are divided into two large groups: narcotic and non-narcotic. The former have a pronounced stimulating effect on the brain and the central nervous system. Non-narcotic drugs suppress the activity of pain mediators.

The action mechanism of opioid pain relievers lies in:

  • violation of the subthreshold pain impulses functioning
  • change in emotional perception of painful and unpleasant sensations
  • blocking the interneuronal transmission of pain impulses to the cerebral cortex

Narcotic analgesics can be agonists or antagonists of opiate receptors, which are responsible for the severity and degree of pain intensity. The therapeutic effect of opioid pain relievers is combined with the impact over patient’s emotions and psychological condition. The main advantages of narcotic drugs are the fast and long-term elimination of symptoms of acute and chronic pain.

Non-narcotic analgesics, posses anti-inflammatory and antipyretic effects in addition to the analgesic effect. The action mechanism of non-narcotic pain relievers lies in:

  • blockage in the development of pain mediators in the peripheral nervous system
  • inhibition of painful impulses transmission along the peripheral nerves and into the deeper parts of the brain

Unlike opioid analgesics, which can be addictive, non-narcotic drugs do not contribute to drug dependence.

Pain pills online

Pain pills (analgesics) are in the greatest demand among Americans. These drugs selectively suppress soreness, increase the tolerance to pain and reduce the emotional reactions to pain.

Most of the pain pills have an over-the-counter (OTC) status and are available in freely sale online and in retail pharmacies of the country. As public polls show, Americans prefer to order pain pills online. This allows them to quickly arrest the pain syndrome and improve their health general physical and mental health.

It is convenient and profitable to buy pain pills via online pharmacy. Long-lasting pain syndrome exhausts people physically. Often, he does not even have the strength to go to the nearest pharmacy to get an anesthetic.

When there is no time or opportunity to go to the pharmacy on your own, and the pain does not pass, people buy pain pills through the Internet without leaving their home. You can buy the right drug at any time, as online pharmacies work around the clock.

In some pharmacies, you can choose the same-day delivery service, and then pain pills will be delivered to the buyer within the shortest possible time. This makes it possible to quickly start treating pain and improve the quality of life.

Many buyers prefer to buy pain pills online because this helps them save their money, as well. As a rule, prices for painkillers in online pharmacies are lower, than those in retail pharmacies.

Affordable prices for pain pills in online pharmacies are explained by the fact that the basis for pricing is a minimum mark-up on drugs. In contrast to retail pharmacies, the cost of maintaining and servicing an online pharmacy is lower.

There is no need to hire a large staff, pay for renting a facility, for electricity. Therefore, the cost of pain pills in online pharmacies for most Americans is more attractive and acceptable.

In fact, there is a large number of drugs that possess analgesic effect. The analgesic effect can be provided not only by pain pills, but also by drugs of different pharmacological groups.

Currently, there are several classifications of pain pills. Traditionally, analgesics are classified into:

  • Non-opioid analgesics;
  • Opioid analgesics.

Non-opioid analgesics are the most popular pain reliever pills, which can be purchased online without a prescription. The popularity of these pain pills is explained by the fact that they:

  • Are not addictive;
  • Have fewer side effects;
  • Effectively relieve chronic pain of mild and moderate intensity.

Non-opioid analgesics include pain pills, the analgesic effect of which is not related to the opioid system.

In the USA, non-steroidal anti-inflammatory drugs (NSAIDs) are among the most common pain pills with analgesic activity. In particular, aniline derivatives (Acetaminophen), salicylic acid derivatives (Aspirin), carboxylic acid derivatives (Diclofenac, Ibuprofen, Naproxen).

The analgesic effect of the NSAIDs is due to the inhibition of the prostanoids synthesis. At that, drugs of this class influence the synthesis of prostaglandins in the neurons of the spinal cord and in the structures of the central nervous system that are involved in the transmission of pain impulses.

Non-opioid analgesics can be purchased in the form of oral capsules and tablets. Since the use of non-narcotic analgesic does not significantly affect the central nervous system, these pain pills are available online and in supermarkets.

In addition to the analgesic effect, non-opioid analgesics can exert provide and antipyretic effects. These pain pills are used for neuralgia, acute articular rheumatism, arthritis, and colds.

NSAIDs are well tolerated, yet a prolonged use of these pain pills can cause damage to the gastric mucosa, which manifests itself as gastropathy.

To reduce the risk of side effects, the manufacturers started producing the tablet forms of these painkillers in a special shell, which dissolves in the intestine, and not in the stomach. Administration of pain pills after a meal can help reduce the irritation of the gastric mucosa.

It should be borne in mind that the analgesic effect of non-opioid analgesics manifests itself in neuralgic, dental, headache, joint, muscle pain. These pain reliever pills are poorly effective in trauma, pain associated with diseases of the internal organs.

To treat acute and chronic non-onocological pain of various origins, as well as to arrest pain syndrome, oncological patients are prescribed opioid analgesics.

Most often, opioid analgesics are offered in the form of oral tablets and capsules. Typically, these pain reliever pills can be purchased online or in conventional pharmacies by prescription.

The action mechanism of these analgesics is well understood and since their effect is related to the impact over the central nervous system, opioids are among the controlled drugs.

Being strongest pain relief medicines, analgesics selectively suppress pain sensitivity, and do not violate consciousness. The use of pain pills increases the threshold of pain sensitivity and reduces the perception of pain.

Moreover, narcotic analgesics can suppress patient’s fear and expectation of pain. The most famous narcotic painkillers are Pentazocine, Codeine, Buprenorphine, Tramadol, Prosidol, and Morphine.

Pain reliever pills from this group possess:

  • high analgesic activity;
  • addictive properties, that is, they can cause a dependence;
  • the ability to effectively cope with acute pains of any localization;

Due to the ability to cause mental and physical dependence, the sale of these pain pills without a prescription is prohibited for retail and online pharmacies. The side effects of opioids are approximately the same. The effect on the central nervous system manifests through sedation, euphoria.

Pain reliever pills can cause constipation, since the secretory activity of the intestinal mucosa decreases in patients, who take these analgesics. Therefore, patients on opioids should also be prescribed laxatives.

Today, analgesics are among the most affordable drugs. Many Americans order pain pills online. However, before you buy a painkiller, it is recommended to find out the exact indications for its use or consult a pharmacist.

Pain medication

Effectiveness of analgesic therapy for acute and chronic diseases, surgical interventions, as well as injuries depends on choice and use of one or another pain medication. Therapy, aimed at alleviating physical and emotional suffering, should begin as soon as possible – at the first signs of pain occurrence.

Regardless of causes of pain occurrence, there are no adequate methods of examination confirming this diagnosis. Diagnosis is based on the patient’s description of pain characteristics and accompanying symptoms, herewith absence of any deviations during medical examination is mandatory.

During medical examination, the patient should describe pain symptoms as detailed as possible. It is very important to inform the doctor how often and in what doses the patient uses analgesics and whether he observes all recommendations for use.

Choice of pain medication is determined in accordance with such pain characteristics as:

  • etiology
  • intensity and type
  • the patient’s individual characteristics

There is no pain medication, universal for all patients. However, based on medical indications, the attending physician will be able to prescribe a medicine that is effective for analgesic therapy of the particular patient.

All painkillers are divided into three large groups:

  • non-narcotic (non-opioid)
  • narcotic (opioid)
  • combined

Non-opioid analgesics include drugs of such pharmacological groups as non-steroidal anti-inflammatory drugs (NSAIDs), Pyrazolone derivatives and others. All non-narcotic drugs do not differ by prolonged anesthetic effect and are not capable to relieve severe pain, but can weaken it and reduce a need for opioids.

Analgesic effect of non-narcotic analgesics is manifested in neuralgic, muscular, articular, dental and headache. However, to alleviate emotional distress during injuries, burns and pain associated with diseases of the internal organs, none of the non-narcotic pain medications will be effective.

Advantages of non-narcotic drugs comparing to opioids:

  • do not depress breathing
  • do not cause drug dependence
  • both adults and children can use

Opioid analgesics are the drugs of choice for alleviating pain symptoms of moderate and high intensity in different fields of medicine. By degree of anesthetic effect, they are significantly superior to all non-narcotic drugs. Opioid drugs have central mechanism of action, realized by interaction with opioid receptors of different brain parts and central nervous system.

The most common opioid pain medication is Codeine. It has several dosage forms (tablets, syrup, injections) and it is widely used in clinical practice. Compliance with the rules for clinical use of all opioid drugs is a prerequisite for preventing risk of possible complications.

The main disadvantage of opioid drugs is a risk of drug dependence. Tolerance is caused by the person’s addiction to the applied dose of an opioid and decrease in analgesic effect during prolonged therapy. Due to the increased risk of dependence, there is a special system for monitoring the use of opioids to prevent possible abuse in many countries.

Combined pain medications are created on the basis of Paracetamol in combination with small narcologically safe doses of opioid analgesics – Codeine, Tramadol and others. Combination drugs surpass Paracetamol in its pure form by their analgesic effect and do not belong to narcotic drugs.

Thanks to several active ingredients, combined analgesics have such effects as:

  • anesthetizing
  • anti-inflammatory
  • spasmolytic (eliminate spasm of smooth muscles and improve blood circulation)

For chronic pain treatment, there are several principles for taking medications. One of them is sequence of application, that is, from weaker drugs to stronger ones. This principle is called a stepwise approach to the use of analgesics.

Depending on the pain severity, systemic analgesic therapy is divided into three stages:

  1. Non-opioid drugs should be used in patients with mild pain.
  2. Low doses of opiates should be used in patients with mild to moderate pain, as well as in those who did not achieve the maximal anesthetic effect with non-opioid drugs.
  3. Therapeutic doses of opiates should be used in patients with severe pain syndrome or in those who are unable to achieve adequate analgesia while using anesthesia scheme of stage 2.

At all stages of alleviating physical and emotional suffering, adjuvant therapy should be used together with analgesics. These are additional methods of treating pain symptoms aimed at increasing effectiveness of pain medication. Adjuvant drugs to reduce pain symptoms can be anxiolytics, antidepressants, antipsychotics, anticonvulsants and other drugs.

If opioid pain medication is used along with non-narcotic drugs and adjuvant therapy, effectiveness of analgesic therapy will significantly increase. An integrated approach to alleviating physical and emotional suffering significantly reduces risk of side effects and complications that can be caused by narcotic drugs.

Many patients, who need pain medication, do not receive adequate pain therapy. This is largely due to an erroneous medical diagnosis or incorrect evaluation of pain severity by the treating physician. The most important condition for alleviating emotional distress is prescription of a drug for regular use, rather than by the patient’s need (i.e., ahead of pain resumption).

Non-pharmacological methods of relieving physical and emotional suffering (relaxing massages, physiotherapy, and moderate physical activity) are very helpful when used along with pain medication.

Pain management

Today, there are many methods of pain management, each of which has its own advantages and disadvantages. The choice of a treatment method for physical suffering is not a simple task, still it remains the factor that influences the time it will take for a patient to get back to his usual way of life.

Pain that has one and the same cause can be perceived by two people in different ways. Therefore, one treatment method will alleviate the suffering of one person, yet it will not always prove effective for another person.

Reporting your pain to the doctor is the first step on the way of its relieving. Therefore, if there is a strong or prolonged pain, you should consult a doctor who specializes in its diagnosis and treatment.

Patients should describe pain in their own words. They should always provide as many details, as possible, even if these seem insignificant to them.

Experienced pain management doctors can determine a diagnosis based on the description of physical suffering and while observing how patients describe them, what emotions they express and what words they use.

Before he makes a diagnosis, the treatment specialist asks additional questions about the pain:

  • Intensity, type, location and strength
  • Time of the onset
  • Factors that affect the intensity
  • Sensory violations
  • Impact on daily activities

Since pain is a subjective sensation of a person, the basis for choosing an effective pain management method is the information, obtained during the survey. Nevertheless, it is necessary to take into account that the information received by the doctor from a patient is not always objective.

Soreness is a natural reaction of the body to various internal and external conditions, so it is very important to determine the cause of its onset. A physical examination, a neurological evaluation, urine, blood or other sample tests will help determine the cause and classify the type of pain.

The overwhelming majority of physical sufferers are relieved or weakened within a few hours. Treatment of pain should occur in parallel, and not instead of treating the causes of soreness. If the disease is incurable, the main purpose of the drug therapy is to reduce suffering.

Management of mild pain

As a rule, the treatment of pain begins with the use of Acetaminophen (Paracetamol). Unlike most other analgesics, Acetaminophen is available at pharmacies without a prescription.

This drug is well tolerated by patients and exerts an analgesic effect that can alleviate mild to moderate pain. Acetaminophen is effective against muscle ache, headache, migraine, as well as physical suffering that are caused by abrasions, sprains, bruises or joint diseases.

If Acetaminophen turns not very effective for pain management, patients can be prescribed non-steroidal anti-inflammatory drugs (NSAIDs). Such drugs are especially often prescribed with swelling, redness, or sports injuries.

NSAIDs effectively reduce pain, yet they cause more side effects, compared to Acetaminophen. The most common side effect is an increase in the production of gastric acid, which can cause stomach ulcer. The risk of ulcers increases with prolonged treatment and use of high doses. If high doses of analgesics do not help or suffering worsens, patient can be prescribed other drugs.

Management of mild to moderate pain

Guidelines for the treatment of patients with moderate pain include the use of more potent drugs than Acetaminophen or NSAIDs. Such drugs are known as weak opioid analgesics and are available in pharmacies only by prescription.

Weak opioid analgesics are used to remove acute or chronic pain, caused by burns, bone fractures and other less common severe injuries. Such drugs can cause addiction and other side effects, so should be used as little as possible.

Weak opioid analgesics can be prescribed in combination with Acetaminophen and reduce pain more effectively, compared to their separate use. Both drugs are taken in lower doses than alone, which reduces the risk of side effects. If treatment is not effective, stronger analgesics are prescribed.

Management of moderate to severe pain

Strong analgesics (opioids) increase tolerance to pain and allow controlling the most intense and unbearable suffering. Drugs of this type work effectively, regardless of whether soreness is of chronic or acute origin.

To avoid problems with toxicity, patients are first recommended to use opioids with a short half-life (up to 4 hours). If the necessary therapeutic effect is achieved, patients can be given strong painkillers of sustained release.

Treatment with opioids is associated with an increased risk of addiction, misuse and substance abuse. Therefore, painkillers of this type are taken under a supervision of an experienced physician, who must address the emotional, physical and psychological aspects.

Pain management clinics specialize in the diagnosis and treatment of various types of pain. The treatment of pain in such clinics is a safe and effective way to regain control of one’s life.

Patients on opioid medications should be warned about possible adverse events, prevention and treatment measures. During the use of such pain relievers, respiratory depression, nausea, constipation, vomiting, dry mouth or dysphoria are most common.

Neck pain relief

Neck pain is one of the most common disease states in people. During life, more than 50% of people had at least one case of discomfort in the neck. Up to 10% of the population at a given time need a neck pain relief.

Pain in the neck is acute and chronic. Acute muscle soreness and discomfort in the neck are evenly distributed between women and men. Chronic soreness in the muscles of the neck (more than 3 months) is less common in men, than in women.

Various methods of treatment are used to reduce muscle ache in the neck, including pharmacotherapy, aerobics, acupuncture and massage. Appropriate methods are chosen based on the causes of soreness.

There are many reasons for neck pain onset, the main of which are:

  • Strain, inflammation or damage to the neck muscles.
  • Wear of the cervical spine.

Damage to soft tissue can be accompanied by pain and stiffness in the neck, as well as in the chest, arms, shoulders and head. Wear of cervical vertebra often leads to the nerves compression. As a result, soreness in the neck can be accompanied by tingly sensation and numbness in the hands or feet.

Discomfort usually increases with frequent turns of the head or energetic physical activity. In a state of rest and stillness, soreness in the muscles of the neck decreases.

Little effort from people can bring a neck pain relief. Massage and exercises for the neck will improve blood circulation and eliminate physical suffering.

If the pain is acute, ice can be applied. Ice effectively reduces discomfort, especially if it is caused by recent soft tissue injuries. Use of tissue or a towel will prevent rapid melting of ice and skin frostbite.

It is recommended to seek help from a doctor if the pain is:

  • very strong
  • more pronounced in the hands, than in the neck.
  • does not decrease or disappear for several days.
  • interfering with daily duties.

Neck discomfort may be a symptom of heavier conditions than muscle strain (e.g., osteochondrosis). If you notice the following symptoms and signs, seek medical help as soon as possible:

  • Pain is accompanied by fever, drowsiness, malaise or difficulty swallowing.
  • Pain is accompanied by weakness of one or both hands.

If physical suffering causes severe discomfort or is unbearable, doctor can immediately recommend using one of the analgesics.

Acetaminophen (Paracetamol) is one of the most commonly used medicines for neck pain relief. Acetaminophen has an excellent efficacy and safety profile. Therefore, it is used to treat neck pain in adults, adolescents and children, including up to 1 year.

Acetaminophen has an analgesic and antipyretic effect and is prescribed to treat mild to moderate pain. Acetaminophen also has an anti-inflammatory effect, which, however, is not as strong as the analgesic or antipyretic effects.

After oral administration, Acetaminophen is relatively quickly excreted from the blood. Therefore, the optimal analgesic effect occurs when this medication is taken up to 4 times a day, at approximately the same time intervals. To treat children, especially small children, it is recommended to use Acetaminophen suppositories.

To control mild to moderate pain, non-steroidal anti-inflammatory drugs (NSAIDs) can be used. The list of known drugs of this type includes

  • Aspirin
  • Naproxen
  • Ibuprofen

NSAIDs cause side effects more often, than Acetaminophen. However, due to the analgesic and anti-inflammatory effect, such medications are often used for short-term treatment of pain, which is caused by strains and injuries of the soft tissues of the neck.

Weak opioid or opioid analgesics can be used to achieve a long-lasting neck pain relief. Drugs of this type are often prescribed for the treatment of chronic pain, including in patients with incurable diseases.

Strong analgesics (for example, Morphine) inhibit signals between nerve cells and reduce physical suffering. The use of such medicines in high doses will help to eliminate the most severe chronic pain in the neck.

Prolonged use of strong analgesics is associated with the risks of appearance and development of dependence. Therefore, when assigning these analgesics, the rate of benefits and potential risks from their use should be carefully assessed.

Morphine and other similar drugs are not often used to treat neck pain. For these purposes, Acetaminophen or NSAIDs are commonly used that allow reducing and controlling pain without side effects.

If a person has discomfort in his neck, he should not rush and start using even the safest drugs. Today, the pharmaceutical industry offers various pain management tools, including the simplest and most inexpensive products.

Neck pain relief pillow will help improve the treatment efficacy and reduce the time of the analgesics use. If such pillows are used when the first symptoms of neck pain appear, you may not have to take analgesics.

Use of a pillow for reducing neck pain will allow to:

  • Provide a high level of comfort throughout the night.
  • Provide a support for the back, neck and head.
  • Prevent strain of muscles and stiffness in the morning.
  • Reduce or stop snoring at night.

People spend about a third of their life sleeping. During rest, it is very important to maintain a correct position of the entire body, including the neck.

Comfortable pillows will provide a good rest, a healthy sleep, as well as protection from strains of the neck muscles. Such pillows will also help to facilitate the treatment of cervical osteochondrosis and other diseases of the spine.

Natural pain relief

Since ancient times, people have collected healing herbs and used them to reduce physical suffering. Knowledge about the healing plants was being accumulated for thousands of years, resulting in a lot of remedies for the natural pain relief.

Despite the great successes observed in modern medicine, traditional medicine makes an important contribution to health care. Today, the analgesic effects of herbs are studied through scientific methods, and their use is considered one of the forms of alternative medicine.

Phytotherapy or botanical medicine is a separate science. It is based on the results of clinical trials, held by public or private pharmaceutical companies.

Thanks to scientific research, people began distinguishing herbs by their effects and other attributes. The appropriate choice of natural analgesics depends on many variables, including pain evaluation:

  • Severity
  • A type
  • Causes
  • Place of occurrence

Typically, medicinal plants are used to treat mild pain. There do exist very powerful natural analgesics, like opioids, but their sale, storage and use is controlled by the relevant government agencies. Such analgesics are available at pharmacies only on prescription.

Plants are a universal solution for natural pain relief. Herbs are used to reduce soreness of a chronic or acute origin.

To control chronic pain, people can use dried herbs. They provide an analgesic effect a few hours after the administration. The effect duration is maintained up to 12-24 hours.

For the treatment of acute pain, it is better to use liquid extracts of herbs. They are well absorbed in the stomach and provides a quick analgesic effect. Creams and gels for external use have the same quick action.

Physical suffering and discomfort manifest for various reasons. The most common of them are:

  • Inflammation of soft tissues
  • Viral and bacterial infections
  • Damage to the skin, bones, ligaments and tendons

Each type of pain has its own set of symptoms, causes, and occurs in people with different frequency. Headache occurs in people very often, for a variety of reasons.

The feverfew plant is one of the best means for a natural pain relief. This plant is effective against chronic headaches. Feverfew is also used to control the symptoms of rheumatoid arthritis.

The extract of feverfew is very bitter and unpleasant to the taste. People, who suffer from migraines, used feverfew extract from ancient times, but reluctantly.

Today, extracts of this plant are supplied in capsules. The use of capsules provides an analgesic effect without an unpleasant bitter aftertaste. Capsules release feverfew in the stomach, which has no taste buds.

Many medicinal plants have a pleasant aroma, like mint, for example. It provides a calming and relaxing effect, and helps with spasmodic headaches.

The healing properties of tea from mint leaves have been known since ancient times. One or more cups of tea consumed quickly calms the nervous system during a migraine attack.

Mint oil is intended for local use. Apply oil to the temples, forehead or wrist to reduce tension and ease the headache.

Many other plants can be used to treat the headache, for example:

  • Basil
  • Lavender
  • Sage

These plants possess different healing properties and are used for various types of pain. For example, rinsing your mouth with sage decoction helps in achieving tooth pain relief very fast.

Natural remedies that contain sage effectively eliminate acute and chronic toothache. Sage will help cope with the toothache, if it is caused by:

  • Destruction of enamel
  • Gum diseases
  • Mechanical damage to teeth

If a patient suffers from teeth problems, and he is unable to quickly get to a dentist, a few more natural remedies can help. These include clove oil, chopped garlic and vanilla extract.

These analgesics are applied directly to the affected tooth or gum. To apply clove oil or vanilla extract, it is better to use a cotton swab. A small amount of chopped garlic can be applied to the gum or tooth using your finger.

Garlic can cause burning, especially if used in large quantities. As a rule, garlic is left in the mouth for several minutes, after which you should rinse your mouth with warm salty water.

Analgesics for topical application are used not only to reduce toothache. If degenerative changes in the spine, musculoskeletal diseases or traumas cause soreness, you can use compresses or creams with natural pain killers.

Relief for back pain can be rapid or gradual. Warm compresses start to work faster than cold ones. Cold compresses are better for treating soft tissue injuries. They provide a mild and prolonged analgesic effect.

In addition to pain alleviation, the use of compresses and creams with herbs allows:

  • Normalizing blood supply
  • Strengthening the muscular corset
  • Reducing the likelihood of injury in the future

St. John’s wort grows in various climatic zones and is one of the most famous plants, used to combat back pain. Remedies with St. John’s wort are effective for the treatment of arthritis, sciatica and neuropathic pain.

If soreness in the back is accompanied by muscle tension, you can use the valerian root alone or together with St. John’s wort. The root of this plant reduces spasms and muscle cramps, and eases the pain.

To reduce pain in muscles, bones and joints, people can add to their compresses other plants with analgesic effect, like celery root, sea buckthorn, cayenne pepper and sunflower root. Having tried various options, people can pick up the best compress for natural pain relief.

Creams that contain extracts of medicinal plants act faster and more efficiently, than the compresses do. Creams are available in many stores or pharmacies, and they are immediately ready for use.