a***c
发帖数: 578 | 1 runner's world上的一篇老文章，大概意思是止痛药的使用要适量，主要危害是kidney
and high blood pressure,不同的止痛药用量不同，最后针对不同的伤病推荐了不同
的止痛药，相对来说，acetaminophen(Tylenol)要安全点，但效果也可能差些
http://www.runnersworld.com/injury-treatment/pill-problem?page=
The Pill Problem
After winning a 24-hour track run in record time, Stephanie Ehret should
have been celebrating. Instead, she was in a Phoenix emergency room,
vomiting up a strange substance, which a doctor informed her was part of her
digestive-tract lining. Feverish and nauseous, Ehret could barely move. "I'
d never felt so bad," she says. "I was pretty sure I was dying."
A few hours later, doctors diagnosed the problem—rhabdomyolysis, a
potentially fatal precursor to kidney failure. Though dehydration and
overexertion contributed to Ehret's condition, doctors told her that the 12
ibuprofen pills she'd taken during the 24-hour race had pushed her kidneys
into the danger zone.
When used properly, over-the-counter pain medications can be a godsend.
Acetaminophen (Tylenol) can tame many pains. And non-steroidal anti-
inflammatory drugs (NSAIDs) like ibuprofen, aspirin, and naproxen can reduce
pain and swelling in the first few days following an acute injury like an
ankle sprain. The trouble comes, doctors say, when people, like Ehret,
misuse these drugs. "A couple of ibuprofens really helped, so I figured more
was better," Ehret says. Indeed, many runners treat anti-inflammatory drugs
like "vitamin I," says pharmacologist Joe Graedon, coauthor of The People's
Pharmacy book series. "They think, I'm putting my body through a lot, so I'
ll just dose up on ibuprofen, without appreciating how potentially dangerous
this drug can be."
Runners Beware
Runners may think that as long as they don't go overboard like Ehret, they'
ll be safe. But experts say the benefits of popping even one pill before a
10-K don't outweigh the risks. NSAIDs inhibit prostaglandins, hormones that
help normalize blood flow to the kidneys. Mix an NSAID with physical
exertion and dehydration, and you can overwhelm your kidneys.
What's more, NSAIDs can bump up your blood pressure, and when you add this
to the natural rise that occurs when you exercise, "suddenly you have two
things increasing your blood pressure," Graedon says. If you already have
high blood pressure, "you could have a mini stroke or a heart attack," he
says. NSAIDs also block an enzyme called cyclooxygenase (COX) that normally
protects the heart, and this might explain why many NSAIDs, including
ibuprofen, may raise the risk of heart attack.
Some forms of COX also protect the stomach lining from digestive acids, so
when an NSAID blocks this enzyme, you may experience nausea, diarrhea,
intestinal bleeding, and cramps. When used during a marathon or ultra,
NSAIDs also seem to boost the risk of hyponatremia, an electrolyte imbalance
that can cause the brain to swell. "It's something you can die of during a
race," says Martin Hoffman, M. D., director of research at the Western
States Endurance Run.
Many runners believe that NSAIDs increase their pain tolerance, but studies
contradict this notion. In 2005, David Nieman, Dr. P. H., director of the
human performance lab at Appalachian State University in Boone, North
Carolina, examined ibuprofen use at Western States. About 70 percent of the
racers said they took it to help them manage the discomfort of racing. But
when he measured pain and muscle soreness in these pill poppers, he found no
reduction compared with nonusers. Worse, ibuprofen takers had more
inflammation. "There's no good reason to use ibuprofen during a race,"
Nieman says. "There are too many potential negatives." Any pain and
inflammation that turns up while running is not something you should
medicate but a signal that it's time to reevaluate your training regimen, he
says.
For relief during or after exercise, Hoffman recommends acetaminophen since
it works via a different mechanism than NSAIDs, and the drug doesn't have
the side effects associated with aspirin or ibuprofen. "It's a relatively
safe drug, and it doesn't present problems with the kidney or gut," he says.
But watch the dosage. While it's safe at recommended doses, acetaminophen
can be toxic to the liver, especially when mixed with alcohol. "You can hit
the tipping point pretty fast with acetaminophen," says Graedon.
Acetaminophen overdose is the most common cause of acute liver failure in
the United States, in part because the drug is found in many over-the-
counter cold and allergy medicines, so it's easy to overdose if you take one
of these drugs with Tylenol.
And limit the number of days you take meds. "Studies show that NSAIDs can
impair the healing process for soft-tissue injuries, so you should never use
them long-term for injuries," says Hoffman.
Since her ordeal, Ehret shares her experience with other racers. If she sees
them downing vitamin I, she tells them about her ER visit. "That's usually
enough to change their habits," she says.
What Hurts?
Pick the right painkiller from your medicine cabinet
PROBLEM "I twisted my ankle on a run, and now it's swollen."
PILL TO POP Ibuprofen (Advil) or naproxen (Aleve)
MED SENSE For injuries with swelling, ibuprofen or naproxen are your best
bets. Take up to 3,200 milligrams of ibuprofen per day for no more than four
days, or take 200 to 400 milligrams of naproxen every 12 hours for up to
four days.
WARNING LABEL NSAIDs should never be combined, so take either ibuprofen or
naproxen.
PROBLEM "I inherited my dad's bum knee and his heart disease."
PILL TO POP Naproxen
MED SENSE Naproxen does not seem to increase the risk of heart problems like
other NSAIDs do. Take 200 to 400 milligrams every 12 hours for up to four
days.
WARNING LABEL Avoid if you have kidney problems or high blood pressure. It
can cause GI bleeding.
PROBLEM "My back is killing me, and so is this recession!"
PILL TO POP Aspirin (Bayer, Excedrin)
MED SENSE Aspirin is the least expensive option for swelling and pain
associated with a new injury. Take up to 650 milligrams every four hours as
needed, for up to four days.
WARNING LABEL If you're prone to ulcers or heartburn, aspirin can cause
intestinal bleeding.
PROBLEM "My Achilles bothers me one day, but it's fine the next."
PILL TO POP Acetaminophen (Tylenol)
MED SENSE Acetaminophen doesn't impair the healing process like other drugs
may. Take 325 to 1,000 milligrams, twice a day. But never exceed 2,000
milligrams in 12 hours.
WARNING LABEL Don't use if you're drinking. Alcohol increases acetaminophen'
s liver toxicity. | R*****s
发帖数: 41236 | | a***c
发帖数: 578 | 3 上次医生开了Naproxen,嘱咐take medicine with food and plenty of water
【在 R*****s 的大作中提到】
: 嗯，基本上能不吃尽量不吃，偶尔应应急...
| R*****s
发帖数: 41236 | 4 看起来泰诺是比较安全的，没啥副作用...
【在 a***c 的大作中提到】
: 上次医生开了Naproxen,嘱咐take medicine with food and plenty of water
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