Painkillers have been consumed due to their excellent efficacy, easy access over the counter, and analgesic and antipyretic properties. In the last couple of years, painkillers have been very popular in the pharmaceutical market due to the rising cases of communicable and non-communicable disorders like viral fevers, cancers, cardiovascular conditions, and musculoskeletal disorders. However excess use of these medications can have harmful effects on a healthy person or an immunocompromised individual equally.
According to Dr Amrutha Sajeekumar, Pharm D, MPH, VELS University, in general, painkillers can cause a multisystemic adverse impact on the human body. She suggests that the most common adverse effects are gastrointestinal bleeding, liver failure, renal failure, stomach ulcers, fluid retention, and elevated blood pressure. Painkillers can also cause headaches, drowsiness, dizziness, and in rare cases strokes and heart failure. There are several painkillers available in the market such as Paracetamol, NSAIDs, and opioids.
Paracetamol is considered to be the safest painkiller. Like other medications, these do have side effects like skin rashes, yellowing of eyes and skin, diarrhea, vomiting, tiredness, unusual bruises, and anaphylaxis. However, an overdose of paracetamol results in diarrhea, loss of appetite, nausea, vomiting, tummy pains, and tenderness in the upper abdomen. Severe overdose can cause an irreversible event like permanent liver damage which can only be rectified by a liver transplant. NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) can be taken for a short period as prescribed by the GP. According to the NHS (National Health Services, UK), prolonged use can cause one of the most common side effects which is gastrointestinal injury like stomach ulcers and stomach lining bleeding. The reason for this is that prostaglandins that protect the stomach lining are reduced by NSAIDs putting the gut at risk. As a result, the patient develops abdominal pain, passes black stools, and vomits blood in extreme cases. It can also adversely impact the heart by causing heart attacks or strokes. NSAIDs can also cause asthma and kidney failure if taken in excess. If this happens, it is best to stop the medication immediately and rush to the casualty. If the patient is already on a blood thinner or steroids, it is best to watch out for adverse events and monitor the dosages.
Lastly, opioids are considered the last medications to be given according to the pain management ladder due to their addictiveness and the sense of euphoria the individual gets after taking the medication. Overdose can cause dry mouth, constipation, nausea, vomiting, disorientation, drowsiness, pinpoint pupils, bradycardia, respiratory weakness, blue lips and fingernails. In extreme instances, it can lead to coma and death.
Therefore, painkillers should be used with a lot of caution. GPs should recommend alternative modes of treatment like topical medications, physiotherapy, and hot and cold therapy for joint pain and stiffness. If the patient is not satisfied with this and insists on painkillers, the GPs must advise their patients to use the drug as prescribed and should educate them on the adverse effects of painkillers so that they do not abuse it.
Health systems around the globe should monitor the prescription by doctors and the sale of painkillers over the counter as overdose via painkillers is a public health crisis that should be tackled promptly.
References:
NHS (2022). NSAIDs. Available at: https://www.nhs.uk/conditions/nsaids/ (Accessed on 06/07/2024)
Hudson, R., Adelman, R. (2023). Painkillers. Available at: https://patient.info/treatment-medication/painkillers (Accessed on 06/07/2024)
Tidy, C., Hazell, T. (2023). Anti-inflammatory tablets. Available at: https://patient.info/treatment-medication/painkillers/anti-inflammatory-painkillers (Accessed on 06/07/2024)
Anderson, L.A., (2024). What medications are opioids? Available at: https://www.drugs.com/medical-answers/medications-opioids-3558446/