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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,