Time: early 21st century
Setting: Department of orthopedics, XX Hospital
Characters: an orthopedic doctor and his dear patient
Scene one: pain relief without addiction
“…” (the previous text is abbreviated, which is supplemented by the officials themselves)
“In this way, I’ll give you some ibuprofen. This medicine can relieve knee pain, and the effect is quite obvious.”
“Wait a minute, doctor. What’s this, ibuprofen, a painkiller?”
“Yes, what’s the matter?”
“Won’t you be addicted to this medicine?”
“No, what are you talking about?”
“Isn’t this the same kind of drug as morphine or codeine?”
“Why? It’s a big difference. “
“Aha? What’s the difference between them? “
“Don’t worry, just listen to me…”
The doctor said:
Morphine and codeine are opioids. This kind of medicine has excellent analgesic effect, but also can calm, antitussive, antidiarrheal, has high clinical application value in medicine, but generally only used to relieve severe pain such as cancer pain, as well as stubborn severe cough.
Because of its excessive use, it will produce acute poisoning, such as coma, needle pupil, cyanosis, shallow breathing, and decreased blood pressure (naloxone for rescue); Withdrawal reaction is easy to occur when drug withdrawal; And there will be constipation and other adverse reactions, which are listed as controlled drugs. Most importantly, because of its strong addiction, it is often prohibitive.
Non steroidal anti-inflammatory drugs
Ibuprofen, also known as Fenbid, ibuprofen and so on, is a more commonly used non steroidal anti-inflammatory drug. Ibuprofen also has analgesic effect, but the analgesic effect is relatively weak, but at the same time, because of its non addiction, low toxicity, less side effects, it is widely used in the treatment of headache, toothache, joint muscle pain, dysmenorrhea and other chronic pain; Because of its convenient, safe and effective use, it can be used as an analgesic for children’s burns; In addition, ibuprofen can effectively relieve the pain caused by anal surgery. In addition to ibuprofen, common NSAIDs include aspirin, paracetamol, diclofenac, indomethacin, rofecoxib, celecoxib, etc. Another popular science, ibuprofen is an OTC drug (over-the-counter drug). Patients can buy ibuprofen by themselves in pharmacies, which is enough to see that ibuprofen is safe and convenient.
You must ask, what is NSAID? This steroid is a kind of chemical structure. Here, it looks like this——
To tell you simply and rudely, it is composed of four rings (three benzene rings + one pentane ring) and three bars on the head. The overall shape is especially like the word “steroid”, so this structure is called “steroid”. It doesn’t matter if you don’t quite understand it. Just know about it.
Steroidal anti-inflammatory drugs
Non steroidal anti-inflammatory drugs (NSAIDs) are mainly different from anti-inflammatory drugs with steroidal structure, that is, steroidal anti-inflammatory drugs. Steroidal anti-inflammatory drugs are mainly steroid drugs, among which glucocorticoids are the most common. Glucocorticoid is a kind of adrenocortical hormone, which is secreted by the columnar cells in the middle layer of adrenal gland. It can inhibit the expansion of blood vessels, reduce edema and play an anti-inflammatory role.
Glucocorticoids used in clinic include natural products and synthetic drugs. The common ones are short acting cortisone and hydrocortisone, medium acting prednisone and prednisolone, and long acting dexamethasone and betamethasone.
These drugs can inhibit the thermoregulatory center, and can play a better antipyretic effect. This kind of medicine can also be used to relieve pain, but it has less effect and is not its main function.
Doctors generally don’t prescribe glucocorticoid drugs easily, because long-term use of such drugs will inevitably produce more side effects, such as: 1) destruction of lymphocytes, so that the human body’s immunity is reduced; ② It leads to the disorder of fat metabolism and the appearance of “centripetal obesity”, that is, “full moon face, buffalo back”; ③ Promote gluconeogenesis, promote glycogen decomposition, inhibit glycogen synthesis and increase blood glucose; ④ Promoting gluconeogenesis, that is, transforming non sugar substances into sugars, including proteins. Due to promoting the decomposition of proteins, long-term use of these drugs will inhibit wound healing.
To sum up, the most suitable analgesic is non steroidal anti-inflammatory drugs, which can relieve pain without addiction and has less side effects.
Scene 2: pain relief, but not just pain relief
(the following dialogue continues)
“Oh, I see. But, doctor, this ibuprofen can only relieve pain, only treat the symptoms but not the root cause. It has no therapeutic effect. Is it really worth using it? “
“It seems that you have fallen into another misunderstanding. Ibuprofen is a commonly used analgesic, in people’s subconscious, its role is simple pain. But listen, ibuprofen is a non steroidal anti-inflammatory drug, so… “
“So it’s also anti-inflammatory!”
“You’re right this time.”
Ibuprofen, since it is called non steroidal anti-inflammatory drugs, then this kind of drugs must have a very important function, that is anti-inflammatory. Prostaglandins are important inflammatory factors. The release of prostaglandins can cause tissue congestion and edema. The release of prostaglandins is inseparable from cyclooxygenase, and ibuprofen plays an anti-inflammatory role by inhibiting cyclooxygenase and reducing the synthesis of prostaglandins.
Ibuprofen can also inhibit the production of prostaglandin E in hypothalamus and stimulate the production of endogenous “cryogen” in human body, so it also has antipyretic effect. Bloven is often used for have a fever caused by common cold or influenza. Ibuprofen is the first choice for the treatment of fever in children because of its low side effects and safety.
Ibuprofen can also treat the pain caused by rheumatoid arthritis and osteoarthritis, and has good effect in the treatment of low back and leg pain, cervical spondylosis and shoulder pain. This effect also has high clinical significance in orthopedics. However, it should be noted that ibuprofen is not effective in the treatment of pain caused by nerve compression.
In conclusion, the clinical application value of ibuprofen includes antipyretic, analgesic, anti-inflammatory and anti rheumatic.
Scene 3 pain relief but not abuse
“Ah! This ibuprofen is really a good medicine. I have to prepare more
“Don’t mention it. I haven’t finished yet. Humanitarianism is: it’s a drug with three poisons. This ibuprofen is good, but if you abuse it indiscriminately, the side effects will be enough for you. “
“Oh, I’m not thoughtful again. I’d like to hear more about it.”
As a whole, ibuprofen has less side effects, but there are still some adverse reactions to a certain extent.
① Digestive tract: peptic ulcer, gastritis, diarrhea, dyspepsia, nausea and vomiting, etc（ Use with caution for patients with poor gastrointestinal function)
② Skin: nonspecific rash, urticaria, pruritus, bullous rash, etc.
③ Central nervous system: dizziness, headache, insomnia, vertigo, severe can appear coma.
Cardiovascular system: induce water and sodium retention, aggravate heart failure, and cause tachycardia. * Caution for patients with heart disease)
⑤ Respiratory system: can cause asthma.
Metabolism can alter glucose metabolism, induce or aggravate diabetes.
Note: ibuprofen should be used with caution in patients with the above basic diseases.
This article focuses on people’s concerns about the use of ibuprofen and other painkillers, and explains that ibuprofen is not addictive. In addition to the non steroidal anti-inflammatory drugs belonging to ibuprofen, the other two kinds of related drugs are analyzed and explained to readers. A large part of ibuprofen’s role is to relieve pain, but in addition to pain, it can also relieve fever, anti-inflammatory, anti rheumatism, clinical application is more extensive. Although ibuprofen is convenient and safe to use, we should be alert to its possible side effects. This is the end of science popularization. I wish you good health
Ibuprofen, an anti-inflammatory and analgesic drug, is often used in orthopedic patients with low back and leg pain
Time: early 21st century