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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Is it possible to use topical NSAIDs for stomach erosions or ulcers?

According to the instructions, it can be done “with caution.” The concentration of the active substance in the blood plasma after the use of topical NSAIDs is less than 10% of that achieved by oral administration. The incidence of adverse reactions from the gastrointestinal tract when using local forms of NSAIDs does not differ from that when rubbing placebo and is significantly lower than when using systemic agents. However, just in case, these drugs are not recommended to be applied to the skin during gastrointestinal bleeding and exacerbation of gastric or duodenal ulcers [5, 14].

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.

Do excipients in the local form of NSAIDs matter?

Yes, they improve skin permeability and perhaps enhance the therapeutic effect in a certain way. In separate studies, for example, topical formulations of diclofenac with dimethyl sulfoxide (DMSO) and diclofenac diethylamine 1.16% have been shown to penetrate the skin faster than “regular” diclofenac sodium gels. In addition, DMSO itself may have a slight anti-inflammatory effect. There is no solid evidence of an increase in the analgesic effect due to the listed supplements, but their use at least helps to overcome the individual characteristics of the skin [7, 9–11].

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.

What does “when used correctly” mean? Anointed, and that’s it.

It is advisable to rub in topical forms of NSAIDs for a while rather than just apply them. The analgesic and anti-inflammatory effect of the ointment will be much higher if you do not just “anoint” it, but actively rub the product into the skin over the sore spot for some time. In the course of relevant studies, it was found that even 45 seconds of rubbing diclofenac diethylamine gel five times increased the transdermal delivery of the drug compared to simple application to the skin. And you need to remember that pain-relieving ointments based on NSAIDs act on areas of pain located immediately under the skin. If we talk about joints, then these are the knees, elbows and small joints of the hands. The local form most likely “will not reach the hip joint.” It should be rubbed “around the circumference” of the limb, for example, not only into the dorsum, but also into the palmar surface of the interphalangeal joint [6, 7].

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?

1. Call our drug treatment center.
2. Make sure the victim is conscious.
3. Find out which particular drug caused the intoxication of the body.
4. Try to determine the approximate dose.
5. Lay the victim on his side and ensure that he does not choke on vomit.
6. Provide fresh air, ventilate the room, remove clothing that may block breathing.
7. Monitor your blood pressure, pulse and breathing.
8. 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.
9. 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.

Ibuprofen

The active ingredient in these pain pills is ibuprofen, and its low concentration in the drug is excellent for treating pain in those who cannot afford an expensive drug. But the cheapness of Ibuprofen does not mean that it is ineffective. On the contrary, the tablets relieve pain well and begin to act as quickly as possible. Other advantages include minimal likelihood of overdose and ease of use. Ibuprofen is prohibited for children under 6 years of age. It is advisable to take the medicine after consulting a doctor in order to take into account all possible contraindications.

Ibuprofen

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Symptomatic treatment: - tension headaches and migraines;
- joint, muscle pain, - pain in the back, lower back, radiculitis; - pain when ligaments are damaged; - toothache; - painful menstruation; — febrile conditions during colds, flu; - rheumatoid arthritis, osteoarthritis. NSAIDs are intended for symptomatic therapy, reducing pain and inflammation at the time of use, but do not affect the progression of the disease. from 16

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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

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2. 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
3. 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
4. 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
5. 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/
6. 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/
7. 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
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9. 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…
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11. 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
12. 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
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