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Painkillers: which helps when? Paracetamol, acetylsalicylic acid, ibuprofen,






diclofenac: many consider pain relievers to be almost the same. But there are






differences in effectiveness and side effects






















BY ULRICH KRAFT, UPDATED ON MAY 17TH, 2019 Medication tablets Painkillers:






Common and sometimes taken carelessly






















© dpa picture alliance / Franziska not connected to Facebook Facebook "share"






dummy not connected to Twitter "Tweet this" dummy Fever and aching limbs






because of this persistent cold? It gets better with acetaminophen. Sprained






your sports? With ibuprofen or diclofenac it doesn't hurt anymore.






That annoying headache again ? As if blown away, thanks to acetylsalicylic






. Paracetamol, acetylsalicylic acid, ibuprofen and diclofenac are among the






best-selling active ingredients among the over-the-counter pain relievers






At least one of these drugs is in almost every household in the






medicine cabinet. Every day they are bought anew umpteen times. It is difficult






to say exactly which quantities of individual agents go over the counter in






pharmacies, because all four pain relieving active ingredients are available






without a prescription - at least up to a certain dosage.






















Deciding based on personal preference is tricky Perhaps it is due to the






commonality of the freedom from prescription that the preparations are viewed






by many consumers as more or less similar. Personal experiences and preferences






often determine whether someone swallows ibuprofen in pain or prefers to use






acetaminophen. The substances are by no means identical, as Professor Hans-






Raimund Casser emphasizes. "Each of the drugs has a different chemical






structure," says the medical director of the DRK Pain Center Mainz. "That is






why there are differences in the mode of action, the possible side effects and






the areas of application."






















Mode of action of ibuprofen, diclofenac and acetylsalicylic acid Ibuprofen,






diclofenac and acetylsalicylic acid (ASA) are non-steroidal anti-inflammatory






drugs, NSAIDs for short. The name has historical reasons, since the substances






were originally used to treat patients with rheumatoid arthritis. Although






acetylsalicylic acid was the first NSAID to appear on the market at the end of






the 19th century, its mechanism of action was only deciphered by John Robert






Vane in the early 1970s. The British biochemist and pharmacologist, who






received the Nobel Prize in Medicine in 1982, demonstrated that the NSAIDs






inhibit cyclooxygenase (COX). This enzyme is indispensable in the human






organism for the production of prostaglandins - a group of tissue hormones that






have a variety of functions and effects.






















There are two sub-forms of cyclooxygenase called isoenzymes. The non-steroidal






anti-inflammatory drugs develop their desired effects primarily by blocking






cyclooxygenase-2 (COX-2). This is always particularly active when tissue in our






body is damaged, for example by injuries or inflammation. The prostaglandins






that are then produced increase the sensitivity of the pain receptors and thus






fuel the sensation of pain. In addition, they increase the setpoint of body






temperature in the brain center for heat regulation - with fever as a result -






and promote inflammatory processes.











































How do painkillers work? This also explains our video:






















© W & B / Edeos "In addition to their analgesic, i.e. pain-relieving, effects,






NSAIDs also have antipyretic and anti-inflammatory effects," explains pain






therapist Casser. "Therefore, they are particularly suitable for inflammatory






." In addition, ASS, Ibuprofen and Diclofenac accumulate






in inflamed tissue due to their chemical structure. This makes them even more






effective for inflammatory pain.






















Paracetamol is less anti-inflammatory This property lacks paracetamol. In






general, the anti-inflammatory effect of this over-the-counter pain reliever is


That is why paracetamol is not one of the "non steroidal anti-






inflammatory drugs" (NSAIDs) in the English-speaking world.






















Exactly how the substance works is still incomplete. It is known that






paracetamol has its analgesic and antipyretic effects mainly in the central






nervous system, i.e. in the spinal cord and in the brain . There it inhibits






COX-2 and probably also interferes with other messenger systems involved in






pain sensation, such as that of the so-called endocannabinoids.

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