Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
There are some other pain relievers that are less used, but
not without merit. There is a group called agents. These are
antagonists that cause less sedation, and danger of breathing
problems. These drugs are especially good in the elderly
where erratic absorption may cause more side effects. Nubain
and Subutrex are the Israeli names for examples of this
class. In higher doses however, they behave exactly like
other narcotics.
It should be mentioned that in children and adults who can
not swallow pills, there is one narcotic that is available in
liquid form called Oxy-cod. It is like Percocet.
Methadone is another very effective pain reliever, but it is
very long acting. It is used mainly for detoxifying drug
abusers, but better alternatives are becoming available for
all addictions -- including smoking and caffeine. It goes
without saying that not starting is always the safest
route.
Tramadol (in Israel -- Tramadex) is a novel drug that binds
to the narcotic receptor in the brain without being a
narcotic. It is very popular in Germany, and can be given to
kids. It does cause an ill feeling. Another drug that binds
to the narcotic receptor is Narcan. It has no pain relieving
effects and reverses all narcotic effects. It is the antidote
for narcotic overdoses, but it is very short acting.
I will just mention that papaverine does nothing for pain.
Despite its popularity, it has never been shown to work.
Spamalgin is another popular drug in this country. It is a
mish-mash of several medications including codeine. It will
cause constipation, nausea and do little else.
Now that we know what medications we have we will discuss the
principles of pain relief.
First and foremost: pain is real and is felt differently by
different people. Nationality, gender and age all play a role
in how you feel pain and the likelihood you will receive
medication for it. Doctors always underestimate pain, and
patients often are afraid to speak up. Narcotics can be
addicting, but never in the short term and I do not know why
there is a problem in prescribing these when pain is intense.
Write me in care of the Yated.
A message from GlaxoSmithKline, sponsor of this
column. We are coming to the end of the summer when
autumn allergies start, and Serevent can help breathing.
Serevent is a long acting airway- opening drug, similar to
Ventolin, but it works a lot longer. This adds up to
breathing easier for longer periods of time -- to allow you
to enjoy the end of summer without wheezing.
