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Drug Use in Pain

Pain is a problem that every person encounters in one way or another throughout their life. It is an uncomfortable feeling that originates from any part of the body, with or without an organic cause, reducing the quality of life. In fact, pain is a reaction and defence of our body, acts as a stimulus. In the absence of pain, it is not possible to protect ourselves and it is a feeling that prevents us from causing great damage to our tissues and organs. In the treatment of pain, narcotic painkillers and non-steroidal painkillers that are strong, effective and do not have an anti-inflammatory effect are generally used. However, apart from these two groups, there are drugs that reduce pain by treating the disease factor that causes pain (e.g. steroids that treat inflammation, heart compression, vascular relaxants used in anginal attacks, etc.).

Drugs used in the treatment of pain are important in many respects. The group that we have the most information and attention to in this regard is narcotic painkillers. This group of drugs is used to increase the quality of life in surgeries and reduce the pain due to advanced cancer cases. This group of drugs is used with a special prescription (red prescription) due to their strong addictive potential. The biggest problem with these drugs is their addictive potential. Abuse of these drugs due to their pleasure-enhancing effects is a major problem all over the world. However, another problem with this group of drugs may be that some physicians may hesitate to prescribe these drugs. For example, in an advanced cancer case, the physician may hesitate to prescribe these drugs due to their addictive effects. The patient has to survive with severe pain, the patient's quality of life decreases even more, his determination to fight his disease decreases and his psychological condition deteriorates. In diseases that cause severe pain during cancer treatment, the addictive effects of these drugs are significantly lower than the addictive effects caused by drug abuse.

Another problem with drugs used in the treatment of pain is the wrong choice of drugs and doses. The biggest problem in this regard arises especially when patients use drugs without consulting a doctor or pharmacist. In many countries, some of these drugs have over-the-counter (OTC) status. In some countries, it is possible to obtain these drugs from places such as markets, etc., apart from pharmacies. Although this is mainly done to reduce health expenditures, it is an issue that needs to be handled carefully. For example, a patient who uses aspirin and has an ulcer in his stomach may face the risk of stomach bleeding when he uses this drug, or it should be known that there will be an increase in the risk of bleeding due to the blood thinning effect (anticoagulant effect) of this drug. This can be important in women who are menstruating. Again, aspirin has the potential to cause hypoglycemia in patients with diabetes.

Another example to be considered is that it is known that this group of drugs should not be used in asthmatic patients. Aspirin, one of the non-steroidal anti-inflammatory drugs, is contraindicated in patients with asthma. These drugs should be used with caution in asthmatics. It should be kept in mind that pyrazolone-derived drugs such as metamizole sodium (novalgin) and propifenazone (algil) cause bone marrow depression and disruptive effects such as thrombocytopenia and aplastic anaemia.

Another issue that requires attention regarding the use of drugs in pain is the misevaluation of the pain and the inability to apply the correct and effective treatment. For example, looking for treatment in the wrong branch for head, face and jaw pain. In some of the headaches, the cause may be a muscle spasm in the neck. Changes in blood flow to the brain can cause headaches, dizziness, tinnitus. Here, it is extremely important to determine the cause correctly. In a situation that you cannot treat with painkillers, giving unnecessary medication to the patient or taking medication without consulting the physician or pharmacist may also cause the patient to risk drug interactions, side effects, contraindications, etc. In such cases, the cause should be determined and treatment should be applied for it. What needs to be considered is to determine the correct diagnosis and the most appropriate treatment method, to prevent the patient from taking unconscious medication, and to inform the society. After all, it should not say that it is a painkiller and nothing will happen. This group of drugs should be used with caution. All factors such as the patient's other diseases, physical condition, age, gender, pregnancy and breastfeeding period should be evaluated by keeping in mind. However, it should be kept in mind that these drugs will not cause any problems when used correctly and effectively, that they have therapeutic and quality-of-life enhancing effects, that there is sufficient information and findings about them, and that they are reliable.

In recent years, there has been an increasing approach in our country that drugs are chemical and harmful, let's turn to natural products. This approach is not accurate and reliable. It should not be forgotten that a drug does not come to the market without being tested first in animals and then in humans with controlled studies. For example, in a patient with high fever, it should be well evaluated to avoid giving a painkiller antipyretic and prefer traditional approaches or herbal preparations instead.

Giving an appropriate painkiller with an anti-inflammatory drug to a patient who suffers from severe pain due to osteoarthritis and has difficulty walking will increase the quality of life of that patient. The important thing here is not whether the drugs have side effects or contraindications, but the successful selection of the appropriate drug for the appropriate patient and disease. In recent years, an increasing number of patients have turned to alternative medicine. Although a large number of data have been revealed on this subject, care should be taken in the use of these products without the advice of a physician and pharmacist. It should not be forgotten that these treatments should not replace the main treatment, and the existing treatment can be supplemented with the recommendation of the physician. In addition, it should be investigated who produces these products and whether there is a science behind them. For example, garlic, which is frequently preferred to support immunity and relieve pain, is produced and offered to the market by many companies. However, it is important to be careful with these products. It should be investigated whether there is indeed a sufficient amount of extract in its content and whether there is any study on the recommended active ingredient in terms of quantity.


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