Old people and drugs, painkillers, part 9

PRISCUS series: pain and inflammation relieving drugs

Around 1.5 billion people worldwide suffer from chronic pain. Pain and anti – inflammatory drugs to provide relief and are one of the most commonly used drugs at all.

Advancing age brings with it automatically the wear and tear of the body. Particularly in the knees and hips symptoms can occur, since a majority of the weight on the joints blamed. The cartilage to protect the joints, has worn out among seniors, in the course of life. Painful consequences are often rheumatic diseases such as osteoarthritis. The protection of the cartilage is not granted, cause the bones to RUB on each other and the leads to in addition to inflammation.

What is the effect of such drugs?

To pain when the joints begin to this leads to insurmountable obstacles in everyday life such as dress Shoes. To remedy the situation, there are drugs with different approaches. So-called non-opioid analgesics act directly on the spot and cause the messenger substance Prostaglandin is no longer manufactured, the sends otherwise pain signals to the brain. The result is: The pain “disappear”. Known substances that inhibit pain, reduce or disappear, are acetylsalicylic acid (Asa), Ibuprofen or Paracetamol.

The second approach to pain relief, the influence of the Central nervous system in pain processing. It is made by opioids, analgesic, related to Morphine or morphine. The opioids bind to the receptors in the body, which in the Central nervous system (brain and spinal cord) and the peripheral nervous system (nerve cells outside the spinal cord). Opioids are the strongest pain relievers. They are difficult to dose and can be used only in the case of particularly severe pain.

What are the difficulties in taking these pain relievers at the problems older people?

In principle, the elderly tolerate the drugs worse rather than younger people. The excretion of harmful substances through the kidney is no longer as fast as it used to, medications remain in the body longer and can cause side – effects that implies. Also, the group of the pain and anti-inflammatory agents is not free of side effects. Particularly in the stomach and in the intestinal tract can lead to bleeding. Also, the increase in blood pressure and water retention are not uncommon, particularly affect people with a weak heart.

In the case of opiates, the focus is directed on the dosage. Known side effects are drowsiness and impaired mental abilities. Therefore, a strict Surveillance is in application is essential. Special care is required in the case of pethidine, the drug increases the risk of falling.

What are the Alternatives?

Pain and inflammatory agents belong to a large group of medicines, to which there are a variety of Alternatives. So many journals, reference lists, with the natural painkillers, which have no harmful side effects. So can natural plants such as the devil’s claw, willow bark and Arnica are already good Alternatives to Aspirin, and co. be.

For more information about the Priscus-list, and free order from: https://www.bundesregierung.de/Content/Infomaterial/BMBF/Medikamente_im_Alter_pdf_1742.html

 

Active ingredient	When used	Side effects	Alternative Active Ingredients
Indomethacin Acemetacin Ketoprofen Phenylbutazone Piroxicam Meloxizam Etoricoxib	Pain, Inflammation	Increased risk of bleeding in the stomach or intestine in growing age	Paracetamol   Other non-steroidal anti-inflammatory Drugs (e.g. Ibuprofen, Diclofenac)   Dipyrone (after careful Benefit-risk assessment)   Weak opioids (e.g. Tramadol, codeine)
Pethidine	Strong to severe pain	In the elderly increased risk of drowsiness and deliranten States   Increased Risk Of Falling	Other opioids with a lower risk of episodes of delirium States (e.g., Tilidine/naloxone, morphine, oxycodone, buprenorphine, hydromorphone)