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Analgesia
Why do some painkillers work better on certain types of pain than on others? For example: I take Tramadol for pain I have had since having a lung operation and they work well for that,but if I have a headache I have to take either paracetamol or ibuprofen as the Tramadol don't touch the pain,they don't work for period pain either.
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Daffy654, youhave asked a most complicated question on which textbooks have been written, but I will try and simplfy it. Pain is perceived.
a) in a part of the brain (thalamus and hypothalamus) transmitted from wherever the insult occured. e.g pain from broken arm transmitted and perceived in the brain.
b) Pain caused by inflammation and not transmitted to the brain but locally acting chemicals causing the pain i.e the inflammatory reaction.
a) can best be relieved by "analgesics" Tramadol, paracetamol etc, but b) are better treated with anti-inflammatory agents e.g Ibobrufen etc.
Please excuse my explanation as I am rather embarrased to simplyfy it in such a way.
a) in a part of the brain (thalamus and hypothalamus) transmitted from wherever the insult occured. e.g pain from broken arm transmitted and perceived in the brain.
b) Pain caused by inflammation and not transmitted to the brain but locally acting chemicals causing the pain i.e the inflammatory reaction.
a) can best be relieved by "analgesics" Tramadol, paracetamol etc, but b) are better treated with anti-inflammatory agents e.g Ibobrufen etc.
Please excuse my explanation as I am rather embarrased to simplyfy it in such a way.
sqad617, you have indeed misread the tone of my comments, but I'll accept your apology.
What I don't understand is why you should feel embarrassed to provide what you imply is a simplistic explanation in reply to the question. It would appear that you're implying that your explanation per se has somehow been coloured by your embarrassment.
It follows that it's feasible that had you not been embarrassed in explaining in the manner that you did, that you would have provided a more detailed answer to the question which hopefully might have covered the issues omitted in your previous reply.
What I don't understand is why you should feel embarrassed to provide what you imply is a simplistic explanation in reply to the question. It would appear that you're implying that your explanation per se has somehow been coloured by your embarrassment.
It follows that it's feasible that had you not been embarrassed in explaining in the manner that you did, that you would have provided a more detailed answer to the question which hopefully might have covered the issues omitted in your previous reply.
Only 2 stars for squad617's answer? Given that he/she has provided a remarkably accurate summary of a complex subject, that seems a bit harsh!
I'll try a different approach:
Imagine that you get a large splinter in your finger (and that you're unable to get it out). As the splinter goes in, and shortly afterwards, you might feel a sharp pain. This is because of damage to the nerve endings. However, a day or two later, you might feel a throbbing pain. This is because infection has set in, resulting in inflammation, which results in pressure on the nerves.
The best treatment for any medical condition is generally, where possible, to deal with the cause, rather than the effect. So, to alleviate the throbbing pain in your finger you should seek to reduce the inflammation. To do so, you should take an anti-inflammatory drug, such as aspirin or Ibuprofen.
However, as with the initial injury when the splinter went in, not all pain is caused by inflammation. In which case, an anti-inflammatory drug won't help at all. When a pain is not caused by inflammation the only option is to try to block the message between the nerve and the brain. That's what analgesic drugs do.
That (roughly) explains the difference between the two types of drugs. However, within each class of drugs certain preparations are better at reaching specific parts of the body than others. (It's, at least in part, to do with their molecular structure and their ability to cross certain cell walls. But I freely admit that I'm getting out of my depth with the finer points of the science!). That's why some drugs work better on certain types of pain than others.
That's nowhere as good as Sqad617's answer but I hope that it might usefully add to it.
Chris
I'll try a different approach:
Imagine that you get a large splinter in your finger (and that you're unable to get it out). As the splinter goes in, and shortly afterwards, you might feel a sharp pain. This is because of damage to the nerve endings. However, a day or two later, you might feel a throbbing pain. This is because infection has set in, resulting in inflammation, which results in pressure on the nerves.
The best treatment for any medical condition is generally, where possible, to deal with the cause, rather than the effect. So, to alleviate the throbbing pain in your finger you should seek to reduce the inflammation. To do so, you should take an anti-inflammatory drug, such as aspirin or Ibuprofen.
However, as with the initial injury when the splinter went in, not all pain is caused by inflammation. In which case, an anti-inflammatory drug won't help at all. When a pain is not caused by inflammation the only option is to try to block the message between the nerve and the brain. That's what analgesic drugs do.
That (roughly) explains the difference between the two types of drugs. However, within each class of drugs certain preparations are better at reaching specific parts of the body than others. (It's, at least in part, to do with their molecular structure and their ability to cross certain cell walls. But I freely admit that I'm getting out of my depth with the finer points of the science!). That's why some drugs work better on certain types of pain than others.
That's nowhere as good as Sqad617's answer but I hope that it might usefully add to it.
Chris
Analgesics work on the nervous system, but are just part of a wholew range of pain-killing drugs. Tramadol's a synthetic drug with narcotic qualities, so probably wouldn't work for something like a headache. Ibuprofen reduces inflamation, so again, isn't really as good for a headache as paracetamol might be.
At last! I've been waiting for someone else to see the problem with the original answer of sqad617 and to my mind, daffy654 has hit the nail on the head.
I have no real problem with the main section of sqad617's original reply - the answer is for the most part correct. However, when you add in the final sentence of the answer that sits alone on it's own, it gives a whole new impression to the total reply.
I'll be honest and say that the answer reads in its entirety as if it's been written by someone with a very condescending attitude. It's as if the writer wishes to make evident that he or she is lowering themselves to answer the question.
Now before everyone jumps up and down about this and tells me I'm mistaken (including sqad617), I'd like to point out that daffy654 has seen seen this patronisation and has reacted accordingly.
At the end of the day, it's horses for courses as they say and I know from my teaching of sciences for years that there are methods of conveying complex concepts without being condescending in the process. This is one of the reasons why I take time out to teach children in my local comprehensive now and again - it enables me to keep my feet firmly on the ground. But I leave the kids judge how clever I am or not, using their own judgment and you can bet your bottom dollar that I would never append a written or oral explanation in the manner done by sqad617 in that initial answer.
Chris, I'd like to suggest that sometimes stars are awarded for reasons other the correctness of the answer as daffy654 has indirectly pointed out. I've had my fair share of criticism for providing apparently complex answers to science questions needlessly on AB, but to my knowledge, what I've never done is to directly infer to a poster that I'm cleverer than they are.
I have no real problem with the main section of sqad617's original reply - the answer is for the most part correct. However, when you add in the final sentence of the answer that sits alone on it's own, it gives a whole new impression to the total reply.
I'll be honest and say that the answer reads in its entirety as if it's been written by someone with a very condescending attitude. It's as if the writer wishes to make evident that he or she is lowering themselves to answer the question.
Now before everyone jumps up and down about this and tells me I'm mistaken (including sqad617), I'd like to point out that daffy654 has seen seen this patronisation and has reacted accordingly.
At the end of the day, it's horses for courses as they say and I know from my teaching of sciences for years that there are methods of conveying complex concepts without being condescending in the process. This is one of the reasons why I take time out to teach children in my local comprehensive now and again - it enables me to keep my feet firmly on the ground. But I leave the kids judge how clever I am or not, using their own judgment and you can bet your bottom dollar that I would never append a written or oral explanation in the manner done by sqad617 in that initial answer.
Chris, I'd like to suggest that sometimes stars are awarded for reasons other the correctness of the answer as daffy654 has indirectly pointed out. I've had my fair share of criticism for providing apparently complex answers to science questions needlessly on AB, but to my knowledge, what I've never done is to directly infer to a poster that I'm cleverer than they are.
Tramadol is a centrally acting synthetic analogue of codeine and consequently is an opioid . Approximately 100mg of Tramadol given as a single dose has the pain relieving power of 1000mg of Paracetamol, or put another way, Tramadol has about one-tenth of the pain relieving power of an equivalent dose of morphine.
Tramadol works in a number of ways on the nervous system. Firstly, it binds along with its metabolite to opioid receptors in the body interfering with pain perception. Secondly, Tramadol interferes with the reuptake of noradrenaline and serotonin, both neurotransmitters, in the brain and spinal cord. This in turn prevents the perception of pain.
As Tramadol is a centrally acting analgesic, it is used for the relief of post-operative pain, trauma injuries in A&E/ER units and a step between non-opioid and opioid therapy for intractable pain. I can testify it's great for headaches as I took it myself a couple of years ago after banging my head on a car door!
Ibuproprofen is the weakest member of the NSAID (Non-Steroidal Anti-Inflammatory Drugs) group of drugs and it is true that it is reasonable effective in relieving inflammation. It works by inhibiting certain Cyclooxygenase enzymes in the body, preventing the formation of prostaglandins which in turn, regulate inflammatory reactions. It is true that Ibuprofen and other NSAID's are not as effective as paracetamol in relieving headaches as headaches are in general, not connected with inflammation. . In combined Ibuprofen/Codeine over-the- counter pharmaceutical products, such as Nurofen Plus, it is the Codeine Phosphate in the preparation that kills the pain not the Ibuprofen.
Tramadol works in a number of ways on the nervous system. Firstly, it binds along with its metabolite to opioid receptors in the body interfering with pain perception. Secondly, Tramadol interferes with the reuptake of noradrenaline and serotonin, both neurotransmitters, in the brain and spinal cord. This in turn prevents the perception of pain.
As Tramadol is a centrally acting analgesic, it is used for the relief of post-operative pain, trauma injuries in A&E/ER units and a step between non-opioid and opioid therapy for intractable pain. I can testify it's great for headaches as I took it myself a couple of years ago after banging my head on a car door!
Ibuproprofen is the weakest member of the NSAID (Non-Steroidal Anti-Inflammatory Drugs) group of drugs and it is true that it is reasonable effective in relieving inflammation. It works by inhibiting certain Cyclooxygenase enzymes in the body, preventing the formation of prostaglandins which in turn, regulate inflammatory reactions. It is true that Ibuprofen and other NSAID's are not as effective as paracetamol in relieving headaches as headaches are in general, not connected with inflammation. . In combined Ibuprofen/Codeine over-the- counter pharmaceutical products, such as Nurofen Plus, it is the Codeine Phosphate in the preparation that kills the pain not the Ibuprofen.
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