Clinically, patients often encounter some long-term use to pain tablets, more common in the elderly, at least two to six tablets a day, or even 10 or more, for several years or even 10 years to 20 years, nocturia, urinary Conventional display: the proportion of low, PH acidic, a small amount of latent hematuria / hidden hematuria, microscopic hematuria / RBC urine, protein little or no proteinuria, renal function normal or mildly to moderately abnormal, the exclusion of other disease factors to consider chronic interstitial nephritis (drug resistance), also called analgesic nephropathy (analgesic nephropathy).
So, to the pain tablets to the body what damage has it?
A first look at the pain tablets adverse reactions and toxicology
Anodyne Tablets (generic name), cable close painkiller tablets (once with the generic name), compound preparation (phenobarbital + phenacetin + caffeine + Amidopyrine).
Adverse reactions
The compound of the ammonia-containing aminopyrine and phenacetin have significant adverse reactions. Taking Amidopyrine may have vomiting, rash, fever, profuse sweating and stomatitis, a small number can cause neutropenia, aplastic anemia, exudative erythema, exfoliative dermatitis, erosion and other glans. Long-term use phenacetin can cause renal papillary necrosis, interstitial nephritis and acute renal failure, renal pelvis and may even induce cancer and bladder cancer, can also cause drug dependence. Phenacetin also easy to make the formation of hemoglobin to methemoglobin, so that the oxygen-carrying capacity of the blood is decreased, resulting in cyanosis, hemolysis can cause liver damage, and some retinal toxicity.
Precautions
1. This product is long-term use can lead to kidney damage, severe cases can cause renal papillary necrosis or uremia, renal pelvis and may even induce cancer and bladder cancer. Not long-term use, in order to avoid the occurrence of neutropenia, drug use more than one week to check blood regularly.
2. Role of aminopyrine occur in acid and food, carcinogenic nitroso compounds can form, especially nitrosamines, and therefore potentially carcinogenic.
3. Long-term use can cause dependence and tolerance.
4. A variety of traumatic pain and visceral smooth muscle cramps invalid.
Pharmacology and toxicology
It is an antipyretic analgesic compound. Which aminopyrine and phenacetin can inhibit the synthesis and release of prostaglandins in the hypothalamus, restore normal body temperature regulation center feel reactive neurons sky cooling effect; also by inhibiting the synthesis of prostaglandins and other sky town Pain effect. Amidopyrine and can inhibit the synthesis and release of inflammatory prostaglandins local tissue, stability of lysosomal enzymes, affect phagocytic cells and play a role in anti-inflammatory effects. Coffee because the central nervous system stimulant, can be excited cerebral cortex, improve the external sense resistance, and contraction of cerebral blood vessels, strengthen the first two drugs relieve headaches effect. Phenobarbital has sedative, hypnotic, anticonvulsant effect, can enhance the analgesic effect of aminopyrine and phenacetin, and to prevent seizures caused by the fever.
Second, to the pain of kidney damage drugs
Many analgesics have varying degrees of kidney damage, studies have shown that long-term use of small doses of aspirin can lead to kidney damage. Most of aspirin-induced renal damage is reversible, in your early detection and timely stop the medication can be restored to normal. Thus, long-term use of aspirin in patients, especially the elderly, should regularly check the urine and kidney function.
Some people think that pain tablets low price, and easy to buy, the body a little discomfort, such as pain, headache, back pain, joint pain, menstrual pain, stomach cramps, etc., eat pain tablets, the dose increasing long-term use, even dependency. However, adverse reactions to pain tablets and toxicology, is as set forth above, can not be long-term use.
Antipyretic analgesics main mechanism of action is to inhibit the synthesis of inflammatory mediators prostaglandins, which play an anti-inflammatory, anti-rheumatic and anti-inflammatory effect. Cause renal ischemia and renal tubular interstitial tissue between chronic inflammation by reducing the vasodilatory prostaglandins. Analgesic metabolites in the renal medulla highly concentrated, have a direct toxic effect on the renal tubular damage renal tubular epithelial cell membrane and cause renal tubular degeneration and necrosis, atrophy. It should be noted reduced synthesis of prostaglandins, for renal vascular condition adversely, mainly for renal vasoconstriction, decreased renal blood flow and glomerular filtration rate decreased, can cause ischemic kidney damage, sodium retention and high blood potassium, it appears above if the clinical manifestations, renal failure can occur, because it is caused by the drug, it is also known as drug-induced renal failure.
Analgesic nephropathy (AN, analgesic nephropathy): Long-term heavy abuse analgesics (non-steroidal anti-inflammatory agent-based or caffeine, codeine) resulting with chronic renal interstitial damage caused by chronic progressive of interstitial disease, renal papillary necrosis, interstitial nephritis, advanced renal failure, called analgesic nephropathy (AN).
AN has been proven to be caused by drugs, including aspirin, phenacetin, salicylamide, antipyrine, aminopyrine, acetaminophen, indomethacin (indomethacin), ibuprofen (Fenbid, An Ruike, dressers Finland), phenylbutazone, naproxen, mefenamic acid, diclofenac (Voltaren), sudoxicam, caffeine, codeine phosphate and the like.
AN is generally believed to occur when more than three years of continuous use of analgesics, analgesics cumulative dose of more than 2 ~ 3kg. Studies have shown that in a group of patients for a variety of reasons (including rheumatoid arthritis, gouty arthritis, etc.) oral non-steroidal analgesics accumulated over 1000 of 24.4% of the patients by intravenous urography, B ultrasound and CT confirmed renal papillary necrosis.
Non-steroidal anti-inflammatory drugs: is not included corticosteroids, including a large class of anti-inflammatory, antipyretic, analgesic effects of the drug.
Third, then, nephropathy and special populations cold medication should pay attention to what matters it?
1. elderly patients, heart disease, hypertension, hyperthyroidism, glaucoma, prostatic hypertrophy patients with dysuria, emphysema and other lung disease who, before applying cold medicine should consult a doctor or pharmacist.
2. Where the driving machine, car, boat or other mechanical equipment operation and maintenance are prohibited during working hours have taken a cold medicine containing a sedative effect.
3. If the patient only sneezing, nasal congestion, runny without fever, muscle pain, headache and other symptoms, in principle, advocates the use of antipyretic analgesics containing cold medicine, so as not to cause allergies and other adverse reactions. When the fever diagnosed, it is usually reached 38.5 ℃ above, the choice of antipyretic drugs. Children with fever above 39 ℃, applications antipyretic drugs. Significant headache, muscle pain, joint pain, apply anti-inflammatory drugs.
The bacterial infection, it can be used under the guidance of doctors prescribing antibiotics.
5. During the taking cold medicine, not with the service tonic medicine.
6. The prohibition of alcohol when taking anti-inflammatory drugs.
7. Drink plenty of water, urinating frequently, increased urine output.
8. pay attention to rest, to prevent fatigue.
9. If the original kidney disease, do not try to or used with caution to the pain medicine
Shijiazhuang Kidney Disease Hospital
Shijiazhuang Kidney Disease Hospital is located in Shijiazhuang city, capital of Hebei Province, which is adjacent to the capital of China, Beijing. It was founded in 1986 and his name has become more widely known in recent decades.....Read More
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