. . . or Aleve or Motrin?
(Respectively: acetylsalicylic acid, acetaminophen, naproxen, and ibuprofen.)
PLEASE NOTE: THIS IS NOT A POLL
Based on the mechanism by which each of these analgesics works (Is it true that no one really knows how aspirin works?), which one works fastest, alleviates the most pain, and lasts the longest?
Depends on what’s causing the pain. Aspirin and Motrin (Ibuporfen) have the benefit of reducing inflammation, which Tylenol will not do. Different individuals respond to each of these differently, also.
Yeah, what CookingWithGas said. Seems to depend upon the person, and what hurts. For me, aspirin (mainly) or ibuprofen work best for headaches. Tylenol doesn’t seem to do anything for me. Additionally, acetominiphen, I’ve heard, is not good for people with liver issues. I try to stick to aspirin.
Also, caffeine is used in Excedrin. I believe that is used as a vasodialator to help ease headaches.
We know how aspirin works. It’s a cyclo-oxygenase inhibitor, which prevents the formation of inflammatory mediators such as cytokines.
Cytokines and other inflammatory mediators sensitise neurons to pain, and cause inflammation.
All NSAIDS work in a similar manner, some having stronger analgaesic effects, and some having stronger anti-inflammatory ones.
So, basically it depends on the cause of the pain, if it’s from inflamed sinuses, I’d take aspirin or ibuprofen, if it’s a hangover, paracetamol (acetominophen).
For migraine, ergotamine derivatives and an anti-emetic.
For moderate pain, ibuprofen plus a central analgaesic like codeine is probably
argh…
Is probably the most effective option.
Personally, I find Advil to be a miracle worker. It, too, is ibuprofen (I think!).
Anyway, Tylenol never works for me, but pop a couple Advil and within 30 minutes, the headache is completely gone. Brilliant, brilliant little pill.
People!
NSAIDS take time to reduce inflammation. One must take ibuprofen (motrin, etc.) at least 3 times a day for a few weeks to appreciate the anti-inflammatory effect. It does however reduce pain quickly after one dose. Whether it reduces it better than acetaminophen (tylenol or APAP) is a very individualistic thing.
BTW: Caffiene is a vaso-constrictor, not a vasodilator.
And watch the codiene here in the states. It’s a Controlled Substance, and unauthorized use can put you in trouble.
QtM, MD
Sorry.
QTM you’re right, but codeine plus ibuprofen is an OTC medication here, which I am very grateful for as it knocks my cramps down from agonising to bearable.
I get pretty bad headachs and aI would have to say that Aleve works best for those and works the best for me for cramps. now, if I have just minor pain then I usually take advil 
My two cents. (What do RN’s know anyway, we just give the stuff and see how it work, then bug the doctor when it doesn’t…)
Acetaminophen is prescribed the most for general pain relief, unless there is some obvious inflammatory process (arthritis, for example) a doctor will just increase the doseage or add codine to the mix ( Tylenol #3)
But NSAIDS like asprin, ibuprofen, naprosyn, etc are effective anti inflammatories that in some people and some cases are much more effective. Depends on the person and the cause. I would never take Tylenol for menstrual pains, naproxyn (Aleve) is much more effective. When I had no Aleve and I had an abcessing tooth, I took Ibuprofen alternating with Tylenol #3(by prescription) and the combination worked better than either alone.
Of course with Tylenol you get the liver cautions, and with the NSAIDs you get the gastric upset/potential for bleeding.
So no real answer, just anecdote. Sorry.
Out of curiosity are there any NSAIDs that are prescription.
I ask cause I took Orudis and it NEVER worked. When I pulled my calf I took a prescription dose and WOW it worked so quick so fast and effective.
I had tooth pulled and my dentist told me to take 4 ibuprophen and it was OK but I took my Orudis at prescription and boom knocked it out.
I noticed at the recommended dosage 1 pill it does nothing.
In the US, many NSAIDS are prescription only, and some are non-prescription when taken in recommended doses, such as naproxen, ibuproven, and ketoprofen. BTW, the OTC recommended doses generally are NOT anti-inflammatory doses. Higher doses (in one pill) are available by prescription for these.
The prescription only ones (and I may be wrong, I frequently am) include sulindac, toradol, diclofenac, vioxx, celebrex, and indocin among others.
And if aspirin came out today, it would probably not pass FDA muster, as its side-effect profile (for anti-inflammatory doses) is much higher than most others.
EEK! :eek:
There is some fairly compelling evidence that taking Tylenol (paracetamol), even ONCE after a lot of drinking is enough to cause some pretty serious liver damage in some people.
Docs here advise strongly AGAINST Tylenol as a cure for a hangover for exactly this reason.
I’m sure I can find a cite somewhere - the research is fairly recent, but it was certainly compelling enough for a number of advisories to be issued.
Just as FYI.
EEK! :eek:
There is some fairly compelling evidence that taking Tylenol (paracetamol), even ONCE after a lot of drinking is enough to cause some pretty serious liver damage in some people - as in liver failure. As in you need a transplant.
Docs here advise strongly AGAINST Tylenol as a cure for a hangover for exactly this reason.
I’m sure I can find a cite somewhere - the research is fairly recent, but it was certainly compelling enough for a number of advisories to be issued.
Just as FYI.
Here we go:
Authors
Draganov P. Durrence H. Cox C. Reuben A., Alcohol-acetaminophen syndrome. Even moderate social drinkers are at risk. Postgraduate Medicine. 107(1):189-95, 2000 Jan.
Schiodt FV. Lee WM. Bondesen S. Ott P. Christensen E. Influence of acute and chronic alcohol intake on the clinical course and outcome in acetaminophen overdose. Alimentary Pharmacology & Therapeutics. 16(4):707-15, 2002 Apr.
Agarwal R. Farber MO.Is continuous veno-venous hemofiltration for acetaminophen-induced acute liver and renal failure worthwhile?.Clinical Nephrology. 57(2):167-70, 2002 Feb.
So, from a quick glance at Medline, it looks like those folks that drink on a regular basis should avoid Tylenol for a hang-over, and those that drink occasionally should perhaps avoid it for a hang-over too.
Hey all,
I’ve been lurking here for several years & finally decided to post. While I can’t answer the OP, there are a few subsequent points that should be cleared up.
In the late 70s, Sir John Vane (Nobel Prize in Medicine, 1982) discovered that aspirin attenuated inflammation via the inhibition of cyclooxygenase (COX). To date, three isoforms of COX have been identified (COX1, COX2, and COX3). Aspirin inhibits both COX1 and COX2 (as does ibuprofen, but via a totally different mechanism). Unfortunately, while this has anti-inflammatory effects, it is also responsible for the gastrointestinal problems (e.g. gastric erosions) associated with NSAIDS. The mechanism of action of acetaminophen, on the other hand, is not well understood. It is believed that it may inhibit COX3, which seems to be selectively expressed in the brain.
This is a little misleading. Cyclooxygenases catalyze the formation of prostaglandin H2 (PGH2), which can then be used as a substrate to produce various other prostaglandins and thromboxanes. And yes, the inhibition of COX1 and COX2 can lead to the inhibition of various cytokines. However, this is a gross oversimplification of what’s going on. Whether a given prostaglandin or cytokine (and there’s LOTS of them) acts in an anti- or pro-inflammatory manner is dependent on its concentration, location, the cell type secreting it, and a whole host of other factors.
This is sort of true. However, the new players in the field, Celebrex and Vioxx, are selective COX2 inhibitors. The thinking is that, because COX1 is constitutively expressed while COX2 is upregulated during inflammation, that inhibiting COX2 but not COX1 will attenuate inflammation while sparing the GI tract. Of course, things are not nearly as simple as that. Pfizer covered up the fact that Celebrex does not differ from conventional NSAIDs in its GI toxicity. Merck covered up the fact that Vioxx can cause serious thrombotic events. But hey- whatever makes a buck.
Sorry for this long-winded post, but it’s an area in which I’m interested. Bottom line: inflammation is your body’s way of trying to deal with a problem. If the problem is as simple as a headache, I suggest you stay away from NSAIDs entirely. Works for me.
-Apoptosis
Here are a few links (although I would really recommend looking for papers by J Vane or J Wallace on PubMed):
Basic stuff- http://www.nsaid.net/
Pfizer lies (scroll down a couple pages)- http://www.who.int/medicines/library/pnewslet/3news2002.pdf
Merck lies (page 13)-
http://www.who.int/druginformation/vol16num1_2002/vol16-1.pdf
Sorry to post again, but I just noticed this:
Heh heh- it’s great to see our doctors have such faith in the FDA. Celebrex and Vioxx were approved VERY quickly and are doing damn well for themselves. Too bad their safety profiles are no better (and are probably actually worse) than that of aspirin.
Here’s a decent cite-
-Apoptosis
Interesting thread. For someone with limitations on these drugs, what would be a solution?
Aspirin and ibuprofin (Advil) give me gastro-intestinal problems, and I had infectious hepatitis (hep-B IIR) after a stay in Mexico.
Aleve is recommended for not oftener than once in 12 hours. Is it an NSAID?
I use acetaminophen, or caffeine, or sugar, for headaches.
I would like to use low-dose aspirin for heart health, and because it may fend off Alzheimer’s.
Any helpful comments? or should I ask my doc on the next appointment–probably wise to warn in advance I will ask this question.
Footnote: my GI gastric reflux/soreness/hiccups cleared somewhat upon avoiding caffeine, but results were quicker and better with sipping cool water throughout the day for about five days–the idea being to cool off the stomach and reduce its irritation and secreting of acids. Free home remedy FYI.
Hi MaryEFoo!
I am not a physician- this is definitely an area you should ask him/her about. Having said that, here’s some info:
Aleve contains the NSAID naproxen, which was actually used as a control drug during the Vioxx trials. As naproxen inhibits COX1 and COX2, it can lead to gastric ulceration (just as ibuprofen and aspirin can).
It’s good to hear you’ve kept the reflux under control. However, please remember that drinking cool water is not going to prevent gastric erosions!
Finally, low-dose aspirin does indeed possess cardioprotective properties. However, patients already taking COX2 inhibitors (e.g. Celebrex) should be VERY cautious about concurrent low-dose aspirin. Please talk to your doctor about this, as the synergistic gastric toxicity is disturbing (see my WHO links above).
I should probably mention at this point that I have no personal vendetta against NSAIDs. They are extremely important in managing pain caused by various inflammatory conditions. However, as with all drugs, the drawbacks need to be measured against the benefits. For instance, an arthritis patient considering switching from a conventional NSAID to Vioxx has to ask themselves this: “what would I rather deal with: gastric ulcers or myocardial infarction?”
-Apoptosis