Everyday pain management ideas

As a young pharmacist, I remember the popularity of codeine containing products--Tylenol® With Codeine, Empirin® with Codeine, and many formulations of cough syrups with codeine.  But as the years have gone by,  the rationale for using these products has fallen by the wayside. First of all, codeine in and of itself is a prodrug. It does not have any pharmacological effect until it is converted by bodily enzymes into morphine, its active form.  Due to genetic variability some people do not possess the enzyme that is responsible for this conversion. When these persons are ordered codeine containing products for pain, or for cough, it does not provide analgesia or cough suppression. Conversely, there are also " ultra-rapid metabolizers " of codeine--in this group, codeine is very quickly converted to morphine, so quickly in fact, that the effect can result in toxicity. Since the medical field does not genetically test people routinely to see who can or can't met...

Do you have medications that you are no longer using in your medicine cabinet?  It might be a good idea to have a look. No one wants a young child or potential addict to have access to these things! My suggestion to you is twofold: If the medications are still in date , consider donating them to a free clinic.  It's always a nice "pay it forward" for someone who can't afford a medication but could really make use of it. If the medication you have is outdated , the FDA has suggestions for you on how to get rid of it. Here is their advice on medication disposal: Source:FDA

The topic for today is NSAIDS.  I hope you know what this acronym stands for, and I hope you know even more about the topic after you read this post! First off, NSAID is an acronym that stands for Non Steroidal Anti-Inflammatory Drug.  This class of drugs has flooded the marketplace in the last twenty or thirty years.  If you don't know the term NSAID, you might be aware of some of the brand or generic names of these drugs, including Aleve®, Naprosyn®, Motrin®, naproxen, and ibuprofen.  But there are many more. These drugs are very effective at reducing fever, pain and inflammation.  But there is more to the story... I came across a survey in recent news...in a poster session at the recent PAINWEEK conference in Las Vegas, authors cited survey results that were truly shocking.  Forty-seven percent of a responders to a small online survey did not know what an NSAID was, including forty percent of responders who reported that they had taken pain med...

A new study published in JAMA ( Journal of American Pediatrics) tells us that pregnant women who took Tylenol® (or its active ingredient--acetaminophen)--had an increased risk of delivering a child with hyperactivity issues. This drug is still relatively safe to take...the researchers say that using acetaminophen products during gestation may ward off more significant problems--for example, if it is being used to reduce fever! So the bottom line here is simply this: There's no reason to avoid these products altogether during pregnancy, but it doesn't hurt to err on the side of caution! You can see the ABC news report on this topic by clicking here . Sources: ABCNews; Flickr

Many patients who are diagnosed with rheumatoid arthritis (RA) find themselves on a serious, and intensive medication regimen..and while these are definitely effective, it's good to know that sometimes there are alternative choices.  If effective, alternative remedies can save a patient from side effects and drug interactions and can be cost saving as well. Fish oil capsules Here is one example of an alternative treatment that can be effective.  Fish oil has been studied in patients with existing RA back in the 1990s and found to be minimally effective. But in the past year, an Australian study, published in Annals of Rheumatic Medicine. The study compared the use of high dose fish oil , low dose fish oil, and standard treatment regimens in patients who had RA for less than one year.  Those patients who were on the high dose fish oil regimen were less likely to progress to more advanced forms of treatment, and seemed to score better on remission assessments th...

If you look around this blog, you will clearly see that I believe opioid medications should NOT be a first line treatment for chronic pain conditions.  Today I would like to raise a few points as to why I think this is the case.  I know there are many people who use this form of therapy for chronic pain and who would refute my arguments. Perhaps for them this post is too little, too late. But for those of you who are contemplating various treatment modalities, here is what I'd have to say... During the 1990's physicians believed that patients using opioid medications for pain would not have problems of addiction if they took medications as prescribed.  In the years that have passed since then, we have learned that this is not really the case.   Addiction can develop very rapidly. According to the Cleveland Clinic, there are 15,000 to 18,000 deaths per year in the U.S. due to overdoses. There are also a number of side effects associated with opioid usage,...

For the 14% of Americans who suffer from migraine headache, remedies come in many forms. There are prescription devices and medication  of many sorts on the marketplace; over-the counter medications such as Tylenol or Excedrin Migraine are the product of choice for others. For yet another group, there's nothing more effective than lying in a dark quiet room and waiting for the storm to pass. One study claims that use of peppermint oil may be just what the doctor ordered.   A product known as Stopain Migraine (a menthol gel formulation) was studied at Thomas Jefferson University.  This may not be a treatment of choice for everyone. For example, if a person becomes sensitive to aromas during a migraine attack, this may not be a good option.  On the other hand, peppermint is a pretty benign substance.  Also, there is no rebound headache following use--which can be a problem with some other treatment options. Sources: StopainMigraine.com; Foxnews.com; Wi...

Whether you are a chronic pain patient, or anyone else for that matter, here is some food for thought. Every medication known to us has the potential to present us with at least three types of problems-- 1) Medications can interact with other medications in a person's system. 2) Medication can interact with foods that people eat. 3) All medications have side effects . Let me elaborate a bit: Medications can interact  with other medications  in a person's system. Many drugs have the potential to interact with other drugs; it's probably a lot more common than one might believe.  A common reason for this type of problem occurs when both drugs in question are metabolized in the liver, commonly through the cytochrome P-450 system.  In this scenario, both drugs are competing for the same enzyme, and usually one drug will predominate.  This results in a change of effectiveness and/or drug toxicity for one or all of the drugs involved.  The opioid d...

I have had a thyroid problem for years. I was diagnosed as hypothyroid (low levels of thyroid hormone) about thirty years ago.  Once I started taking medication and following up regularly, things were great for a long time. Then, after menopause, I started having problems again.  At that point, my levels were abnormal because of all the changes a woman's body undergoes at this point in life.  In case you are uninformed about the problems caused by thyroid imbalance, here is a short list...it's incomplete but it will give you the idea: Symptoms of Hypothyroidism                                          Symptoms of Hyperthyroidism  ( underactive gland)                                                           ...