How Do Painkillers Find & Kill Pain?

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First, we need to make a distinction between the two main classes of painkillers, which are used for different situations and function via different mechanisms.

The first class is the narcotic opioid drugs. These are the heavy-duty drugs, like morphine and codeine, used to treat severe pain. They relieve pain in two ways: first by interfering with and blocking the transmission of pain signals to the brain, and then by working in the brain to alter the sensation of pain. These drugs neither find nor kill pain, but reduce and alter the user's perception of the pain. They're kind of like having an optimistic friend that says, "Hey man, everything will be cool. Nothing's wrong. Here, look at this shiny, distracting thing!"

The other class is the aspirin drugs, like paracetamol and ibuprofen. These are the over the counter drugs we reach for whenever we've got a headache or a sore back. Throughout history, people all over the world were using botanical remedies for pain. The ancient Egyptians used leaves from the myrtle bush, Europeans chewed on hunks of willow bark and Native Americans did the same with birch bark. In the nineteenth century, scientists isolated the chemical in all these plants that gave them their pain relieving properties: salicin (which is metabolized to salicylic acid when consumed). They also discovered that these chemicals produced the side effect of horrendous digestive problems (which answers that other burning question, "Why is that Native American in that old commercial crying?").

Bayer aspirin
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Eventually, a scientist at Bayer Pharmaceutical synthesized a less harmful derivative chemical, acetylsalicylic acid (ASA). Bayer dubbed it Aspirin and commercialized it. Hoffmann went on to develop a "non-addictive" substitute for morphine. The resulting product, heroin, was less successful than aspirin.

Despite its long history, we didn't discover how aspirin works until the early 1970s. Unlike narcotics, aspirin drugs are real workhorses that actually go to the source of pain and stop it. When cells are damaged, they produce large quantities of an enzyme called cyclooxygenase-2. This enzyme, in turn, produces chemicals called prostaglandins, which send pain signals to the brain. They also cause the area that has been damaged to release fluid from the blood to create a cushion so the damaged cells don't take any more of a beating. This cushion is the swelling and inflammation that goes along with our aches and pains. When we take aspirin, it dissolves in our stomachs and travels through the whole body via the bloodstream. Although it's everywhere, it only works its magic at the site of cell damage by binding to the cylooxygenase-2 enzymes and stopping them from prostaglandins. No more prostaglandins means no more pain signals. The cells at the damage site, of course, are still damaged, but we're left blissfully unaware.

This prostaglandin-stopping power is also why people take aspirin regularly to reduce the risk of heart attacks, since prostaglandins in the bloodstream can cause clotting. Additionally, aspirin reduces the production of thromboxane, a chemical that makes platelets, a type of blood cell, sticky. With aspirin in our systems, platelets make less thromboxane and are less likely to form a clot and block an artery.

From Cocaine to Chloroform: 28 Old-Timey Medical Cures

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YouTube

Is your asthma acting up? Try eating only boiled carrots for a fortnight. Or smoke a cigarette. Have you got a toothache? Electrotherapy might help (and could also take care of that pesky impotence problem). When it comes to our understanding of medicine and illnesses, we’ve come a long way in the past few centuries. Still, it’s always fascinating to take a look back into the past and remember a time when cocaine was a common way to treat everything from hay fever to hemorrhoids.

In this week's all-new edition of The List Show, Mental Floss editor-in-chief Erin McCarthy is highlighting all sorts of bizarre, old-timey medical cures. You can watch the full episode below.

For more episodes like this one, be sure to subscribe here.

10 Facts About High Blood Pressure

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People with high blood pressure (hypertension) are at a greater risk for a host of medical issues, including heart failure and stroke. Despite the severe health threats it poses, high blood pressure often goes unnoticed or untreated by some who have it. From high blood pressure symptoms to what levels are considered normal, here are some facts about the condition.

1. High blood pressure symptoms are sometimes unnoticeable.

Blood pressure is a measurement of the force of blood moving through the circulatory system. High blood pressure, a condition in which blood is putting too much force on arteries and organs, is often called the “silent killer.” It contributes to hundreds of thousands of deaths each year, but only half of high blood pressure patients know they have it. In most cases, hypertension signs are difficult to detect, making it hard to diagnose and keep under control. Chest pain, dizziness, shortness of breath, and heart palpitations are some of the most common hypertension signs in people who do show symptoms.

2. Anxiety causes some of the same symptoms as high blood pressure.

When it comes to managing high blood pressure symptoms, mental health is as important as physical health. Anxiety can lead to sudden spikes in blood pressure, and spikes that occur often enough can inflict serious damage on the heart and blood vessels the same way chronic high blood pressures does. Stress and anxiety also make people vulnerable to the top risk factors associated with chronic hypertension, such as smoking, excessive drinking, and overeating.

3. A normal blood pressure range is lower than it used to be.

If you haven’t had your blood pressure measured in a couple years, it’s time for a check-up: In November 2017, the American College of Cardiology and the American Heart Association updated its normal blood pressure guidelines. The two components that make up blood pressure are systolic pressure—the pressure in blood vessels, represented by the top number in test results—and diastolic pressure, the pressure in the heart between beats represented by the bottom number. According to the old guidelines, the threshold for normal blood pressure was 140 systolic pressure and 90 diastolic pressure, or 140/90. The new guidelines lowered that marker to 130/80. Now that the normal blood pressure range has dropped, 14 percent more people could diagnosed with hypertension in the U.S.

4. "White-coat hypertension" is real.

Not every patient who exhibits hypertension signs in the doctor’s office has high blood pressure. “White-coat hypertension” occurs when patients get nervous in a medical setting, leading to a spike in blood pressure that doesn’t necessarily reflect their true health. But this type of hypertension should be taken seriously, even if it is a product of nerves. According to one study, people with white-coat hypertension have a greater chance of developing cardiovascular disease than those with normal blood pressure levels. This may be because people with white-coat hypertension are more prone to anxiety.

5. People with high blood pressure should consume less than one teaspoon of salt per day.

One of the worst things to eat if you have hypertension is food that’s high in salt. Sodium, which makes up 40 percent of table salt (sodium chloride), promotes water retention in the body. More water means more blood volume, which puts added pressure on the heart and blood vessels. Medical experts recommend consuming no more than 2300 milligrams of sodium per day, or just over 1 teaspoon of salt. If you have high blood pressure, the American Heart Association recommends an ideal limit at 1500 milligrams of sodium a day—equal to three-quarters of a teaspoon of salt.

6. Almost half of U.S. adults have high blood pressure ...

According to the American Heart Association, more than 100 million people in the U.S. have high blood pressure—that’s nearly half of American adults. The condition is so common that even if you don’t have it now, chances are you will develop it at some point in your life. The lifetime risk in the U.S. for hypertension in 90 percent.

7. ... and black Americans are most affected.

High blood pressure affects certain groups disproportionately. Black Americans are more likely to have high blood pressure than any other group in the country, and when they develop it, it’s usually more severe. Hypertension also affects black Americans earlier in life: Three in four black people in the U.S. will develop the condition by age 55. Health experts believe that the prevalence of high blood pressure is associated with the higher rates of obesity and diabetes among the black population.

8. A female hormone may protect against high blood pressure.

High blood pressure rates are pretty similar among men and women before middle age. But once women hit menopause, their chances of developing hypertension increase: 75 percent of postmenopausal in the U.S. have high blood pressure. This may have to do something with decreased levels of estrogen—a hormone that’s been shown to boost premenopausal women’s vascular health.

9. High blood pressure can be life-threatening ...

High blood pressure doesn’t kill people directly, but it can lead to some deadly complications. Hypertension adds potentially fatal stress to vital organs like the heart, kidneys, and brain. When you have high blood pressure, your risk of heart attack, stroke, chronic heart failure, kidney disease, and even blindness all significantly go up.

10. ... but improved with medications and healthy living.

The best way to reduce your blood pressure is to change your lifestyle. Smoking, drinking too much alcohol, and eating too much salty food all increase your risk of developing hypertension, and doctors recommend avoiding these risk factors to keep blood pressure levels under control. Regular exercise and certain medications, like diuretics (to get rid of excess water in the body) and ACE inhibitors (which block an enzyme that tightens blood vessels), can also lower blood pressure.

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