OTC Painkillers - Use With Care

The two most commonly used over-the-counter pain relievers are acetaminophen (Paracetamol, Tylenol) and nonsteroidal anti-inflammatory drugs or NSAIDs (Aspirin, Ibuprofen, Aleve). There are many types of OTC painkillers marketed under different brand names with different prices, but there is no evidence that more expensive pills works better than cheaper ones.

Acetaminophen

Tylenol and Paracetamol belongs to the acetaminophen class. This type of drugs reduce pain and fever, but it does not have reduce inflammation and swelling. They are generally used to treat minor pain like tension headaches, influenza, and in chronic conditions where no inflammation is present.

Acetaminophen is metabolized in the liver and kidney. Therefore, people with liver and kidney condition or those who drinks alcohol should avoid taking it. Interaction with other medications like blood thinners and birth control pills also warrant precaution. Because acetaminophen is a common component in cough mixtures and in prescription medication, people often don't realize that they are taking products containing the same ingredient, resulting in overdose.

"People often don't realize that they are taking products containing the same ingredient."

Taking as little as 10-15 g of acetaminophen in 24 hours can cause life threatening liver damage which may not be apparent for 4-6 days. Symptoms of overdose includes nausea, vomiting, stomachache, kidney failure, and brain damage. Even though initial symptoms are not significant, patients should seek immediate medical attention.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

NSAIDs relieve pain and is especially useful in reducing inflammation. There are three types of NSAIDs available for purchase without prescription: aspirin (Anacin, Bufferin, Empirin), naproxen (Aleve), ibuprofen (Advil, Motrin, Excedrin). Naproxen is more long-acting than aspirin and ibuprofen.

The most concerning side effect of NSAIDs is stomach bleeding. Symptoms includes black tarry stools, abdominal pain, or vomiting blood. Long term use may also cause kidney problems, even more prevalent than that caused by acetaminophen. That's why acetaminophen is a safer choice for chronic usage.

Children under 18 years old should not take aspirin because of the risk of developing Reye Syndrome, a potentially fatal condition. Aspirin also increases the risk of bleeding in people undergoing surgery. So be sure to tell your dentist or doctor that you take aspirin before they perform any procedure.

Understanding Hypertension (High Blood Pressure) Part 2: About Treament

Continuing from Part 1: How high is high? This entry is all about the treatment of hypertension.

What is the goal of hypertension treatment?

The goal of treatment is to reduce blood pressure to <140/90 mmHg in otherwise healthy subject and to <130/80 in patients with diabetes or chronic kidney disease. Even though lifestyle modification is an important part in the treatment plan, most people with high blood pressure will require medication to achieve this goal.

Lifestyle modification

Lifestyle modification, however, remains as the first and most critical step in managing hypertension. Examples of changes you can try to help reduce your blood pressure are as follows:

• Eat healthy diet, including the DASH (Dietary Approaches to Stop Hypertension) diet which consists eating more fruits and vegetables, reduce fatty foods and eating less red meat.
  

  

  reduce salt intake

  Reduce the amount of sodium in your diet to less than 1500 milligrams a day (less than two-third teaspoon of salt).
• Try to lose some weight if you are overweight or obese.
• Quit smoking.
• Exercise regularly, especially aerobic exercise such as brisk walking or jogging at least 30 minutes a day
• Limit alcohol consumption to two drinks a day for men and one drink a day for women. Drinking red wine in a small amount helps maintain cardiovascular health due to its antioxidant properties.

Medications

If lifestyle modification fails to control the blood pressure, then starting medication is the next step. Depending on the stage of your hypertension, usually your physician will start giving a single drug or a combination of two drugs. Diuretics (a type of drug that makes you urinate a lot) are almost always the first choice regardless what your initial condition is. Listed below are the common medications for hypertension:

take your medicine regularly

• Angiotensin-converting enzyme (ACE) inhibitors 
• Angiotensin receptor blockers (ARBs)
• Alpha blockers
• Beta blockers
• Calcium channel blockers
• Central alpha agonists
• Diuretics
• Renin inhibitors
• Vasodilators

The most important thing to be aware of when you're starting medication is to always remember to monitor your blood pressure regularly to avoid sudden drops in your blood pressure.