Symptoms and consequences of an overdose of painkillers

Painkillers and NSAIDs (non-steroidal anti-inflammatory drugs) can in most cases be found in the medicine cabinet in every home. This is a very common drug group. Medicines are taken to reduce fever, relieve pain, and eliminate other discomfort and symptoms.

Do they pose a danger to the human body?

«Everything is medicine and everything is poison - it's all a matter of dose».

Paracelsus

The danger of overdosing on painkillers

In some cases, when indicated, doctors prescribe opioid treatment to patients.
These are very dangerous drugs that cause drug addiction quite quickly. All you have to do is not follow the doctor’s prescription, increase the period of use and dosage specified in the instructions or allowed by the doctor, and the dependence on the pills is in your pocket.

Opioids have great analgesic activity, so their abuse can easily lead to severe poisoning and even death.

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Nimesil during pregnancy and lactation

Nimesil, like other drugs of the NSAID class, is contraindicated for use during pregnancy and lactation. The active substance of the drug - nimesulide - negatively affects the course of pregnancy and the embryo, as it can lead to premature closure of the ductus arteriosus, hypertension in the pulmonary artery system, impaired renal function, an increased risk of bleeding, decreased contractility of the uterus, and the occurrence of peripheral edema.

Nimesil is contraindicated during pregnancy

Also, it is worth considering that Nimesil is not recommended for use by women who are planning to become pregnant, as the drug can negatively affect female fertility.

Causes of poisoning

More than 12% of drug poisoning and overdose cases involve NSAIDs. Non-opioid analgesics are widely available and can be purchased at any pharmacy, as they are vital supplies. However, it is impossible to buy narcotic painkillers without a prescription. Their free distribution without a prescription is punishable by law. Painkillers often contain codeine, which is sought after by drug addicts.

Why does poisoning occur with painkillers:

failure to comply with instructions or doctor's prescription;
incorrect reception;
doctor's error;
increasing dosage;
lack of knowledge about taking medication;
low body resistance;
combination with alcohol, drugs, other drugs;
cumulative effect due to prolongation of the course of treatment;
taking the drug for recreational purposes;
intake during pregnancy;
when attempting suicide.

Among the most dangerous non-steroidal anti-inflammatory drugs is phenacetin, previously contained in such drugs as Sedalgin and Askofen. This analgesic quite often caused the development of allergic reactions and disruption of internal organs. Today, a substance used as an antipyretic, paracetamol, is used to a greater extent in medicine.

If the patient takes the medicine as prescribed and prescribed by the doctor, an overdose of analgesics and local anesthetics occurs quite rarely. However, most often an overdose of anesthetics is used by drug addicts to achieve euphoria. Pharmacy drugs have long become a source of cheap “high” for them.

Contraindications

history of hepatotoxic reactions caused by the active substance;
bronchospasm, urticaria, rhinitis associated with the use of acetylsalicylic acid or other non-steroidal anti-inflammatory drugs in the anamnesis;
concomitant use of drugs with potential hepatotoxicity;
condition after coronary artery bypass surgery;
inflammatory bowel diseases (ulcerative colitis, Crohn's disease) in the acute stage;
increased body temperature in infectious and inflammatory diseases;
exacerbation of a peptic ulcer, a history of ulcers, perforation or bleeding in the digestive tract;
a combination of bronchial asthma, nasal polyposis and intolerance to non-steroidal anti-inflammatory drugs;
bleeding of cerebrovascular or other localizations; diseases accompanied by pathological bleeding;
decompensated heart failure;
severe blood clotting disorders;
decompensated renal failure, hyperkalemia;
liver diseases;
liver failure;
alcoholism, drug addiction;
pregnancy or lactation;
age under 12 years;
hypersensitivity to the components of the drug.

The decision to prescribe the drug Nimesil remains with the attending physician.

Overdose symptoms

Symptoms of an overdose of painkillers and NSAIDs depend on the individual characteristics of the human body, the drug taken and its dosage. In some cases, a person may become ill even after taking a therapeutic dose. Therefore, in order to prevent poisoning from local anesthetics and narcotic analgesics, it is necessary to strictly follow the instructions, which necessarily indicate the maximum daily dosages.

Acute poisoning with narcotic analgesics

Painkillers have different effects on the body, so the dose that can lead to intoxication is different.

Signs of poisoning:

dizzy;
be sick;
vomiting occurs;
It's difficult to breathe;
weakness, drowsiness;
increased sweating;
loss of consciousness;
pallor, cyanosis;
the temperature drops;
constipation, upset stomach;
weakening of the pulse;
swelling;
pressure drop;
convulsions, tremors.

Among the first signs: lethargy, drowsiness, lethargy, breathing problems. The condition is deteriorating quite quickly. Common complications that arise from an overdose of anesthetic: cerebral edema, pulmonary edema, cardiac arrest, renal failure. A severe overdose of local anesthetics manifests itself in paralysis of the respiratory center. If you do not call an ambulance in time, the risk of death is close to 75%.

Free phone number for a narcologist in Moscow and throughout Russia: 8 (800) 333-20-07. .

It is important to understand that a person who is poisoned by pills can fall into a coma. Even after emerging from this state, irreversible health consequences are possible: mental disorders, dysfunction of certain internal organs.

For recreational purposes, addicts often overdose on painkillers such as Tempalgin or Nurofen to achieve euphoria. Often, to enhance the effect, pharmaceutical drugs are mixed with alcohol and barbiturates, which significantly increases the intoxication of the body and increases the risk of death.

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Non-narcotic analgesics

Non-opioid and non-steroidal anti-inflammatory drugs in pharmacology include drugs that do not have narcotic potential and are not used by drug addicts. These medications are used as anti-inflammatory, antipyretic, painkillers, etc. Regarding doses, for example, if the daily dose, according to the instructions, is 4 grams, then death can occur even after consuming 15-20 g.

Symptoms of Paracetamol overdose:

liver dysfunction (the medicine is a dangerous toxin for the liver, causes bleeding disorders, hepatitis);
disruption of the gastrointestinal tract (stomach pain, nausea, vomiting);
damage to the central nervous system (drowsiness, weakness, lethargy);
metabolic disorder;
low pressure;
renal failure (nephritis and other kidney diseases);
disruption of the cardiovascular system due to general intoxication;
encephalopathy.

Acute poisoning can last for 10-12 hours. You can also be poisoned by the drug if you use it for a long time in an increased dosage, as it accumulates in the tissues of the internal organs. Paracetamol is part of many modern drugs sold in pharmacies, including Spazmolex and Pentalgin. These are dangerous pharmaceutical drugs that addicts use to get a “high.” Often such substances are used for the purpose of suicide attempts.

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Salicylic acid and salicylates

It is quite easy to get poisoned by this common drug among people; it is enough to consume 10-40 g. The dosage of tablets is individual and depends on the condition of the patient’s body. Death is possible in 2% of cases.

Signs of salicylate poisoning:

your head is spinning, your ears are ringing, your consciousness is confused;
headache;
hallucinations, hearing loss;
chills, cramps;
euphoric sensations;
pain in the abdomen, under the ribs, heartburn;
nausea, vomiting, upset stomach;
violation of movement coordination;
excited state;
deterioration of cognitive functions;
disruption of the functioning of the heart and blood vessels, internal organs;
arrhythmia and tachycardia;
increased fatigue;
breathing problems, shortness of breath.

When using salicylic acid, for example, Aspirin in large quantities, internal bleeding may occur.

How to take Nimesil?

Nimesil is sold in pharmacies in powder form, from which a suspension is prepared immediately before administration. So, Nimesil is taken orally, 1 sachet (100 mg of the active substance nimesulide) 2 times a day. It is recommended to take the drug after meals. The contents of the sachet are poured into a glass and dissolved in approximately 100 ml of warm boiled water. The prepared solution cannot be stored. The interval between doses of the drug is at least 12 hours. It is prohibited to increase the dosage.

Nimesil should be taken after meals with a glass of water.

You should remember some instructions when calculating the dosage and use of the drug Nimesil.

The maximum duration of treatment is 15 days. To reduce the risk of adverse reactions, it is recommended to use the minimum effective dose for the shortest possible period of time.

For adolescents (ages 12 to 18 years), there is no need to change the dosage.
In case of impaired renal function, there are no indications for dose adjustment in mild to moderate forms of renal failure (creatinine clearance 30-80 ml/min).
When treating elderly people, the need to adjust the daily dose is determined by the doctor based on the possibility of interaction with other drugs.

As for toothache, diluting Nimesil granules is exactly the same as described above. After about 20 minutes you can feel relief. Since Nimesil effectively suppresses the inflammatory process in tissues (including lowering the temperature), it is drunk for pain, gumboil and other inflammatory diseases of the oral cavity. But it should be remembered that the drug only relieves pain, but does not cure the disease. Therefore, you should not put off visiting the dentist.

Emergency help

The consequences of an overdose of painkillers and drug poisoning are quite serious; without timely emergency medical care, a person can die. If you know that a loved one has taken too many medications, is using pharmaceutical drugs, and you see that he is turning pale and looks sick, you should immediately call a narcologist from the Center for Healthy Youth to your home. Delay in this case can cost your life. Of course, specialists at home will do everything possible to help the victim, but it is necessary to hospitalize him in a hospital for examination, intensive care and resuscitation.

Overdose of painkillers - what to do?

Call our drug treatment center.
Make sure the victim is conscious.
Find out which particular drug caused the intoxication of the body.
Try to determine the approximate dose.
Lay the victim on his side and ensure that he does not choke on vomit.
Provide fresh air, ventilate the room, remove clothing that may block breathing.
Monitor your blood pressure, pulse and breathing.
In case of mild or moderate poisoning, it is necessary to rinse the stomach, give the person activated charcoal or an enterosorbent known to you.
If a person is not breathing or has no pulse, cardiopulmonary resuscitation is necessary.

If a person’s condition is serious, doctors at the drug treatment clinic begin to provide assistance on the way to the hospital. Naloxone is most often used for poisoning with narcotic analgesics. It is an opioid receptor antagonist, an antidote, which is widely used in modern narcology. It is used when coding alcoholism and drug addiction to reduce cravings for chemicals.

If the victim has trouble breathing, he may need a ventilator. Doctors prescribe treatment based on tests, examinations, examinations and diagnostics. It is important to understand that therapy is always individual and depends on existing indications and contraindications.

Indications for use

Paracetamol is a drug with antipyretic and analgesic effects. It is prescribed to adults and children for colds and viral diseases, as well as for various types of pain. The main active ingredient of this drug helps block cyclooxygenase in the central nervous system, effectively affects pain receptors and thermoregulation. The medication does not have anti-inflammatory properties and does not have a harmful effect on the mucous membrane of the stomach and intestines, which is why it is successfully used in patients with gastrointestinal diseases. But the drug can have a negative effect on the liver and kidneys, so if the patient has chronic diseases of these organs, then he should use paracetamol with caution.

What does the choice depend on?

The doctor determines the form of administration, relying not only on those drugs that are available. He pays attention to the patient’s age, gender, financial capabilities, and even his mood and attitude towards treatment. Children require special attention.

“Choosing the form of a drug is partly a creative process,” says Ekaterina Bokova, a therapist at the 120 to 80 clinic. “There are no ready-made solutions here. But most often we focus on age. If this is a very young baby, then we choose liquid or rectal forms to prevent spitting and choking. This way, the child will receive his dose of the active substance with a greater guarantee. Sometimes you even have to make a choice in favor of an injectable drug. In any case, a child should not be prescribed “adult” pills and divided into parts.”

The wishes of the patient or relatives also matter when choosing the form of the medicine. For older people, it is important to take fewer pills per day, otherwise you can get confused, especially if there are a lot of medications. In such cases, tablet holders or planners help.

“Unfortunately, older people usually insist on prescribing the most affordable drug,” says Ekaterina Bokova, “here, if possible, we will meet them halfway.”

How many times a day and for how long can you apply such drugs?

Typically three to four times a day for two weeks. Topical NSAIDs act quite quickly - the effect occurs within an hour - and help control acute somatic pain of moderate intensity. They cope worse with chronic pain. If there is no effect within two weeks of proper use, you should consult a doctor. There is a chance that he will recommend switching to oral forms or another group of drugs.

Sources

Derry S, Conaghan P, Da Silva JA, et al. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database Syst Rev. 2016; 4: CD007400. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007400.pub3/full
Derry S, Wiffen PJ, Kalso EA, et al. Topical analgesics for acute and chronic pain in adults – an overview of Cochrane Reviews. Cochrane Database Syst Rev. 2017; 5: CD008609. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008609.pub2/full
Klinge SA, Sawyer GA. Effectiveness and safety of topical versus oral nonsteroidal anti-inflammatory drugs: a comprehensive review. Phys Sportsmed. May 2013; 41(2): 64–74. https://www.ncbi.nlm.nih.gov/pubmed/23703519
Kloppenburg M, Kroon FP, Blanco FJ, et al. 2022 update of the EULAR recommendations for the management of hand osteoarthritis Annals of the Rheumatic Diseases 2019; 78: 16–24. https://ard.bmj.com/content/78/1/16
Honvo G, Leclercq V, Geerinck A, et al. Safety of Topical Non-steroidal Anti-Inflammatory Drugs in Osteoarthritis: Outcomes of a Systematic Review and Meta-Analysis. Drugs Aging. 2019; 36(Suppl 1): 45–64. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6509095/
Hasler-Nguyen N, Fotopoulos G. Effect of rubbing on the in vitro skin permeation of diclofenac-diethylamine 1.16% gel. BMC Res Notes. 2012 Jun 21; 5: 321. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3424122/
Hagen M, Baker M. Skin penetration and tissue permeation after topical administration of diclofenac. Curr Med Res Opin. 2022 Sep; 33(9):1623–1634. https://www.tandfonline.com/doi/full/10.1080/03007995.2017.1352497
Rafanan BS Jr, Valdecañas BF, Lim BP, et al. Consensus recommendations for managing osteoarthritic pain with topical NSAIDs in Asia-Pacific. Pain Manag. 2018; 8 (2): 115–128. https://www.futuremedicine.com/doi/10.2217/pmt-2017-0047?url_ver=Z39.88-2003&rfr_id=ori:rid:…
Pradal J, Vallet CM, Frappin G, Bariguian F, Lombardi MS. Importance of the formulation in the skin delivery of topical diclofenac: not all topical diclofenac formulations are the same. J Pain Res. 2019; 12: 1149–1154. https://www.dovepress.com/importance-of-the-formulation-in-the-skin-delivery-of-topical-diclofen-pee…
Galer BS. A comparative subjective assessment study of PENNSAID® and Voltaren Gel®, two topical formulations of diclofenac sodium. Pain Pract. 2011; 11 (3): 252–60. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1533-2500.2010.00420.x
Tieppo Francio V, Davani S, Towery C, Brown TL. Oral Versus Topical Diclofenac Sodium in the Treatment of Osteoarthritis. J Pain Palliat Care Pharmacother. 2022 Jun; 31 (2): 113–120. https://www.tandfonline.com/doi/abs/10.1080/15360288.2017.1301616?journalCode=ippc20
Simon LS, Grierson LM, Naseer Z, et al. Efficacy and safety of topical diclofenac containing dimethyl sulfoxide (DMSO) compared with those of topical placebo, DMSO vehicle and oral diclofenac for knee osteoarthritis. Pain. 2009; 143(3):238–45. https://insights.ovid.com/article/00006396-200906000-00016
Van Amburgh J. Can Topical and Oral NSAIDs Be Combined for Pain Relief? Medscape. https://www.medscape.com/viewarticle/861740
Roth SH. Nonsteroidal anti-inflammatory drug gastropathy: new avenues for safety. Clin Interv Aging. 2011; 6: 125–31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3131982/
Kowalski ML, Makowska JS, Blanca M, et al. Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) – classification, diagnosis and management: review of the EAACI/ENDA and GA2LEN/HANNA. Allergy 2011; 66:818–829. https://www.eaaci.org/attachments/668_Kowalski%20Hypersensitivity%20to%20nonsteroidal%20anti-inflamm…
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Tablets for children

Paracetamol in tablet form is prescribed to children over 12 years of age and adults to reduce body temperature.

Paracetamol tablets are used in the following cases:

increased temperature due to respiratory and other infectious diseases;
headache;
toothache;
neuralgia;
muscle pain;
pain from injuries, burns;
painful menstruation in women.

Paracetamol can be used in pregnant women and mothers who are breastfeeding.

Prevention

To prevent various types of pain in the back, lower back and other places associated with the musculoskeletal system, as well as to prevent pain in the internal organs, the following rules must be followed.

Correctly get up, stand, walk, sit and lie down.
Maintain proper posture when lifting and moving heavy objects.
Exercise vigorously.
Follow a strict diet and switch to a healthy diet.
Monitor your psychological state and do not give rise to negative emotions.

Paracetamol for children

It is used to reduce temperature, relieve pain of various localizations; in children, in addition to these indications, the drug is used to reduce the body’s reaction after vaccination.

Children's Paracetamol is available in the form of syrup. Oral dosage for children:

6-12 years - 250-500 mg,
1-5 years - 120-250 mg,
from 3 months to 1 year - 60-120 mg,
up to 3 months - 10 mg/kg.

The interval between doses of the drug is 4 hours, but no more than 3-4 times a day. It is allowed to combine Paracetamol with other antipyretics.

Paracetamol for a child from 3 months

Drotaverine

Perhaps one of the most inexpensive and effective antispasmodics prescribed for pain in the gastrointestinal tract and spasms of the smooth muscles of internal organs. "Drotaverine" has very few contraindications: childhood, intolerance to the drug components, severe liver and kidney failure. Drotaverine contains a low concentration of the active substance, so the risk of side effects is practically eliminated. Due to its low cost, this painkiller is available to everyone. Among the disadvantages is that sometimes Drotaverine is difficult to find in pharmacies.

Drotaverine

Planet Organics; Borisov medical plant drugs, Belarus; NPC Pharmzashchita, Russia; PJSC "Biosintez", Russia; Ozon LLC, Russia; FSUE "Armavir Biofactory", Russia; PJSC "Biokhimik", Russia; Deco, Russia; JSC Dalkhimfarm, Russia; Novosibkhimpharm OJSC, Russia; Vifitech/Vilar, Russia; Update, Russia; Sintez OJSC, Russia; JSC PharmProject, Russia; PJSC Valenta Pharm, Russia; "Moskhimfarmpreparaty" named after. N. A. Semashko, Russia; JLLC "Lekpharm", Belarus; Medisorb, Russia; Obolensk pharmaceutical enterprise, Russia; Solopharm, Grotex LLC, Russia; Ellara MC, Russia

Spasm of smooth muscles of the urinary and biliary organs (renal colic, pyelitis, tenesmus, biliary colic, intestinal colic, dyskinesia of the biliary tract and gallbladder of the hyperkinetic type, cholecystitis, postcholecystectomy syndrome).
Spasm of smooth muscles of the gastrointestinal tract (usually as part of combination therapy): pylorospasm, gastroduodenitis, gastric and duodenal ulcers, spastic constipation, spastic colitis, proctitis. Tensor headache. Dysmenorrhea, threatened miscarriage, threatened premature birth, postpartum contractions. When conducting some instrumental studies, cholecystography. from 12

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