Which Works Better? – Cleveland Clinic

Over-the-counter painkillers have earned their spot in your medicine cabinet. You reach for them to lower a fever, banish a headache or ease those monthly cramps.

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Both acetaminophen (such as Tylenol®) and ibuprofen (Advil® or Motrin®) are used to treat fevers and pain. But they’re not exactly interchangeable. Which should you choose? Here family medicine specialist Matthew Goldman, MD, discusses what you should know about which med makes the most sense for your aches and pains.

Ibuprofen basics

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). As the name suggests, it tends to be most helpful for discomfort that goes hand in hand with inflammation, which can include redness, swelling, heat, pain and/or loss of function at the site or source. That makes it a smart pick for pain such as:

• Back and neck pain.
• Earache.
• Menstrual cramps.
• Muscle sprains and strains.
• Sinus infections.
• Toothache.

Acetaminophen basics

Acetaminophen is a type of drug called an analgesic. Translation: It reduces pain signals within the nervous system and not at the site itself. That makes it a good choice for pain such as:

• Headaches.
• Joint pain/arthritis.
• Sore throat.

Pain medication side effects

Both acetaminophen and ibuprofen carry a risk of side effects, so follow the dosage info on the labels. Here’s what to look out for when you’re taking these painkillers.

Ibuprofen side effects

Common side effects of ibuprofen include:

• Constipation.
• Heartburn.
• Nausea.
• Stomach pain (so it’s important to take with food).

Taking ibuprofen for a long time or at high doses can also increase the risk of more serious side effects, such as:

• Blood clots.
• Heart attack.
• Kidney damage.
• Stomach bleeding (ulcers).
• Stroke.

Acetaminophen side effects

Side effects of acetaminophen are minimal, but some people experience problems including:

• Nausea.
• Vomiting.
• Headache.

Ibuprofen is metabolized by the kidneys and therefore is not a great option for those with kidney issues. Acetaminophen is metabolized by the liver and is not a great option for those with liver issues. For those who have neither kidney nor liver issues, sometimes we alternate acetaminophen and ibuprofen to avoid overdosing as well as attacking pain and inflammation from two different approaches.

Acetaminophen can also be hiding in several over-the-counter medicines, including cough and cold medications. If you’re taking more than one medication, read drug labels carefully so that you don’t go over the recommended dosage. For example, it may not be safe to take cold medicine and Tylenol at the same time.

Which painkiller should you pick?

So which pain med reigns supreme? While there’s no right answer, these pointers can help you decide.

Fever

Most research suggest acetaminophen and ibuprofen have similar results in controlling fevers, so pick what works for you.

Stomach trouble

If you have a sensitive stomach or find that ibuprofen causes heartburn or nausea, give acetaminophen a whirl.

Period pains

Ibuprofen reduces your body’s production of prostaglandins. These are the chemicals that trigger the uterus to contract and start periods each month. Ibuprofen can ease menstrual cramps and may also make menstrual bleeding lighter.

Other meds

Both ibuprofen and acetaminophen can interact negatively with some prescription and over-the-counter drugs. If you’re taking medication, talk to your provider doctor or pharmacist before reaching for the painkillers.

Persistent pain

If you’re taking painkillers over several days, consider alternating ibuprofen and acetaminophen to lower the risk of side effects.

Kids

Both ibuprofen and acetaminophen can control pain in kids. But ibuprofen tends to work better as a fever reducer. Be sure to follow the dosage guidelines on the label for your little one’s age and weight.

What’s the takeaway? When used responsibly, ibuprofen and acetaminophen are safe choices for turning down the dial on fever and pain. And isn’t it good to have options?

Side Effects of Tylenol-Codeine (Acetaminophen and Codeine), Warnings, Uses

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Acetaminophen (Tylenol®)

Acetaminophen (a see tah MIN o fen) is the generic name for Tylenol® (TIE len ol). Other names for this medicine are Tempra® and Feverall®.  Many grocery stores and pharmacies have their own brands.

You can get acetaminophen as a liquid, chewable tablets, regular tablets or capsules, and suppositories. It comes in different strengths and does not need a prescription.  

Acetaminophen is used to reduce fever and treat pain. Your child’s symptoms should get better in 15 to 30 minutes after taking a dose.  

How to Give This Medicine

• Shake this medicine before using if it is a liquid.
• Use a pediatric measuring device such as a syringe, spoon or cup (available at the pharmacy) to get the exact dose. Many packages will have their own measuring device in the box. Do not measure liquid medicines in kitchen spoons.
• Read the label carefully and make sure you are giving your child the right amount. It is easy to confuse the different forms and strengths.
• Give the exact dose of medicine that your child’s health care provider ordered (Picture 1).
• Ask your child’s pharmacist, nurse or health care provider before crushing any medicine.
• Chewable tablets may be chewed, dissolved in liquid or swallowed whole.
• Stay with your child until they have swallowed the dose of medicine.
• Suppositories should be moistened with water or Vaseline® before inserting into your child’s rectum.
• Do not give more than 5 doses of this medicine in a 24-hour period unless ordered by your child’s health care provider.
• Do not give this medicine for more than 3 days without checking with your child’s health care provider.

If a Dose is Vomited

• If your child gags or chokes and spits out the dose before swallowing it, let the child calm down and then give the same amount one more time.
• If the medicine is vomited (thrown up) right after you give it, wait 20 minutes. Then give the same size dose one more time. If the vomiting continues, call your child’s doctor.

Drug and Food Interactions

Acetaminophen should not be taken with the following:

• Alcohol. Drinking alcohol when taking acetaminophen may cause liver damage.  
• Some daily prescription medicines. Long-time treatment with acetaminophen and certain prescription medicines that are taken every day may cause liver damage. Examples include carbamazepine (Tegretol®), isoniazid (INH), lamotrigine (Lamictal®), phenytoin (Dilantin®) and warfarin (Coumadin®). Ask the prescriber or pharmacist if your child’s medicines can be taken with acetaminophen.
• Narcotic pain medicines that contain acetaminophen (such as Tylenol® with codeine, Vicodin®, Lortab®, Norco®, and Percocet®). Giving these with plain acetaminophen may cause your child to overdose on acetaminophen. 
• Over-the-counter (OTC) medicines. Many OTC medicines for cough and cold, allergies, pain and sleeplessness contain acetaminophen. Read the label or check with your child’s health care provider or pharmacist first.  
• Vitamin or mineral supplements. Ask your child’s health care provider if it is all right to give these.

Warnings

It is not safe to give your child more than 4 grams (4,000 milligrams (mg)) in 24 hours. Let your child’s health care provider know if your child:

• is allergic to acetaminophen. 
• has a condition called G6PD deficiency.
• has a condition called phenylketonuria (PKU). Some acetaminophen products, like the chewable tablets, contain aspartame which can be harmful to children with PKU.
• has liver or kidney disease.

Medicine Storage

• Store all medicine out of the reach of children.  
• Always keep medicine in the original bottle from the pharmacy.
• Do not keep this medicine in the refrigerator. Store at room temperature.
• If this medicine is a tablet or capsule, light and moisture make the medicine not work as well. Keep the bottle tightly closed and store it in a dark, dry place. Do not keep it in the bathroom or above the kitchen sink.
• If this medicine is a suppository, it may melt if stored in excessive heat. Store suppositories in a cool, dark place.  They can also be stored in the refrigerator.
• Keep this medicine away from heat and direct sunlight.
• Do not use this medicine after the expiration date printed on the container.

Possible Side Effects

Side effects from acetaminophen are rare. However, if a skin rash or bruises appear, stop giving the medicine and call your child’s health care provider (see next section). 

When to Call the Doctor

Call your child’s doctor or health care provider if your child has any of these signs:

• your child does not look well
• the fever goes higher after giving the medicine
• fever is 103°F or higher
• fever lasts for more than 3 days
• pain is not better or gone after taking the medicine
• your child develops a skin rash
• your child has signs of liver damage, such as: 
  • nausea and vomiting
  • dark urine
  • belly pain on the right side
  • light colored bowel movements
  • skin or white of eyes turn yellow
  • bleeds easily
  • easy bruising or any bruises on the skin

When to Call for Emergency Help

Call for emergency help if your child has any of the following after taking a medicine:

• Trouble breathing
• Swelling of the tongue
• Swelling of hands, feet or ankles.   

Other Advice About Medicines in General

• Tell your child’s health care provider and pharmacist if your child has a strange or allergic reaction to any medicine.
• If you carry medicine in your purse, keep it in its childproof bottle and keep your purse out of the reach of children. 
• Ask your pharmacist for two labeled bottles if your daycare provider will be giving this medicine.
• Bring all your child’s medicines with you in the original bottles whenever your child sees a doctor, goes to an emergency room or is admitted to the hospital. This helps doctors and health care providers who may not know your child.
• Learn the name, spelling and dose of the medicines. Also, teach your child if they are old enough. You will need to know this information when you call the doctor or pharmacist.
• If your child takes too much of any medicine, or if someone else takes your child’s medicine, first call the Central Ohio Poison Center at 1-800-222-1222 (TTY 614-228-2272). They will tell you what to do.
• Do not use this medicine if the package has been opened or if the plastic seal or safety wrap is broken before you use it the first time. 
• When this medicine is no longer needed, mix the leftover medicine with an unwanted material like coffee grounds or kitty litter. Place the mixture into a container or a bag that will not leak. Then, throw it away in the trash where children and pets cannot reach it.

Acetaminophen (PDF)

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Oxycodone/Acetaminophen (Percocet®) | OncoLink

How to Take Oxycodone/Acetaminophen

This form of oxycodone is a pill that can be taken with or without food. You should take the pill whole; if you can’t, contact your care team. Oxycodone/acetaminophen comes in various dosages. The pill is usually taken either as needed for pain or on a regular schedule decided by your care provider. When oxycodone/acetaminophen is swallowed, it gets absorbed by your body. It will begin working to relieve pain in about 15 to 30 minutes, although it reaches its peak effect in 1 hour. It will continue to work for 3 to 6 hours.

It is important to make sure you are taking the correct amount of medication every time. Before every dose, check that what you are taking matches what you have been prescribed.

Because this medication contains both oxycodone and acetaminophen, an overdose of oxycodone/acetaminophen has the same liver toxicity as an overdose of acetaminophen. There is a maximum amount of acetaminophen that a person can take per day. If someone takes too much oxycodone/acetaminophen, the acetaminophen in it can permanently damage the liver. Be sure to read labels of any other medications you take and do not take any additional acetaminophen. Also, oxycodone/acetaminophen should not be used with alcohol, because the acetaminophen can increase the likelihood that the liver will become damaged.

This medication can interact with other medications that depress the central nervous system like barbituates (including phenobarbital), tranquilizers (including Haldol®, Librium® and Xanax ®), other narcotics, and general anesthetic. It can also interact with many commonly prescribed medications, as well as herbal supplements. Be sure to tell your healthcare provider about all medications and supplements you take.

DO NOT share this medication or give it to someone else, as severe breathing problems and death can occur.

This medication can cause dizziness, sleepiness, and confusion. You should not drive or operate machinery while taking this medication until you know how it will affect you.

Storage and Handling

Store this medication at room temperature in the original container. Due to the risk of diversion (someone else taking your narcotic medication to obtain a high, rather than for symptom relief), you may want to consider keeping your medication in a lockbox or other secure location. Keep this medication out of reach of children and pets.

To prevent someone from accidentally taking this medication, it should be disposed of when no longer needed through a medicine take-back program or by dropping them off at a DEA-authorized collector. For locations near you, check www.dea.gov. Ask your pharmacist or care team for assistance in the disposal of unused medications. If you cannot use these options, you can flush these medicines down the sink or toilet as soon as they are no longer needed.

Where do I get this medication?

Oxycodone/acetaminophen pills are available through retail and mail-order pharmacy. Your oncology team will work with your prescription drug plan to identify an in-network retail/mail order pharmacy for medication distribution. Mail order delivery must be hand-delivered and signed for. This medication cannot be “called in” or electronically prescribed to your local pharmacy; you must provide the original prescription to the pharmacist. Many pharmacies do not keep this medication in stock but will order it for you. There may be a delay in availability, so plan prescription refills accordingly.

Insurance Information

This medication may be covered under your prescription drug plan. Patient assistance may be available to qualifying individuals without prescription drug coverage. Co-pay cards, which reduce the patient’s co-pay responsibility for eligible commercially (non-government sponsored) insured patients, are also offered by the manufacturer. Your insurance company may require you to utilize other pain medications prior to authorizing a prescription for this medication. This is called step therapy. Due to risk for diversion and misuse, the quantity of medication you receive may be limited to a 2 week or 1 month supply.

Possible Side Effects of Oxycodone/Acetaminophen

There are a number of things you can do to manage the side effects of oxycodone/acetaminophen. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects: 

Slowed Breathing or Low Blood Pressure

You may experience low blood pressure or slowed breathing while taking an opioid painkiller. This usually only occurs when the dose of medication is too high or it is increased too quickly. This rarely happens to patients who have been taking opioid medications for a long time.

These side effects can also result from an overdose of opioids. If you suspect that you or someone you know has taken an overdose of opioids, call 911 immediately. If you feel extremely tired, lightheaded, dizzy, sweaty, nauseated, or short of breath, you need to see a doctor immediately. Sometimes patients who have taken too much opioid medication will be so sleepy that they can’t be awakened or aroused. These side effects are emergency situations. If any of these symptoms occur, you should seek emergency medical attention.

Sleepiness (Somnolence)

Feeling sleepy, drowsy or lightheaded may accompany the use of opioid pain medication. Some people just don’t “feel like themselves” on these medications. Avoid driving or any other potentially dangerous tasks that require your concentration and a clear head until you feel normal again. Avoid alcohol or other sedatives while using these medications unless they are specifically prescribed by your care team. Most people will begin to feel like themselves after a few days on the medications. If you continue to feel “out of it” after a couple of days, talk to your healthcare provider about adjusting your dosages.

Concerns About Addiction, Tolerance, and Dependence

Many people who are prescribed opioid pain relievers are worried that they may become addicted to these medications. This fear stems from the fact that opioid medications can cause euphoria and pleasure when used by people who are not in pain. However, when these medications are used to treat physical pain, it is unlikely that patients will become addicted to them. Addiction is a psychological need for the drug that very rarely affects people who take opioids for pain control. People addicted to opioids use them for the purpose of getting “high”. These people also crave opioids, lack control over their use, and will continue to use opioids despite knowing they are causing them harm. People experiencing pain use opioids to relieve their pain.

A person on long-term opioids may stop getting proper pain relief after taking these medications for a while. This phenomenon is called tolerance. As patients develop tolerance, they will need higher doses to get good pain relief. Tolerance is a completely normal aspect of taking opioid pain medications and is nothing to be concerned about. The point of using these medications is to keep pain well-controlled, and the exact doses that a patient requires are not important as long as they can be kept comfortable. If you think you need to change the dose, work with your healthcare team to find the right dose to make you comfortable. Do not try to change the dose on your own, as this may cause unwanted side effects.

As a person takes regular doses of opioids, for as little as a week, their bodies will begin to adapt to the medications. This causes tolerance, but it can also cause dependence. Dependence means that the body “gets used to” the opioids. Dependence DOES NOT equal addiction. Dependence is a natural, physical phenomenon that happens to everyone on long-term opioid therapy. The important thing to know about dependence is that once a patient becomes dependent on opioids, they will feel very sick if they stop the medication abruptly. This is called withdrawal and the symptoms it causes can start within 2 days of abruptly stopping opioids and may last up to 2 weeks. Withdrawal is preventable if you lower the opioid dose slowly, generally over a week or so, with the help and guidance of your health care team. The exact amount of time to wean varies based on dose, how long you’ve been taking them, and some other individual factors. It is important to remember that dependence is normal and happens to everyone who takes opioids for a long period of time. Talk to your provider if you have any concerns. 

Liver Toxicity

This medication can cause liver toxicity, which your oncology care team may monitor for using blood tests called liver function tests. Notify your healthcare provider if you notice yellowing of the skin or eyes, your urine appears dark or brown, or you have pain in your abdomen, as these can be signs of liver toxicity.

Constipation Caused by Pain Medications

Constipation is a very common side effect of pain medications that continues as long as you are taking the medications. This side effect can often be managed well with the following preventative measures:

• Drinking 8-10 glasses of water a day. Warm or hot fluids can be helpful.
• Increasing physical activity when possible.
• Attempting a bowel movement at the same time each day.
• Eating plenty of fruits and vegetables.
  • Four ounces of prune juice or 3-4 dried prunes/plums can help promote bowel movements.
  • However, high fiber foods (ex. bran flakes, high fiber cereals) and fiber supplements (such as Metamucil) can actually make constipation from pain medications worse and should be avoided.

Your care team may recommend a bowel regimen, using stool softeners and/or laxatives, to prevent or treat constipation. Stool softeners (such as docusate sodium or Colace) work by bringing water into the stool, making it softer and easier to pass. A stimulant or laxative (such as Dulcolax (bisacodyl) or Senakot (senna)) works by stimulating the movements of stool through the bowel. Your provider may recommend Miralax (Polyethylene glycol 3350), which is an osmotic laxative. It works by causing water to be retained in the stool, softening the stool so it is easier to pass. These medications can be taken together. Untreated constipation can lead to a bowel blockage, so be sure to notify your healthcare team if you do not have a bowel movement for 3 or more days.

Nausea and/or Vomiting

Nausea, with or without vomiting, can be a side effect of opioid pain medications. For some patients, it lasts just a few days to weeks after starting the medication, but for some it is a long-term side effect. Nausea and vomiting can interfere with pain management if the nausea and/or vomiting affects the patient’s ability to take the medication. You may find that eating or not eating when taking this medication may be helpful for you. Talk to your healthcare team so they can prescribe medications to help you manage nausea and vomiting.

Less common, but important side effects can include:

• Serotonin Syndrome: This medication can cause a high level of serotonin in your body, which in rare cases, can lead to serotonin syndrome. Symptoms can include shivering, agitation, diarrhea, nausea and vomiting, fever, seizures, and changes in muscle function. Symptoms can arise hours to days after continued use, but can also occur later. This is a serious side effect and you should contact your care provider immediately if you have any of these side effects.
• Adrenal Insufficiency: Adrenal insufficiency (inadequate function of the adrenal gland) is a rare but serious side effect of taking this medication. It most often occurs after taking the medication for one month or longer. Symptoms are not very specific but can include nausea, vomiting, anorexia, fatigue, weakness, dizziness, and low blood pressure. It is important to contact your care provider if you experience any of these side effects.
• Allergic Reaction: Although it is uncommon, some people have allergic reactions to certain opioid preparations. If after taking morphine or other opioids, you experience chest tightness, swelling, wheezing, fever, itching, blue skin color, or cough, you need to call 911. These side effects are emergency situations. If any of these symptoms occur, you should seek emergency medical attention.

Reproductive Concerns

Chronic exposure of an unborn child to this medication could result in the child being born small and/or early, or having symptoms of withdrawal (including respiratory distress, behavioral changes, and seizures) after birth. Effective birth control should be used while on this medication. Even if your menstrual cycle stops or you believe you are not producing sperm, you could still be fertile and conceive. You should not breastfeed while receiving this medication as it is passed through a mother’s milk.

Morning sickness and nausea during pregnancy: Symptoms, treatments, & causes

What is morning sickness?

Morning sickness is a feeling of nausea, sometimes accompanied by vomiting, that many women have during pregnancy – usually in the first trimester. In fact, at least 70 percent of pregnant women have morning sickness during pregnancy.

The condition is common and, unless very severe, does not pose a threat to you or your baby. But it can make life miserable and become a problem if you can’t keep food or fluids down and begin to lose weight.

Morning sickness usually starts around the fifth or sixth week of pregnancy and tends to get worse during the next month or so. It goes away for most women by around 14 to 20 weeks of pregnancy.

Scientists believe that morning sickness may be the body’s way of protecting a fetus in early pregnancy from toxins and potentially dangerous foods. This theory makes sense because the first trimester – when most women have the strongest morning sickness – is the crucial period of development when all of a baby’s organs and physical structures form.

Morning sickness symptoms

Women with morning sickness can experience:

• Nausea (a feeling of queasiness)
• Vomiting
• Retching (dry heaving without bringing anything up)
• Excessive salivation

If your nausea and vomiting are so severe that you can’t keep anything down – including water, juice, food, prenatal vitamins, or medications – you may have hyperemesis gravidarum. In this case, you may need to be treated with IV fluids and medications in the hospital.

Talk to your doctor or midwife immediately if:

• You lose 2 pounds or more.
• You develop nausea and vomiting after 9 weeks of pregnancy.
• You have nausea and vomiting after 20 weeks of pregnancy.
• You vomit blood.
• You feel dizzy when you stand.
• You have signs of dehydration, including dark urine or infrequent urination.
• You have abdominal pain, fever, headache, or swelling in the front of the neck.
• You can’t keep down any liquids for 12 hours or any solids for 24 hours.

Is it normal to have morning sickness all day?

Yes, morning sickness can happen anytime and, for many women, lasts all day. There’s a wide range of normal: Some women with morning sickness feel symptoms constantly, while for others morning sickness is worse in the morning and eases up later. And some women feel okay during the day and have morning sickness at night.

Is it normal to have morning sickness all through pregnancy?

It’s uncommon, but a small number of expecting moms have morning sickness that lasts into the second – and even third – trimester.

Talk to your healthcare provider if your nausea or vomiting lasts beyond 20 weeks of pregnancy. Lingering morning sickness can make you miserable, and a very severe case can lead to dehydration and prevent you from gaining a healthy amount of weight.

Occasionally nausea and vomiting can be a sign of another medical problem, not pregnancy, so it’s a good idea to get unusually long-lasting morning sickness checked out. (This is especially important if your morning sickness has started back up again after being gone for a few weeks.)

What causes morning sickness?

No one knows for sure what causes nausea during pregnancy, but it’s probably some combination of the many physical changes taking place in your body. Some possible causes include:

• Human chorionic gonadotropin (hCG). This hormone rises rapidly during early pregnancy. No one knows how hCG contributes to nausea, but it seems especially likely that it does because the timing is right: Nausea tends to peak around the same time as levels of hCG. What’s more, other conditions that cause a higher level of hCG, such as carrying multiples, are also associated with higher rates of nausea and vomiting.
• Estrogen. Estrogen is another possible cause because it also rises rapidly in early pregnancy. A surge in estrogen may be responsible for the enhanced sense of smell and sensitivity to odors (and resulting food aversions) that many women experience in the first trimester.
• A sensitive stomach. Some women’s digestive tracts are more sensitive to the changes of early pregnancy. Also, some research suggests that women with Helicobacter pylori bacteria in their stomach are more likely to have nausea and vomiting. However, not all studies confirm this link.
• Genetics. Two genes involved in the development of the placenta (GDF15 and IGFBP7) have been linked to hyperemesis gravidarum, the most severe form of morning sickness. Researchers at UCLA found that women with hyperemesis gravidarum had abnormally high levels of proteins expressed by these genes. They’re now trying to figure out if these protein levels can be changed as a way to treat severe morning sickness.
• Pregnant with multiples. If you’re pregnant with twins or higher multiples, you’re more likely to experience nausea or vomiting during pregnancy. This may be from the higher levels of hCG, estrogen, or other hormones in your system. You’re also more likely to have severe morning sickness. On the other hand, it’s not definite – some women carrying twins have little or no nausea.

Is morning sickness a good sign?

It may be. A number of studies have found a lower rate of miscarriage among women with morning sickness or hyperemesis gravidarum. But plenty of women with perfectly normal pregnancies have little or no nausea during their first trimester.

If your baby or your placenta wasn’t developing properly, you’d have lower levels of pregnancy hormones in your system. So if hormones are what causes nausea, morning sickness could be a sign that your body is doing what’s needed to support your pregnancy. That doesn’t make it any more enjoyable, though!

Morning sickness remedies

Simple changes and strategies may help to relieve morning sickness symptoms, especially if you have a mild case. But if they don’t work for you, let your healthcare provider know. Some women hesitate to seek treatment for morning sickness because they’re concerned that medications could harm their baby. But there are many morning sickness remedies that are safe and effective – dietary and lifestyle changes as well as medications.

Home remedies and alternative therapies for morning sickness

If you have a mild case of nausea and vomiting, these strategies may help:

• Avoid triggers such as heat, strong food odors, and fragrances. Fried, fatty, and spicy foods can also trigger nausea.
• Eat small meals often: An empty stomach can make nausea worse, so eat five or six small meals a day. Before you get out of bed, eat a small snack such as dry toast or crackers.
• Sip cold, fizzy beverages. Use a straw if that helps. Ginger ale made with real ginger can ease nausea. Some women also find sour drinks, such as lemonade, appealing.
• Try peppermint or ginger hard candy. Sucking on hard candies may help. Some women also get relief from ginger or peppermint tea, which is usually safe in pregnancy.
• Take your vitamin at night. Taking your prenatal vitamin with food right before you go to sleep may reduce nausea. If you still get nauseated, ask your provider to recommend a different prenatal vitamin.
• Aromatherapy: Scents such as citrus or peppermint may ease your nausea. Use a diffuser to fill the room with the scent of citrus or mint essential oil, or place a drop or two on a handkerchief that you carry with you to sniff whenever you start to feel queasy. (Essential oils are very strong, so use very little.)
• Acupressure bands: This soft cotton wristband is often sold at drugstores. When you put it on, a plastic button pushes against an acupressure point on the underside of your wrist. Designed to prevent seasickness, these have helped some pregnant women through morning sickness, although research suggests that it may be largely a placebo effect.
• Acupuncture: Consider seeing an acupuncturist who has experience treating nausea during pregnancy.
• Acustimulation: Ask your provider about this therapy, which uses a device to stimulate the underside of your wrist with a mild electric current. The device is safe for pregnant women, though it can cause irritation where it touches the skin. (It often comes with gel to prevent this.) Though acustimulation isn’t widely used, there is some research showing that it may help.
• Hypnosis: Although there’s no definitive evidence that it helps with morning sickness, it has been shown to be effective in combating nausea during chemotherapy.

Morning sickness medicine

If natural morning sickness remedies don’t help, ask your provider about anti-nausea medicines. Several supplements and medications are considered safe to take for morning sickness.

Over-the-counter (OTC) medicines:

• Vitamin B6. Taking vitamin B6 (also known as pyridoxine) has been shown to relieve nausea in some pregnant women. It’s safe and available over the counter. But before taking vitamin B6, check with your provider to find out how much to take and whether the amount in your prenatal vitamin counts as one of the doses. Your provider may suggest that you start by taking 10 to 25 mg, three or four times a day.
• Doxylamine is found in over-the-counter sleep aids like Unisom, and it’s also used to treat nausea and vomiting during pregnancy.
• Combination vitamin B6 and doxylamine is often recommended as an initial treatment for morning sickness. Your provider can recommend an OTC dose, or may prescribe prescription versions sold under the brand names Diclegis and Bonjesta (extended release).
• Reflux medicines such as Pepcid sometimes help if your nausea is triggered by heartburn.

Prescription medicines:

Your provider may prescribe one of the medications below if other treatments aren’t effective.

• Metoclopramide (Reglan)
• Promethazine (Phenergan)
• Prochlorperazine (Compazine)
• Trimethobenzamide (Tigan)
• Ondansetron (Zofran): Safety data on ondansetron has been inconsistent. Some studies suggest it’s linked to a slight increase in the risk of cleft palate or heart defects in babies born to women who took the drug during early pregnancy. Other studies have found an overall low risk. Given this data, many doctors prescribe ondansetron after 10 weeks, when the above structures have formed.

Foods for morning sickness

Certain types of food may help reduce your nausea – or at least be less likely to make you feel sick:

• High-protein foods: Foods high in protein such as nuts, lean meat, eggs, tofu, and yogurt may help settle your stomach.
• Complex carbohydrates: Think whole-grain breads, brown rice, whole-wheat pasta, and starchy vegetables.
• Foods with vitamin B6: Nuts, green beans, carrots, cauliflower, potatoes, lean meats, and fish are good sources of this vitamin, which has been shown to ease nausea in some women.
• Bland foods: Try the BRATT diet – that’s bananas, rice, applesauce, toast, and tea. Not only are these foods mild in flavor, they’re also easy to digest. (Bananas are also high in nausea-fighting B6.)
• Cold food: Cooking smells can bring on bouts of nausea, so cold meals may be more appealing until your morning sickness passes.
• Food made by others: Again, because cooking can bring on nausea, some women find it easier to eat food they haven’t prepared themselves. Get takeout from a market or restaurant, or ask a loved one to make your meal.

What Can Be Done When Treatments Don’t Seem to Help?

Many people with gastroparesis will respond to medical management including some dietary modification. However, medication failures or side effects are common. Many physicians have little knowledge or experience with treating gastroparesis.

Some practical things to consider when treatment does not seem to help include:

• Check the diagnosis
• The cause matters
• Review the diet
• Consider other medications
• Treat the pain
• Manage the psychosocial aspects
• Know when to consider surgery
• Be persistent and be careful

Check the Diagnosis

Nausea is the hallmark symptom of gastroparesis. Other medical problems should be considered when nausea is not a prominent symptom.

Dyspepsia is characterized by pain/burning in the mid-upper abdomen and/or bothersome fullness following a normal sized meal and/or inability to complete a meal (early satiety). People with esophageal diseases such as gastroesophageal reflux disease (GERD) or achalasia can have abnormal gastric emptying studies.

Nausea may be a secondary symptom in people with countless other medical problems. Cyclic vomiting syndrome (CVS) is a disorder where otherwise completely healthy people have stereotypical intermittent episodes of severe nausea, vomiting, and abdominal pain. People with intestinal pseudo obstruction have prominent symptoms of bloating and severe constipation. Rumination syndrome is characterized by constant regurgitation and either vomiting or re-swallowing food or drink soon after eating. Small bowel obstruction should be considered in people who have had previous abdominal surgery.

The Cause of the Gastroparesis Matters

In diabetic gastroparesis it is important to control the blood sugar, as intestinal motility is impaired when the blood sugar is elevated. Intravenous erythromycin should be considered in hospitalized patients with diabetes. Unfortunately, erythromycin seems to be beneficial for only a few days at a time.

Patients with idiopathic post-viral gastroparesis usually improve over the course of time, ranging from several months to one or two years. During that period it is important to consider that any irreversible surgical procedures not be performed in these patients to treat idiopathic post-viral gastroparesis.

Identifying and treating any underlying systemic disorder may rarely help, and is worth the effort.

Review the Diet

Many physicians tend to skip dietary recommendations, although it is the area of most interest to patients. It is important to review the low-fat, low-fiber diet and to discuss nutritional supplements.

Rarely, feeding tubes and total parenteral nutrition are necessary. Enteral feeding tubes should be placed in the jejunum, not the stomach. These should not be considered early in the course of the patient’s illness, as they are not without risk. They must be carefully managed to avoid serious complications like infection.

Consider Other Medications

The utility of the prokinetic agents is often limited by their side effects. There is a good bit of anecdotal evidence that medications like amitriptyline can decrease the sensation of nausea. The typical dose is 25–50 mg at bedtime, which is well below the dose that is required to treat depression. A doctor can check blood levels, and modify the dose accordingly. Side effects, including blurry vision, urinary retention, sleepiness and constipation are uncommon because of the low dose.

Bacterial overgrowth (SIBO) may accompany gastroparesis. The main symptom is bloating. Judicious use of antibiotics and probiotics may be helpful in the management of these symptoms.

It is difficult for patients with nausea and vomiting to tolerate oral medications. Obviously, hospitalized patients should receive intravenous medication. Outpatients may do better with medication that dissolves in the mouth.

Reports from highly specialized (tertiary) medical centers that often see people with severe gastroparesis suggest that bloating is a common symptom. Bloating impairs quality of life. Bloating severity appears related to intensity of other gastroparesis symptoms but is not affected by gastric emptying rates. Antiemetics, probiotics, and antidepressants with significant norepinephrine reuptake inhibitor activity may help.

Treat the Pain

Abdominal pain may be overlooked in gastroparesis. However, controlling abdominal pain can be the key to success in the management of many patients. Pain does not correlate with gastric emptying. Non-steroidal anti-inflammatory drugs (NSAIDs) may help. Low dose tricyclic medications, such as amitriptyline, nortriptyline, and desipramine, have been shown to reduce pain in other functional gastrointestinal (GI) conditions and may reduce pain associated with gastroparesis. Other drugs found useful in treating neuropathic pain may be tried. Opiates, or narcotics, should be avoided.

Manage the Psychosocial Aspects

Not surprisingly, anxiety and depression are very common in people with chronic debilitating illnesses. The physician and staff need to have compassion and patience. If necessary, psychological consultation should be considered. Low dose tricyclic medications do not treat anxiety or depression. Real emotional disorders require real psychological treatment. Appropriate treatment can lead to improvement in the GI symptoms.

Patients with an eating disorder may be given a diagnosis of gastroparesis. However, it is probably more common for patients with gastroparesis to be accused of having an eating disorder, rather than actually having one.

When to Consider Surgery

Patients failing medical therapy should have a thorough evaluation before considering surgical therapy. Surgical procedures all have inherent risks that need to be carefully weighed and understood. Most surgical treatments are irreversible, but work in carefully selected patients, having the correct surgery done, by an experienced and accomplished surgeon.

Be Persistent and Be Careful

Most medications work only less than half of the time. Nonetheless, most people will respond to some therapy. If a medication causes side effects, consider a lower dose. If it doesn’t work, try something else. Combining medications may be helpful. The effectiveness of various agents differs between individuals. Importantly, a medication regimen must be carefully chosen under the direction of the physician. Keep hydrated and as nutritionally fit as possible.

When treatment is failing and there appear to be no other options – whether you are the patient or the physician – get another opinion. Persistence pays off, as most people with gastroparesis ultimately will do well.

Adapted from IFFGD Publication: Gastroparesis (Delayed Gastric Emptying) by J. Patrick Waring, MD, Digestive Healthcare of Georgia, Atlanta, GA; and William F. Norton, Communications Director, International Foundation for Functional Gastrointestinal Disorders, Milwaukee, WI.

Advil, Aleve and Tylenol: What’s the difference?

You wake up with a terrible headache, a sore muscle or yesterday’s sunburn is bothering you, and shuffle your way to your medicine cabinet. You open the cabinet, hoping to find something to help with the pain and discomfort, but find yourself faced with three choices: Advil, Aleve and Tylenol. Which one should you take? What are the differences to consider before taking?

“All of these pharmaceuticals are useful to treat pain and reduce fever, which is why they’re such common occurrences in households,” said David E. Potter, Ph.D., professor and chair of pharmaceutical sciences with the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy. “However, there are some instances where one of these medicines may work better than its counterparts.”

To help navigate when to choose which of these common over-the-counter medications, Potter offers the following information about each pain and fever-reducer:

Tylenol (acetaminophen)

Acetaminophen (Tylenol’s generic name) is a popular option for treating cold and flu-like symptoms, but Potter cautions that users need to be aware of how much they take in a day. Since acetaminophen is often combined with other over-the-counter cold medications that contain fever-reducing ingredients, people may end up taking multiple doses and exceeding the daily limitations.

“More than Advil and Aleve, Tylenol has a definite dosage ceiling of 325 milligrams per pill or capsule. Additionally, people should avoid taking more than 3000 milligrams per day, or they might begin to experience liver toxicity,” Potter warned.

People with liver disease, or who have consumed alcohol regularly, should be especially wary of the dosage they consume as unintentional overdosing can result in severe liver damage or even failure. Fortunately, these serious complications can be avoided if treated within 24 hours. Potter explains that the most common symptoms of acetaminophen overdose are lethargy (a sluggish state) and nausea or vomiting. If an individual exhibits these symptoms, they should seek medical attention within 24 hours, if possible.

Unlike its counterparts, acetaminophen does not possess any anti-inflammatory effects. For injuries like a sprain or discomfort from arthritis, Tylenol will not treat the pain as effectively as Advil or Aleve.

However, in the case of viral infections in young children and infants, acetaminophen’s can lower temperature effectively. In these situations, Tylenol is a better option to reduce fever than aspirin, Advil or Aleve. In all cases, be sure to adjust the dosage accordingly for the child’s age.

Advil (ibuprofen) and Aleve (naproxen sodium)

As far as anti-inflammatories go, ibuprofen and naproxen sodium have almost identical attributes. The main discriminating factors between the two are the active duration of each dose – Aleve is advertised as lasting almost four hours longer than Advil – and that naproxen causes a higher instance of photosensitivity (sensitivity to light).

For injuries or inflammatory symptoms, either ibuprofen or naproxen can both reduce inflammation or swelling and manage the pain. However, in the case of prolonged exposure to the sun or tanning, ibuprofen is probably a better alternative to naproxen.

Although most people have these medications or are aware of them, Potter suggests that not everybody should use these as their primary form of pain management.

“With ibuprofen and naproxen, there are higher incidences of gastrointestinal (GI) bleeding or ulcers that can occur in people predisposed to peptic ulcer disease. When taking either medication, it’s recommended that individuals take them with food to help with any GI discomfort. People who are predisposed to GI disorders should generally try to avoid ibuprofen or naproxen so as not to exacerbate symptoms and damage to the intestinal lining,” Potter said.

So if you wake up with a headache, any one of the three will help manage pain. If you’re combating sore muscles or arthritis, either ibuprofen or naproxen are your best bet to treat inflammation; and if that sunburn is bothering you, or you like to use suntan beds, stick with ibuprofen or acetaminophen.

— Elizabeth Grimm

instructions, use, analogues of the drug, composition, indications, contraindications, side effects in the reference book of medicines from UNIAN

Tylenol use

Indications for use

Tylenol – composition and release form of the drug

Tylenol: how to take the drug

Tylenol – contraindications and side effects

Tylenol’s analogs

Tylenol is a remedy for colds. Tylenol belongs to the group of non-narcotic analgesics.The drug acts on the centers of thermoregulation, pain, its active ingredient is paracetamol.

Application of Tylenol

Indications for use

The drug Tylenol is effective for fever associated with infections, helps with toothache, headache, as well as pain caused by arthralgia, migraine, myalgia arising from algodismenorrhea.

Tylenol – composition and release form of the drug

Composition and release form

1 caplet contains paracetamol 500 mg; in a blister 10 pcs., in a box 1 blister or in strips of 2 pcs., in a box of 50 strips.

Form of issue. Tablets

Tylenol: how to take the drug

How to use

Inside Tylenol is taken one to two hours after eating. Children over 12 years old, weighing more than 40 kg, and adults are prescribed Tylenol in a single dosage of 500 mg. Tylenol is taken about 4 times a day. The therapy lasts 5-7 days.

If the patient suffers from impaired liver function, kidney function or Gilbert’s syndrome, he needs to adjust the dose downward.The same applies to elderly patients. In addition to reducing the dose of Tylenol for such patients, an increase in the intervals between doses is practiced.

Children under six months, weighing up to 7 kg are prescribed 350 mg of Tylenol.

Children under 1 year old, weighing up to 10 kg are given 500 mg of Tylenol.

Children under three years old, weighing up to 15 kg are given 750 mg.

Children under 6 years old, weighing up to 22 kg – 1 g.

Children 9 years old, weighing up to 30 kg are given 1.5 g of Tylenol.

Children under 12 years old – 2 g.

Tylenol – contraindications and side effects

Side effects

Tylenol from side effects can cause skin rash, erythema, angioedema, dizziness, nausea, epigastric pain, agitation , hepatonecrosis, anemia, shortness of breath, cyanosis, heart pain, agranulocytosis, thrombocytopenia, leukopenia, neutropenia.In large quantities, Tylenol can be nephrotoxic: renal colic, papillary necrosis, or interstitial nephritis appear.

Contraindications

Tylenol is contraindicated in children under one month of age for allergies to it. Caution is observed when prescribing Tylenol to patients with renal, liver failure, benign hyperbilirubinemia, viral hepatitis, alcoholism, diabetes, glucose-6-phosphate dehydrogenase deficiency, as well as elderly patients, lactating, pregnant women, children under 3 months.

Tylenol analogs

Source: State Register of Medicines of Ukraine. The instructions are published with abbreviations for information only. Before use, consult your doctor and read the instructions carefully. Self-medication can be harmful to your health.

TAYLENOL: instructions, reviews, analogues, price in pharmacies

TAYLENOL: instructions, reviews, analogues, price in pharmacies – Medcentre.com.ua

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Tylenol is a remedy for colds.Tylenol belongs to the group of non-narcotic analgesics. The drug acts on the centers of thermoregulation, pain, its active ingredient is paracetamol. Tylenol has no negative effect on the mucous membranes of the gastrointestinal tract, water-salt metabolism. It affects the centers of thermoregulation and pain, thereby reducing body temperature and removing pain. This medication does not cause retention of sodium ions and water in the body. In addition, it is completely harmless to the digestive tract, the walls of which are usually affected by other similar drugs.

Indications for use

The drug Tylenol is effective against fever associated with infections, helps with toothache, headache, as well as pain caused by arthralgia, migraine, myalgia, arising from algodismenorrhea.

Directions for use
Inside Tylenol is taken one to two hours after a meal. Children from 12 liters, weighing more than 40 kg and adults are prescribed Tylenol in a single dosage of 500 mg. Tylenol is taken about 4 times a day.The therapy lasts 5-7 days. If the patient suffers from impaired liver, kidney function or Gilbert’s syndrome, he needs to adjust the dose downward. The same applies to elderly patients. In addition to reducing the dose of Tylenol for such patients, an increase in the intervals between doses is practiced. Children under six months, weighing up to 7 kg, are prescribed 350 mg of Tylenol for children under 1 year old, weighing up to 10 kg are given 500 mg of Tylenol; children under three years old, weighing up to 15 kg, are given 750 mg; up to 6 liters, weighing up to 22 kg – 1 g; children 9 liters, weighing up to 30 kg are given 1.5 g of Tylenol; children under 12 years old – 2 g.Suspension for children 6-12 liters. give 10-20 ml; children 1-6 y. – 5-10 ml; children from three months to one year are given 2.5-5 ml. For children under 3 months of age, the dosage of Tylenol is determined individually. The suspension is given to children 4 times a day. Without medical supervision, the drug can be given only for 3 days to relieve fever and no more than 5 days for pain relief. Rectal suppositories Tylenol for adults are prescribed at a dosage of 500 mg, they are used no more than four times a day. Children 12-15 years old. appoint 250-300 mg of Tylenol about four times a day; 8-12 years old – 250-300 mg no more than three times a day; 6-8 years old – 750-900 mg in three doses; 4-6 years old – 150 mg about 3-4 times a day; child 2-4 years old – 300-450 mg in two or three doses; 1-2 years – 80 mg of Tylenol no more than four times a day; from six months to a year – 80 mg no more than three times a day; 3-6 months

– 160 mg per day, in two divided doses.

Side effects

Tylenol from side effects can cause skin rash, erythema, angioedema, dizziness, nausea, epigastric pain, agitation, hepatonecrosis, anemia, shortness of breath, cyanosis, heart pain, agranulocytosis, thrombocytopenia, neutropenia. In large quantities, Tylenol can be nephrotoxic: renal colic, papillary necrosis, or interstitial nephritis appear.

Contraindications

:
Tylenol is contraindicated in children under one month of age for allergies to it.Caution is observed when prescribing Tylenol to patients with renal, liver failure, benign hyperbilirubinemia, viral hepatitis, alcoholism, diabetes, glucose-6-phosphate dehydrogenase deficiency, as well as elderly patients, lactating, pregnant women, children under 3 months.

Pregnancy

:
Taking Tylenol during pregnancy is not recommended unless the doctor believes that the benefit to the mother at that time is more important than the potential harm to the fetus.

Interaction with other medicinal products:
Tylenol reduces the effectiveness of uricosuric drugs. The concomitant use of paracetamol in high doses increases the effect of anticoagulant drugs (a decrease in the synthesis of procoagulant factors in the liver). Inducers of microsomal oxidation in the liver (phenytoin, ethanol, barbiturates, rifampicin, phenylbutazone, tricyclic antidepressants), ethanol and hepatotoxic drugs increase the production of hydroxylated active metabolites, which makes it possible to develop severe intoxication even with a small overdose.Long-term use of barbiturates reduces the effectiveness of paracetamol. Ethanol contributes to the development of acute pancreatitis. Inhibitors of microsomal oxidation (including cimetidine) reduce the risk of hepatotoxic effects. Long-term joint use of paracetamol and other NSAIDs increases the risk of developing “analgesic” nephropathy and renal papillary necrosis, the onset of end-stage renal failure. The simultaneous long-term administration of high doses of paracetamol and salicylates increases the risk of developing kidney or bladder cancer.Diflunisal increases the plasma concentration of paracetamol by 50% – the risk of developing hepatotoxicity. Myelotoxic drugs increase the manifestations of the drug’s hematotoxicity.

Overdose

:
Symptoms of an overdose of the drug Tylenol : in the first 24 hours – pallor, nausea, vomiting and pain in the abdominal region; 12–48 hours later – damage to the kidneys and liver with the development of liver failure (encephalopathy, coma, death), cardiac arrhythmias and pancreatitis. Liver damage is possible when taking 10 g or more (in adults).
Treatment: the appointment of methionine by mouth or intravenous administration of N-acetylcysteine.

Storage conditions

Store Tylenol at 15-30 ° C.

Release form

Capsules, effervescent powder for oral solution [for children], solution for infusion, oral solution [for children], syrup, rectal suppositories, rectal suppositories [for children], oral suspension, suspension.

Composition

:
Paracetamol.

Basic parameters

TYLENOL Reference

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SELF-TREATMENT CAN HARM YOUR HEALTH

How bad is it to mix booze with painkillers?

Ax , friends . It’s like family, but cooler. Fully subject to personification. Fall – and one of them will be right there to lift you back. But as good as friends are, they also do a lot of downright stupid things. Such that the brain explodes. For example, it sometimes seems crazy that you even hang out with people making such shitty decisions. Such that, if it were revealed, they would seem terribly shameful to any person with even a drop of self-respect. Luckily for your friends, they can ask their deepest, darkest questions for you.And luckily for you, we’ve created this column to answer these incredibly embarrassing questions.

Scenario: It’s Saturday morning and your friend wakes up with a terrible headache. His usual combination of pedialight with a bold brunch won’t work; he needs pharmaceutical help. He reaches for a bottle of over-the-counter pain-relieving pills and shakes out three, brushing aside the bold-printed warnings to take two and not take if you’ve had more than three glasses.Last night he drank (oh!) Three times three glasses, so you are sure that now he may need to sign up for a liver transplant at any time – as if he drank too many pills , and because alcohol is still present in his body.

So will he die from this dose? Let’s deal with all the risks one by one. Chances are that your friend has taken one of the three most popular pain relievers: acetaminophen (Tylenol), aspirin (Bayer), or ibuprofen (Advil).Be that as it may, first of all he got it right by drinking more than the recommended dose – usually no more than two tablets.

Acetaminophen tends to panic the most, so let’s start with that. One regular dosage Tylenol tablet contains 325 mg of acetaminophen, the active substance in Tylenol, as well as in drugs such as Excedrin, Alka-Seltzer and Nikvil. It is usually recommended to take two Tylenol tablets at a time, but your friend took three for 975 mg.Now you’re getting nervous because everyone’s always saying that Acetaminophen overdose can cause severe liver damage that can lead to liver failure.

The idea that acetaminophen puts the liver at risk can be linked to the results of a widely cited 2002 study published in the Annals of Internal Medicine, which found that acetaminophen overdose was the leading cause of acute liver failure in the United States.After tracing 308 patients at 17 hepatology centers over 41 months, the researchers concluded that 39 percent of acute liver failure cases were associated with acetaminophen. This was serious at the time, because prior to that, studies indicated that the main culprit was viral hepatitis (which can be caused by contaminated food or exposure to infected blood).

“A small percentage of acetaminophen is metabolized into a substance called N-acetyl-p-benzo-quinone-imine, which, if taken at the recommended dose, is neutralized by a compound called glutathione and excreted in the urine,” explains Harmut Jeschke, researcher acetaminophen from the University of Kansas Medical Center.- But if you take too much, so that as a result, an excess of N-acetyl-p-benzo-quinone-imine is formed or there is not enough glutathione – and this happens when there is malnutrition – N-acetyl-p-benzo-quinone-imine binds to liver cells and kills them. And the death of a sufficient number of cells can lead to severe liver damage. ”

But it’s too early to panic. A closer look at the details of the results reveals that most of the cases of acute liver failure associated with acetaminophen were caused by rather severe overdoses: the average amount absorbed by humans was 13,000 mg, which is the same as consuming 40 tablets of 325 mg.That’s a lot of pain reliever given that the FDA recommends no more than 4000 mg per day (closer to 12 tablets).

So while you think your friend would benefit from a good scary story (which is what friends are for, right?) That will cause him to reconsider his careless habits, in fact, it is unlikely that anything bad will happen if he took 975 mg instead of 650.

“The most important thing is not to take more than 1000 mg at a time,” says Ed Krenzelok, former director of the Pittsburgh Poison Center and the Drug Information Center at the University of Pittsburgh Medical Center.“I’ve never seen this one-time dose be a problem for the average person, whether you have a hangover or not,” Yeschke agrees. “If you follow the recommended intervals or take a pill every four to six hours, your glutathione levels can easily recover in just a few hours,” he says.

Both ibuprofen and aspirin are NSAIDs or non-steroidal anti-inflammatory drugs. They are not metabolized in the same way as, for example, acetaminophen, that is, they do not produce that potentially toxic liver metabolite, but they still have their drawbacks.To work, NSAIDs block the production of prostaglandins, hormones that increase pain and swelling. But these hormones also help protect your stomach lining, so turning them off can also leave you vulnerable to gastrointestinal problems like discomfort or even ulcers. And in some people, even the recommended dose of NSAIDs can irritate the gastrointestinal tract, so exceeding it can lead to even more irritation and pain, says Krenzelok. In the fragile state of a hangover, the last thing you need is new reasons for nausea.

What about mixing drugs with booze? In the end, your friend took these pills, clearly exceeding the “maximum of three glasses”. Read the information on any acetaminophen bottle and you will find a memorable warning: “Severe liver damage may occur after drinking three or more drinks a day while taking this drug.” There is a similar warning on ibuprofen and aspirin, only they talk about stomach bleeding. Both are clearly not fun.

Before you get your friend to start writing a will, keep in mind: it turns out that there is no consensus in the scientific community about how harmful acetaminophen (or ibuprofen or aspirin) is when drinking alcohol, and researchers are still trying to come up with it. to agree on how much drinking is causing problems when taking the medication.

“If you drink a lot one night and then take a medicated dose of acetaminophen, for example 1000 mg at a time, it is unlikely that you will develop any liver damage,” says Richard Dart, director of the Poison and Drug Center in Rocky Mountain. “The fact is that alcohol and acetaminophen are competing for conversion by the same enzymes, so less N-acetyl-p-benzo-quinone-imine is produced.”

Some experts believe that, in general, people who drink moderately or take acetaminophen after occasional binges may have more leeway compared to chronic alcoholics (that is, women who drink more than two glasses a day and men who drink more than three glasses per day).“The chronic alcoholic, who gets the majority of his calories from alcohol and is poorly nourished, will certainly have lower levels of glutathione and more enzymes that process acetaminophen, and therefore produces more N-acetyl-p-benzo-quinone-imine, which makes them more susceptible to acetaminophen overdose, ”says Jeschke. This means that a dose of just over 4,000 mg of acetaminophen could harm these people.

The link between drinking and NSAIDs is not well researched, but given their propensity for gastric complications, they are not recommended for those who drink.“Drinking alcohol, especially in large doses, can irritate the stomach, which can be aggravated by taking aspirin or ibuprofen, as these are also stomach irritants,” explains Jeschke. In healthy people, moderate alcohol consumption with medicated doses of acetaminophen or NSAIDs should not do anything bad, but if you are prone to abdominal problems, acetaminophen alone is probably best. And if you already have stomach problems like ulcers or gastritis, I would avoid ibuprofen and aspirin altogether. ”

Okay, here’s what you need to know: If your friend is not a chronic drunkard, does not eat poorly, is not underweight, and does not take these medications in excessive doses, it probably will not be a sin if you take two or three hangover pills. Experts worry that “because acetaminophen is sold over the counter and is available in so many drugs, people may be taking excessive doses of it without even knowing it,” says Nikolaos T. Pirsopoulos, director of the Department of Gastroenterology and Hepatology, and also medical director of the Liver Transplant Unit at Rutgers University.So if your friend takes the liberties in treating his hangover and doesn’t pay attention to the dosage of, say, his acetaminophen cold medicine, it could smell like kerosene. All the experts interviewed stressed the importance of reading the instructions without fail.

According to FDA , “preparations containing 325 mg of acetaminophen should be taken at a dosage of 325-650 mg every 4 hours for as long as symptoms persist, without exceeding the total dose of 3900 mg in 24 hours for no more than 10 days.Preparations containing 500 mg should be taken according to the following dosage regimen: doses for adults – up to 1000 mg, not more than 4000 mg in 24 hours. Pirsopoulos even recommends to play it safe if you often go into binges – take less than 4,000 mg per day for a hangover. Since alcohol is already irritating to the gastrointestinal tract, the experts advocated less for the use of NSAIDs like ibuprofen or aspirin when drinking alcohol (this is normal in other cases, if you, again, do not have stomach problems).

Finally, taking a larger dose of anything doesn’t necessarily help the pain.“There is a certain threshold for the effectiveness of drugs,” says Krenzelok. “Behind it, the pain reliever won’t heal the headache any better.”

Spearmint for the treatment of cancer and indigestion

Spearmint treats indigestion and fights cancer

If you’ve ever chewed peppermint gum or inhaled the scent of peppermint, then you’ve certainly experienced its refreshing properties.Both the smell and taste of this plant are pleasantly invigorating. Spearmint is a relative of peppermint, but there are some differences.

Spearmint leaves and oil are used for the production of medicines. The oil has the ability to reduce inflammation, fight bacteria and even cancer cells when taken internally.

When used topically, this plant is rich in menthol and relieves muscle pain, neuralgia, and even arthritis.Other benefits of spearmint include relieving headaches, sore throats, toothaches, and cramps.

What is spearmint?

Spearmint or Mentha spicata is an aromatic herb that is widely used in both cooking and medicine. The spearmint, named for its shape, belongs to the Lamiaceae family ( Lamiaceae ).

It is a perennial plant that can spread very quickly.His homeland is considered to be Europe and Asia.

The leaves of this plant can often be found dry or fresh as a condiment in soups, salads, sauces, drinks, meat or fish, and when serving fruits and vegetables.

Peppermint essential oil is widely used to flavor toothpastes, mouthwashes, lip balms, marmalade and candy. It is also used in cosmetics and household goods such as lotions and candles.

Tea with spearmint

Mint tea is a great way not only to enjoy the taste and aroma of this plant, but also to experience all of its beneficial properties for yourself. On sale you will find both tea bags and loose tea.

If you prefer loose tea, just pour 1 teaspoon of dried leaves with one glass of boiling water. Let it brew for 5 minutes, strain and enjoy. It can be drunk hot or cold.

You can add mint to black, green, or white tea for a distinctive flavor. Or mix it with other medicinal herbs, and you get a collection with the necessary medicinal properties and a pleasant smell.

To avoid unwanted chemicals, it makes sense to purchase trusted brands of tea from a pharmacy or store.

Nutritional properties

Medicinal herbs can be invisible in small amounts, but are very beneficial and nutritious.

Two tablespoons of fresh spearmint contains about:

• 4.9 Calories
• 0.9 g carbohydrates
• 0.8 g fiber
• 0 g fat
• 0.4 g protein

90,079,456 IU vitamin A (9% of the RDI) 90,080

• 1.3 milligrams iron (7% of the RDI)
• 0.1 milligrams manganese (6% of the RDI)
• 11.8 mcg folate (3% of the RDI)

90,079 1.5 milligrams vitamin C (2% of the RDI) 90,080

• 22.4 milligrams calcium (2% of the RDI)
• 7.1 milligrams magnesium (2% of the RDI)

Spearmint and peppermint

Definitely, these two plants have a lot in common, but there are also differences:

• Peppermint and spearmint are two species of mint and belong to the same Lamiaceae family.
• Both plants have a distinctive smell and taste, but spearmint is slightly sweeter and peppermint is more refreshing.
• Both plants are often used in candles, chewing gum, toothpaste and mouthwash.
• Both peppermint and spearmint (dry and fresh) are consumed as tea.
• These herbs help relieve pain, relieve stress, improve memory, and cope with digestive problems.
• Both types of mint contain the active ingredient menthol, but peppermint contains more of it (therefore more refreshing).
• Spearmint and peppermint contain carvone, but the former contains more of it (therefore, it is sweeter).
• In cooking, peppermint is used primarily in sweet dishes and when serving chocolate. Spearmint is added to more savory dishes.

Health Benefits

Spearmint is used for a variety of problems, both externally and internally. It has the following properties:

1. Fights intestinal upset and flatulence

According to scientists, one of the active components of mint, carvone, has an antispasmodic effect on the intestines.

The calming effect of mint on the gastrointestinal tract can help relieve ailments such as flatulence and abdominal pain.

2. Improves memory

Some experts recommend using spearmint extract, which is rich in polyphenols such as rosmarinic acid, to improve memory. It will be especially useful for the elderly.

2018 double-blind placebo-controlled study published in “ Journal of Alternative and Complementary Medicine ” studied as a dietary supplement supplemented with Mentha extract , affects the cognitive functions of people with age-related memory impairments, as well as their mood and sleep.

Thus, 90 volunteers with age-related memory impairments were randomly selected. They were asked to take 900, 600 and 0 mg of Mentha spicata extract daily for 90 days. The results of the experiment showed that in patients taking 900 mg of the extract, there was a 15% improvement in memory, while they began to fall asleep faster.

Overall, the study concluded that spearmint extract could be “a beneficial and nutritious supplement for older adults with age-related memory impairments.”

3. Helps to cope with nausea and vomiting

Nausea and vomiting are common side effects of chemotherapy. A 2013 randomized double-blind study found that spearmint and peppermint essential oils can help treat these symptoms.

This study found that the use of these essential oils resulted in a decrease in the frequency and intensity of vomiting associated with chemotherapy treatment.

Moreover, their use has not shown any side effects.Scientists note that the use of essential oils can be very effective in combating the effects of chemotherapy when compared to traditional methods.

4. Antineoplastic properties

Study in vitro (“in vitro”), published in the journal “ Complementary and Alternative Medicine ” , highlights the ability of spearmint oil (which contains at least 44 components) have an antiproliferative effect on three types of human cancer cell lines.

Another analysis in vitro , carried out in 2014, showed similar anticancer capabilities of both spearmint and other plants of the mint genus against four cancer cell lines (COLO-205, MCF-7, NCI-h422 and THP-1) …

5. Fights bacteria and fungus

Looking for a good mouthwash or toothpaste? Spearmint oil in the product gives it antibacterial properties.

Research has shown that essential oil Mentha spicata , may have antimicrobial effect, which means it can prevent the spread of germs, fungi and even some viruses.

Peppermint essential oils are also able to fight microorganisms such as E.coli and Salmonella.

6. Stabilization of hormonal levels and reduction of manifestations of hirsutism

Hirsutism is a condition in which women experience excessive hair growth in areas where it should not be, such as the chin and neck, and hair loss on the head. This disease occurs due to an increase in the amount of the male hormone-androgen testosterone in the body.

A 2017 small scientific review found that spearmint tea can lower androgenic hormone levels in women with hirsutism.

However, judging by the latest analyzes, the intake of mint should be long-term (more than 30 days), which means that the observation period during the study must be increased.

7. Has a general sedative effect (hypnotic effect is possible)

Spearmint tea has traditionally been used to relieve stress and treat insomnia.Animal studies tell us that peppermint extract can fight anxiety and have soothing and hypnotic effects.

Scientists also claim that the plant’s calming effect is due to its menthol content, which acts on GABA receptors.

GABA is a neurotransmitter that helps transmit signals between the brain and nervous system. A decrease in neural excitability leads to a decrease in anxiety and the acquisition of calmness.

Side effects and interactions with other drugs

For most people, mint is safe in the amount normally found in foods. When taken as a dietary supplement or when used topically in moderate doses, it does not cause side effects.

During pregnancy, it should be remembered that excessive consumption of spearmint, whether it be tea or a dietary supplement, can harm the fetus. Therefore, use this plant only in the amount recommended by specialists.

In high doses, mint can be detrimental to the liver and kidneys. If you suffer from any kind of kidney or liver disease, keep in mind that peppermint can aggravate your condition. Even mint tea, if drunk in large quantities, can be detrimental to your health.

For this reason, we recommend that you limit mint in your diet if you are taking any medications that can affect the liver. These include acetaminophen (Tylenol and others), amiodarone (Cordarone), carbamazepine (Tegretol), isoniazid, methotrexate (Rheumatrex), methyldopa (Aldomet), fluconazole (Diflucan) and many other.

Peppermint should be taken with caution if you are using liver-enhancing supplements such as niacin, dehydroepiandrosterone (DHEA), comfrey, chaparral, mint oil, red yeast rice, and others.

Peppermint is also not recommended to be consumed with other natural drugs that cause drowsiness. It can be 5-hydroxytryptophan, calamus, Californian poppy, catnip, hops, Jamaican dogwood, intoxicating pepper, St. John’s wort, valerian, and others.

Final conclusions

• Spearmint is a herb that belongs to the Lamiaceae family, like peppermint.
• Which plant is better, spearmint or peppermint? If you are comparing medicinal properties, then it is very difficult to say which plant is healthier. When it comes to cooking, peppermint is mainly used in desserts, while spearmint is used in spicy dishes.
• Spearmint is used in many areas, for example, in medicine, cooking and in the production of cosmetics.
• Potential benefits of spearmint include stress relieving, improving memory and sleep, and fighting digestive problems and germs.
• According to recent research, spearmint has anti-cancer properties.
• You can add dry and fresh mint leaves to your meals and drinks, and even make tea.
• For maximum benefit, try to use 100% therapeutic grade organic essential oil or other organic mint products.

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How to get rid of sciatic nerve neuralgia pain

Shot from the tailbone to the entire thigh?

Physicians do not distinguish sciatica as an independent disease, they call it a syndrome, since it can occur in various conditions. Therefore, the approach to relieving pain and other signs of inflammation is far from universal.First of all, an experienced doctor tries to find out the cause of the pain syndrome, and only then prescribes treatment.

Manifestations of sciatic nerve neuralgia can be different in their severity. For some, this disease can proceed with intense pain, and for some they are quite tolerable, although they progress over time. Sciatica pain is usually noted on one side. And depending on the level of damage to the nerve roots of the lumbar plexus, it can be felt both in the buttock and given to the lower leg, foot or fingers.

In addition to pain, people complain of numbness or tingling sensations. In addition, sciatic nerve neuralgia is manifested by pain in the back of the leg, which increases in a sitting position of the patient, as well as burning or tingling in the lower leg, weakness and difficulty in moving the leg. It should be noted that sciatic nerve neuralgia may be accompanied by back pain, but in intensity it is inferior to leg pain.

The manifestations of sciatica depend on the level at which the nerve roots are affected.In most patients, leg pain can worsen with coughing, sneezing, laughing. Muscle weakness in sciatica is explained by the fact that the sciatic nerve innervates the main part of the muscles of the lower limb, and in the popliteal fossa it divides into the tibial and peroneal nerves.

Notes

Several ways to manage sciatica pain on your own.

Avoid bending your spine, lifting weights, or sitting on a soft, low chair – this can worsen leg pain.

If you are not allergic to medications and do not take blood thinners (such as warfarin), you can try medications such as Tylenol, indomethacin, ibuprofen, aspirin, and other NSAIDs.

Try applying cold topically. This could be an ice pack, a plastic bottle filled with frozen water. Massaging movements with a piece of ice in the area of ​​pain also help.

It is also recommended to alternate the local application of cold and heat (using a heating pad).

Lying on a hard surface with a pillow under your knees can also relieve pain. This technique allows you to reduce the tension on the sciatic nerve.

If the pain has disappeared for a while, then it may soon bother you again. Therefore, it is important, in addition to using the methods of “ambulance”, to also deal with the determination of the reasons and receive the doctor’s recommendations regarding the most optimal treatment for the disease.

Currently, the simplest and most common diagnostic method is radiography. It allows you to see the presence of osteochondrosis, spondylolisthesis and some other causative factors. However, X-rays will not help to see a herniated disc. Therefore, you often have to use the capabilities of computed tomography or magnetic resonance imaging. If a person has been previously diagnosed with a malignant tumor or has been taking steroid medications for a long time, the doctor may prescribe a radioisotope scan of the spine.In addition, doctors also carry out a neurological examination – checking reflexes on the lower limb by tapping with a hammer, as well as determining skin sensitivity. This study also allows you to assess the level of damage to the nervous system.

Conservative treatment of sciatic nerve neuralgia does not differ from that in other diseases of the spine. It consists primarily in the use of pain relievers. First of all, these are non-steroidal anti-inflammatory drugs (NSAIDs).Their action is based on the fact that they block the formation in the body of chemicals (prostaglandins) that are responsible for pain. The most popular NSAIDs are Ceberex, Ketoprofen, Piroxicam, Sulindac, Ibuprofen, Naproxen, Indomethacin, Ketorolac.

It should be remembered that drugs in this group have a bad reputation. Their use leads to the appearance of a number of side effects – irritation of the gastric mucosa with the appearance of pain, nausea, and vomiting. In severe cases, peptic ulcers and bleeding may even occur.Then, NSAIDs lead to a decrease in blood clotting and complications of urological diseases.

Attention!

Non-steroidal anti-inflammatory drugs are contraindicated in the following cases:

Peptic ulcer of the stomach or duodenum;

Anemia;

Bleeding tendency;

High blood pressure;

Diseases of the heart, liver and kidneys.

The next group of drugs that are used to treat sciatic nerve neuralgia are steroid anti-inflammatory drugs. These are derivatives of the natural human hormone cortisol. Steroids are usually used for a short period of time (1–2 weeks), as long-term use can cause serious side effects. The effect of such drugs is based on the fact that they relieve inflammation, thereby reducing pain, and also eliminate tissue swelling.

Side effects of steroid drugs include weight gain, stomach ulcers, osteoporosis, facial edema, increased blood clotting and decreased immunity.

In addition to pills and ointments, neuralgia is treated with physiotherapy. Of course, it does not allow you to get rid of the disease that caused sciatica, but it can significantly alleviate the patient’s condition by eliminating the pain. Physiotherapeutic methods include UHF therapy, magnetotherapy, paraffin applications, diadynamic currents, electrophoresis and phonophoresis with drugs.

All these methods are based on the fact that they create heat at the site of inflammation. This relieves swelling and improves blood circulation, resulting in pain relief.

Epidural administration of steroids is considered a separate area of ​​medical treatment. This injection method involves the doctor injecting a steroidal anti-inflammatory drug directly into the space between the membranes of the bone marrow, which allows the drug to act directly at the site of nerve root inflammation. The injection itself is performed by lumbar puncture into the spinal canal.Although the effect of epidural injections of steroid drugs is temporary, and such injections are not suitable for all patients, the number of thighs they saved is significant.

The advantages of epidural administration of steroidal anti-inflammatory drugs in comparison with treatment with tablets are that this method allows you to reduce the dose of the drug, since it acts directly on the site of inflammation, and also reduces the risk of side effects.

In cases where conservative treatment of sciatic nerve neuralgia does not eliminate the pain syndrome, it is necessary to resort to surgical intervention.The choice of surgery depends directly on the cause of the sciatic nerve neuralgia. There are a lot of options, and only a neurosurgeon can choose the most suitable one. At least in his opinion …

Igor ZAIKOVATY

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90,000 Tylenol Dosage for Infants and Children – Health

Tylenol (acetaminophen) is a popular over-the-counter drug often given to children of all ages when they have pain or fever.The fact that it is sold over the counter does not mean

Content

Tylenol (acetaminophen) is a popular over-the-counter medication often given to children of all ages when they have pain or fever. The fact that it is sold over the counter does not mean it has no risks. Every parent should learn about Tylenol in order not to abuse this common drug.

Precautions for giving Tylenol to a child

Important precautions include:

• You should generally not give Tylenol to children under 12 weeks of age without consulting a pediatrician (pain or fever should be investigated quickly at this age).
• Do not give children doses more often than every 4-6 hours, and do not give more than five doses a day.
• When giving liquid acetaminophen products, always use the supplied measuring tool, keeping in mind that teaspoons are not a precise dispenser.
• Be sure to shake the bottle well before giving the dose to your child.
• Always double-check the medicine, dose, and what you have measured correctly before giving Tylenol or any other medicine to your child.
• Do not use Tylenol with other medicines containing acetaminophen, or you will double the same ingredient and most likely overdose your child.
• Follow the manufacturer’s warning and call your doctor if your child “gets worse or lasts more than 5 days” or “has a fever worse or lasts more than 3 days”.
• You need to know how to find or calculate a Tylenol dosage for infants and toddlers under 24 pounds because the drug label lists dosages only for older children who weigh at least 24 pounds and are 2 years of age or older.

Call a Poison Control Center if you have given too much Tylenol or given a dose too early. Remember, more is not better when it comes to taking medications like Tylenol, so do not give more than the recommended dose for your child’s age and weight, or more often than recommended.

Standardized Dosage

In 2011, regulations standardized the concentration of Tylenol in liquids to 160 milligrams (mg) per 5 milliliters (ml), which avoids some of the confusion associated with prescribing Tylenol to children.You no longer had to come up with different doses for babies. who can use concentrated drops, and older children use less concentrated syrup.

Pharmaceutical companies did not accept all the expert recommendations. For example, many people wanted Tylenol to have dosage instructions for infants as young as 6 months old. Instead, these labels, even the Tylenol Infant Liquid Suspension, still read: “If your child is under 2 years old, be sure to ask your doctor for the correct dose.”

Hope your pediatrician has advised you on the right dose for your check-up so you don’t have to panic in the middle of the night when you need to give your child the right dose of Tylenol.

Tylenol Dosage Calculator

If necessary, to calculate your child’s dose of Tylenol, you can:

1. Measure your child’s weight in pounds.
2. Take a look at the Tylenol dosage by weight below.
3. Use the syringe or dosing cup that came with the medicine and measure out the dose for your child.

For example, when using Tylenol Suspension Liquid 160 mg per 5 ml for children:

• 6 to 11 lbs = 1.25 ml or 40 mg
• 12 to 17 lbs = 2.5 ml or 80 mg
• 18 to 23 lb = 3.75 ml or 120 mg
• 24 to 35 lb = 5 ml or 160 mg
• 36 to 47 lb = 7.5 ml or 240 mg
• 48 to 59 lb = 10 ml or 320 mg
• 60 to 71 lb = 12.5 ml or 400 mg
• 72 to 95 lb = 15 ml or 480 mg
• Over 96 lb = 20 ml or 640 mg

Other forms of Tylenol for children

In addition to Tylenol liquid suspension for infants and children, other forms of Tylenol include:

• Children’s Tylenol Meltaways chewable tablets: 80 mg per tablet
• JR Tylenol Meltaways chewable tablets: 160 mg per tablet
• Tablets for adults 325 mg (if your child can swallow tablets)
• Tablets for adults 500 mg

Because your child will most likely not take them until age 2, the dose for your child will be indicated on the label.