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Cyclocomputers: a dumb comment.

Started by RonSonic · · Last activity · 45 posts · 1,571 views

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Cycling Equipment
Published
28 September 2004
Last activity
8 October 2004
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RonSonic
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45
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  1. Jim Smith said:
    Quoted message said:

    The two drugs are probably combined in a convenient tablet
    because they combine different and desirable pain-relief
    actions, not because anyone wants to damage the livers of
    drug addicts, who (as Jeff points out) are unlikely to be
    worried about long-term health problems connected with too
    much acetaminophen.

    No. They are combined for policy, more than medical, reasons. Codeine
    in combination is schedule III in the US, while codeine by itself is
    schedule II. (codeine alone is not currently prescribed in the US.)
    There certainly is nothing medically magical about the combination.

    There are not really any long-term health effects from too much
    acetaminophen. It is a big deal acutely though. Tylenol is still a
    popular drug among suicidally motivated folk, but I suspect it would
    not be if they knew what was involved. It is also rarely succesfull
    these days, but often good for a few days in the unit and occasionally
    a liver transplant. For some reason one doesn't see folks overdosing
    on tylenol while trying to get high with combined opiates. Perhaps
    this is because, as qfq pointed out, the extraction is simple.

    Quoted message said:

    In the U.S., we have Tylenol (acetaminophen) over the
    counter for any sissy afraid to face aspirin, while Tylenol
    with codeine is prescribed for patients with more severe
    pain, such as having their wisdom teeth carved out.

    The combination drugs do fit nicely in an "analgesic ladder" starting
    with tylenol and ending with morphine: Too much pain for Tylenol? not
    enough for vicodin? T3 is just the thing! This isn't because of
    anything magical about the combination though.

    Dear Jim,

    No one is claiming a magical combination,

    Codeine relieves pain.

    So does Tylenol, to a lesser degree.

    Tylenol also reduces fever (unlike aspirin, it doesn't
    reduce swelling, which aggravates many painful conditions).

    Fever is a common reaction to surgery, injury, and
    infection.

    So the two are often prescribed in a convenient single
    tablet.

    Carl Fogel

  2. Jim Smith <[email hidden]> wrote in
    news:[email hidden]:

    Quoted message said:

    You are right, there really isn't any difference. The combination
    pills with N-acetyl-p-aminophenol and codeine are just conveniently
    dosed for mild/moderate pain. A couple of mgs of po morphine would do
    just as well, but morphine is schedule II in the US, plus all
    pharmacies have T3s and T4s and they work well and are safe so that is
    what generally gets prescribed for that level of pain.

    Sure - I'm just reiterating your point that it's a pure policy decision
    which places the combination analgesics (which are just as powerful as the
    non-combination ones) at a lower level of restriction.

    Quoted message said:

    I take it by "synthetics" you mean things like meperidine and
    fentanyl? Those aren't really used much except, perhaps, by
    anesthesiologists and pain specialists. And then there are drugs like
    tramadol and ketorolac which have fairly specific uses.

    I've seen tramadol used as a generic post-operative pain medication. I've
    also seen a recommendation that pethidine not ever be used except in very
    specific circumstances.

    --
    to email me, run my email address through /usr/bin/caesar
    (or rotate by -4)

  3. [email hidden] wrote in news:qqa6m0hv4akd4f5q6tri1t87rc6nr0jgvb@
    4ax.com:

    Quoted message said:

    Tylenol also reduces fever (unlike aspirin, it doesn't
    reduce swelling, which aggravates many painful conditions).
    Fever is a common reaction to surgery, injury, and
    infection.
    So the two are often prescribed in a convenient single
    tablet.

    Why not bundle an NSAID in that combination? It'd be much more useful.

    [When I had my wisdom teeth removed, I was prescribed vicodin. I didn't
    take any, I used 1-1.2g of ibuprofen 8-hourly instead. It was, in
    hindsight, an excellent decision.]

    --
    to email me, run my email address through /usr/bin/caesar
    (or rotate by -4)

  4. qtq said:

    [email hidden] wrote in news:qqa6m0hv4akd4f5q6tri1t87rc6nr0jgvb@
    4ax.com:

    Quoted message said:

    Tylenol also reduces fever (unlike aspirin, it doesn't
    reduce swelling, which aggravates many painful conditions).
    Fever is a common reaction to surgery, injury, and
    infection.
    So the two are often prescribed in a convenient single
    tablet.

    Why not bundle an NSAID in that combination? It'd be much more useful.

    It's been done.

    NSAIDs are not recommended for broken bones and a few similar things. Apparently
    some of the inflammation is a part of healing. There's some debate going on
    this, but a lot of doctors prescribe accordingly.

    Quoted message said:

    [When I had my wisdom teeth removed, I was prescribed vicodin. I didn't
    take any, I used 1-1.2g of ibuprofen 8-hourly instead. It was, in
    hindsight, an excellent decision.]

    If it was adequate, it was a good decision.

    Ron

  5. Ronsonic said:
    qtq said:

    [email hidden] wrote in news:qqa6m0hv4akd4f5q6tri1t87rc6nr0jgvb@
    4ax.com:

    Quoted message said:

    Tylenol also reduces fever (unlike aspirin, it doesn't
    reduce swelling, which aggravates many painful conditions).
    Fever is a common reaction to surgery, injury, and
    infection.
    So the two are often prescribed in a convenient single
    tablet.

    Why not bundle an NSAID in that combination? It'd be much more useful.

    It's been done.

    NSAIDs are not recommended for broken bones and a few similar things. Apparently
    some of the inflammation is a part of healing. There's some debate going on
    this, but a lot of doctors prescribe accordingly.

    This sort of highlights the point that, except for very special
    circumstances, combination drugs are a bad idea.

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