Pain Killers

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1. Acetaminophen (Tylenol, Paracetamol)

  • Form: Tablet, capsule.
  • Availability: Over-the-counter (OTC).
  • Use: Mild to moderate pain relief, fever reduction.
  • Effects on Health:
    • Liver: High doses (over 4,000 mg/day) or chronic use can cause serious liver damage.
    • Kidneys: Generally safe for kidneys at recommended doses.
    • Stomach: Minimal effects, does not typically cause gastrointestinal issues.

2. Ibuprofen (Advil, Motrin)

  • Form: Tablet, capsule.
  • Availability: Over-the-counter (OTC); higher doses are prescription-only.
  • Use: Inflammatory pain, headaches, muscle aches, arthritis, fever.
  • Effects on Health:
    • Liver: Minimal effect at recommended doses.
    • Kidneys: Long-term or high doses can lead to kidney damage, especially in those with pre-existing kidney conditions.
    • Stomach: Can cause irritation, ulcers, and bleeding in the stomach lining, especially with prolonged use.

3. Naproxen (Aleve, Naprosyn)

  • Form: Tablet, capsule.
  • Availability: Over-the-counter (OTC); higher doses available by prescription.
  • Use: Inflammatory pain, arthritis, muscle aches, menstrual cramps.
  • Effects on Health:
    • Liver: Low risk to the liver at recommended doses.
    • Kidneys: Long-term use can lead to kidney damage or failure, especially in individuals with pre-existing kidney problems.
    • Stomach: Similar to ibuprofen, it can cause stomach ulcers, irritation, and bleeding.

4. Aspirin (Bayer, Ecotrin)

  • Form: Tablet, capsule.
  • Availability: Over-the-counter (OTC); low-dose aspirin is often prescribed for heart conditions.
  • Use: Pain, fever, anti-inflammatory; low-dose aspirin is used for cardiovascular protection.
  • Effects on Health:
    • Liver: Minimal impact on the liver at normal doses.
    • Kidneys: Prolonged use may impair kidney function in susceptible individuals.
    • Stomach: High risk of gastrointestinal irritation, ulcers, and bleeding with long-term use.

5. Diclofenac (Voltaren, Cataflam)

  • Form: Tablet, capsule.
  • Availability: Prescription only in many countries; topical forms are available OTC.
  • Use: Moderate to severe inflammatory pain, arthritis.
  • Effects on Health:
    • Liver: Rarely causes liver toxicity.
    • Kidneys: Prolonged use can lead to kidney problems, similar to other NSAIDs.
    • Stomach: High risk of gastrointestinal side effects, including ulcers and bleeding.

6. Celecoxib (Celebrex)

  • Form: Capsule.
  • Availability: Prescription only.
  • Use: Arthritis, inflammatory pain, and chronic pain conditions.
  • Effects on Health:
    • Liver: Low risk of liver damage.
    • Kidneys: Similar risks to other NSAIDs, with possible long-term kidney damage.
    • Stomach: Lower risk of stomach ulcers compared to traditional NSAIDs, but still a risk.

7. Tramadol (Ultram)

  • Form: Tablet, capsule.
  • Availability: Prescription only.
  • Use: Moderate to severe pain, often used when NSAIDs are ineffective.
  • Effects on Health:
    • Liver: Metabolized in the liver but generally safe unless taken in very high doses.
    • Kidneys: Can accumulate in those with kidney failure, requiring dose adjustment.
    • Stomach: Less gastrointestinal irritation compared to NSAIDs.

8. Codeine

  • Form: Tablet, capsule (often combined with acetaminophen or aspirin).
  • Availability: Prescription only (some low-dose formulations available OTC in certain countries).
  • Use: Moderate pain relief, often combined with other analgesics.
  • Effects on Health:
    • Liver: Can be dangerous when combined with acetaminophen due to the risk of liver toxicity.
    • Kidneys: Requires dose adjustment in kidney impairment.
    • Stomach: Can cause nausea, vomiting, and constipation but generally less harmful to the stomach lining than NSAIDs.

9. Oxycodone (OxyContin, Percocet [combined with acetaminophen])

  • Form: Tablet, capsule.
  • Availability: Prescription only.
  • Use: Severe pain relief, often post-surgical or in cancer patients.
  • Effects on Health:
    • Liver: Risks are higher when combined with acetaminophen (Percocet) due to potential liver toxicity.
    • Kidneys: Safe for short-term use but may require dose adjustments for those with kidney disease.
    • Stomach: Less gastrointestinal side effects compared to NSAIDs but can cause constipation.

10. Morphine

  • Form: Tablet, capsule.
  • Availability: Prescription only; hospital use for severe pain.
  • Use: Severe pain management, often for chronic conditions or post-surgery.
  • Effects on Health:
    • Liver: Metabolized by the liver but generally does not cause liver damage.
    • Kidneys: Dose adjustments needed for those with kidney impairment; can accumulate in the body.
    • Stomach: Can cause nausea, vomiting, and constipation, but no significant impact on the stomach lining.

11. Hydrocodone (Vicodin [combined with acetaminophen])

  • Form: Tablet, capsule.
  • Availability: Prescription only.
  • Use: Moderate to severe pain, often post-surgical.
  • Effects on Health:
    • Liver: Risk of liver damage when combined with acetaminophen (Vicodin).
    • Kidneys: Adjustments needed for those with kidney disease.
    • Stomach: Causes fewer stomach issues than NSAIDs, but constipation is a common side effect.

12. Ketorolac (Toradol)

  • Form: Tablet, capsule (also available as an injection for hospital use).
  • Availability: Prescription only; used for short-term pain management, often in hospitals.
  • Use: Severe pain, post-surgery.
  • Effects on Health:
    • Liver: Rarely causes liver damage.
    • Kidneys: High risk of kidney damage, especially with prolonged use.
    • Stomach: High risk of gastrointestinal ulcers and bleeding; typically limited to short-term use (5 days max).

Summary of Organ Effects

  • Liver: Acetaminophen-containing medications carry the highest risk of liver damage, particularly at high doses.
  • Kidneys: NSAIDs like ibuprofen, naproxen, and diclofenac can lead to kidney damage with long-term use, especially in those with pre-existing conditions.
  • Stomach: NSAIDs also have the highest risk of stomach ulcers, irritation, and bleeding. Opioids like oxycodone and morphine have fewer gastrointestinal effects but can cause constipation and nausea.

  

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