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Senior Health & Medicine
Acetaminophen May Help Pain but Not Heart after
Heart Attack
Sold as Tylenol it is
also found in Excedrin Extra Strength, Excedrin Migraine and Vanquish
May 16, 2006 – Acetaminophen (Tylenol) is safe to
use as a pain reliever and fever reducer after a heart attack, but it
does not protect the heart muscle, a new study using sheep and rabbits
concluded.
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Health & Medicine |
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The study could have implications for people who
have suffered heart attacks, about a million people in the U.S. each
year, said researcher Robert C. Gorman, a medical doctor and associate
professor of surgery at the University of Pennsylvania. "It's a high
volume problem," he said.
People who suffer heart attacks need to know which
pain relievers are safe to use. Some studies have suggested there is an
increased risk of stroke and heart attack among patients taking
non-steroidal anti-inflammatory drugs (NSAIDs), Gorman said.
And a recent clinical study from Denmark suggested
that NSAIDS may increase mortality if taken after a heart attack. NSAIDs
are a major class of pain reliever and fever reducer that includes
ibuprofen.
Acetaminophen is a popular over-the-counter pain
medication that is an alternative to NSAID and aspirin. It is the active
ingredient in Tylenol and is found in Excedrin Extra Strength, Excedrin
Migraine and Vanquish, according to the American Academy of Family
Physicians. (See a facts by the Academy on OTC Pain
Relievers below this news report.)
Some classify aspirin as an NSAIDs, although Gorman
said it is more common to place aspirin in its own separate category.
Is it safe; does it protect?
The researchers wanted to find out if acetaminophen can be used
after a heart attack. In particular, they wanted to know if it is safe
to use after subjects have undergone reperfusion therapy, a procedure to
restore blood flow to the heart.
Reperfusion therapy is used as soon as possible
following a heart attack to get the blocked artery open and to save as
many heart muscle cells as possible. Reperfusion therapy, which may use
balloon angioplasty, surgery, or clot dissolving drugs, is used in about
40% of heart attack patients, and its use is becoming increasingly
common, Gorman said.
If acetaminophen does no harm, it could be used to
relieve pain or reduce fever by people who have had heart attacks.
Gorman and his team also wanted to know if acetaminophen could be used
in conjunction with reperfusion therapy to salvage heart muscle cells
damaged by the heart attack or to improve the heart's ventricular
function.
The research was done within the context of a
recent study on humans that reported an increased risk of death among
those who had suffered a heart attack and subsequently took NSAIDs.
Other studies have suggested that using NSAIDs may increase the risk of
stroke and heart attacks, Gorman said.
Safe, but not protective
The researchers assigned eight sheep and 11 rabbits to a group that
received acetaminophen, and an equal number of sheep and rabbits to a
control group that did not receive any drug. The researchers surgically
induced the heart attack and then restored blood flow – 30 minutes later
for rabbits and 60 minutes later for sheep.
They found that acetaminophen had no effect on:
● amount of blood flow to the heart muscle
● how much heart muscle was saved
● blood pressure
● ventricular function
● heart rate
The results are at odds with a previous study using
dogs, which concluded that acetaminophen reduced the area affected by a
heart attack by 22%. Gorman said the difference may be due in part to
the abundance of blood vessels dogs have compared to humans, rabbits and
sheep.
Next step
The researchers will compare animals treated with NSAIDS and those
treated with acetaminophen over a longer period of time after a heart
attack to see if there is a difference in cardiac function, Gorman said.
Source and funding
"Role of acetaminophen in acute myocardial infarction," by Bradley G.
Leshnower, Hiroaki Sakamoto, Ahmad Zeeshan, Landi M. Parish, Robin
Hinmon, Benjamin M. Jackson, Joseph H. Gorman III and Robert C. Gorman,
Harrison Department of Surgical Research, University of Pennsylvania
School of Medicine, Philadelphia, and Theodore Plappert, Division of
Cardiology, University of Pennsylvania School of Medicine, will appear
in the June issue of the American Journal of Physiology-Heart and
Circulatory Physiology published by the American Physiological Society.
Leshnower and Sakamoto contributed equally to this study.
Research was supported by grants from the National
Heart Lung Blood Institute, National Institutes of Health and from
McNeil Consumer and Specialty Pharmaceuticals.
The American Physiological Society was founded in
1887 to foster basic and applied bioscience. The Bethesda,
Maryland-based society has 10,500 members and publishes 14 peer-reviewed
journals containing almost 4,000 articles annually.
Pain Relievers: Understanding Your OTC Options
By American Academy of Family Physicians
Following are excerpts from a Web page on OTC Pain
Relievers. For the complete details –
click here.
★
What types of OTC pain relievers are available?
Over-the-counter (OTC) pain relievers are medicines
that you can buy without a prescription from your doctor. Two main types
of OTC pain relievers are available. One type is acetaminophen (brand
name: Tylenol). The second type is nonsteroidal anti-inflammatory drugs
(also called NSAIDs). NSAIDs include the following:
● Aspirin (two brand names: Bayer, St. Joseph)
● Ibuprofen (two brand names: Advil, Motrin)
● Ketoprofen (one brand name: Orudis KT)
● Naproxen (one brand name: Aleve)
Some products contain both acetaminophen and
aspirin (brand names: Excedrin Extra Strength, Excedrin Migraine,
Vanquish).
★
How do pain relievers work?
Acetaminophen seems to relieve pain and reduce
fever by working on the parts of the brain that receive pain messages
and control the body’s temperature.
NSAIDs relieve pain and fever by reducing the level
of hormone-like substances (called prostaglandins) that your body makes.
These substances cause the feeling of pain by irritating your nerve
endings. They also are part of the system that helps your body control
its temperature.
★
Will an OTC pain reliever work as well as a prescription one?
For most people, OTC drugs are all they need to
relieve pain or reduce fever. If an OTC drug doesn’t help your pain or
fever, or if you’ve been taking an OTC drug for more than 10 days for
pain or 3 days for fever, call your doctor. These may be signs that you
have a more serious problem or need a prescription medicine.
★
Who shouldn’t take acetaminophen?
You generally shouldn’t take acetaminophen if you
are already taking another product containing acetaminophen. If you have
severe kidney or liver disease, or if you have 3 or more drinks that
contain alcohol every day, you should talk to your doctor before taking
acetaminophen.
★
Who shouldn’t take NSAIDs?
You shouldn’t take NSAIDs if you are allergic to
aspirin or other pain relievers. Talk to your doctor or before you take
an NSAID, especially aspirin, if you:
● Take blood-thinning medicine or have a
bleeding disorder
● Have bleeding in the stomach or intestines, or have peptic
(stomach) ulcers
● Have liver or kidney disease
● Have 3 or more drinks that contain alcohol every day
★
What should I look for on the drug label?
When choosing an OTC pain reliever, check the drug
label for possible side effects or interactions with other drugs you are
taking. This information will appear in the “Warnings” section of the
label.
Be sure to check that you are not taking two
medicines that contain the same active ingredient. You will find this
information in the “Active Ingredient” section.
Always read and follow the directions on the label.
Be sure you understand the label information before taking the medicine.
If you have any questions, ask your family doctor or pharmacist.
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