How Do Painkillers Find & Kill Pain?

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iStock

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.

Illinois Becomes the First State to Require Insurance Companies to Cover EpiPens for Kids

Joe Raedle/Getty Images
Joe Raedle/Getty Images

The ever-changing landscape of the U.S. healthcare system has created difficulties for people who may no longer be able to afford potentially lifesaving medications like EpiPens. The Illinois government decided it was time to step in: Beginning on January 1, 2020, health insurance companies will be required to cover EpiPen costs for children in the state with severe allergic reactions. Tonya Winders, president and CEO of the Allergy & Asthma Network, told CNN that Illinois is the first state to pass such legislation.

CNN reports that Governor J.B. Pritzker officially signed the law, House Bill 3435, which mandates insurance coverage “for epinephrine injectors for persons 18 years of age or under.” Pritzker also tweeted that “this legislation takes a big step forward in protecting our children and families.” Illinois Senator Julie Morrison, who sponsored the initial proposal, echoed the governor’s sentiment in her own statement.

“We should be doing everything we can to expand access to affordable lifesaving drugs and medicines,” Morrison said. “No child with a serious allergy should be without an epinephrine injector because they cannot afford one.”

In 2009, the purchase of two EpiPens would have set you back about $100; by 2016, that number had skyrocketed to $600. During that time, the situation became so dire that some people were opting to fill their own syringes with epinephrine instead, making it more difficult to measure the dose and also administer the injection. Thankfully, the FDA approved a generic version of the EpiPen last year, providing market competition for pharmaceutical company Mylan, which has been manufacturing EpiPens thus far.

EpiPens work by injecting a high dose of epinephrine, or adrenaline, into your bloodstream, which reduces the rapid swelling of your airways during anaphylactic shock. Since allergic reactions can happen so quickly, your life could be seriously threatened if you don’t have an EpiPen nearby at the time of the attack. Wondering what anaphylactic shock looks like from the inside? Find out here.

[h/t CNN]

Marathon Karaoke Session Lands Man in Hospital With a Collapsed Lung

cookelma/iStock via Getty Images
cookelma/iStock via Getty Images

While over-imbibing is the usual culprit behind a fun night out gone wrong, it turns out that too much karaoke can be bad for your health, too. According to Newsweek, a 65-year-old man from eastern China was hospitalized with a collapsed lung after singing 10 high-pitched karaoke songs in a row.

“I was very excited in the heat of the moment and after singing a few songs with very high notes, I found myself having breathing difficulties,” the man, who was identified only by his last name, Wang, said in a video posted to the Chinese platform PearVideo.

Since Wang had belted out the same tunes plenty of times before, he decided to ignore the pain that he felt in his left lung as he was performing and simply sing through it. After his condition worsened over the next day, Wang was taken to the hospital.

In the same video, Dr. Peng Bin-fei confirmed that the injury was most likely a direct result of the man’s energetic commitment to hitting the high notes, and advised that karaoke enthusiasts should limit their performances to a maximum of two hours. (For everyone's sake.)

A collapsed lung, or pneumothorax, happens “when air leaks into the space between your lung and chest wall. This air pushes on the outside of your lung and makes it collapse,” according to the Mayo Clinic. Medical professionals can suck out the air with a needle or small tube, but the condition can be life-threatening.

Since sometimes a pneumothorax can occur on its own, it’s always a good idea to seek medical attention if you suddenly experience uncharacteristic chest pain or shortness of breath. Often, it’s the result of a blunt-force injury to the chest or damage from a lung disease. Newsweek mentioned a recent pneumothorax case that was caused by yet another perhaps unexpected culprit: electronic cigarettes. Doctors found black spots and a hole in the collapsed lung of a Florida teenager.

Unlike electronic cigarettes, there’s no compelling reason to quit karaoke altogether, as long as you’re doing it safely. But if you feel like your lungs are straining against that High C, maybe pass the microphone off to the nearest soprano.

[h/t Newsweek]

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