7 minute read
Relief
TARGETED PAIN RELIEF
When patients experience muscle and joint pain, pharmacists can recommend topical analgesics (rubs, creams and sprays) to help provide relief for their symptoms. Helping customers choose the right topical analgesic for their individual needs is key if they are to gain optimum benefit.
Musculoskeletal pain is likely to affect a significant percentage of the population and encompasses a huge range of conditions.
Low back pain, for example, is acknowledged to be the leading cause of disability worldwide and osteoarthritis is purported to affect 60% of 60-year-olds.”
While musculoskeletal conditions and the pain, stiffness and immobility that go with them can compromise the lives of sufferers in many obvious physical ways, mental health and wellbeing is also affected.
Patients will often use OTC topical analgesics for the treatment and management of musculoskeletal injuries and disorders. These products may have local analgesic, anaesthetic, antipruritic, and/or counterirritant effects. Topical analgesics for musculoskeletal pain can be used alone or in conjunction with oral analgesics when appropriate and warranted. External analgesic products may contain one or more of the following ingredients: methyl salicylate, camphor, menthol, methyl nicotinate, capsicum, and trolamine salicylate.
ASSISTING SELECTION
Patient confusion regarding the wide array of topical products and formats available can also hinder usage. Consumers want help and reassurance when it comes to self-treating. They do not understand the difference between various types of topical – hot, cold and non-steroidal anti-inflammatory drugs – or how to use them. Following the introduction of the codeine regulations, pharmacists now encourage the use of acetaminophen as first in line choice of pain relief, followed by ibuprofen, before codeine-based analgesics.
In addition, patients must be made aware of how to use the medication properly and must be informed by pharmacists of the possible side effects that can occur when a product is used after the recommended period of three days. Products may have local analgesic, anaesthetic, antipruritic, and/or counterirritant effects. ingredients. Counterirritants are approved for the topical treatment of minor aches and pains of muscles and joints.
They are often employed for the treatment of acute musculoskeletal injuries and as an adjunct therapy in the treatment of chronic musculoskeletal disorders.
Counterirritants differ from other external analgesics in that pain relief results more from nerve stimulation than depression. Topical analgesics for musculoskeletal pain can be used alone or in conjunction with oral analgesics when appropriate and warranted.
External analgesic products may contain or more of the following ingredients: methyl salicylate, camphor, menthol, methyl nicotinate, capsicum, and trolamine salicylate.
Salicylates: These same ingredients that give aspirin its pain-relieving quality are found in some creams. When absorbed into the skin, they may help with pain, particularly in joints close to the skin, such as the fingers, knees, and elbows. Capsaicin: The main ingredient of hot chilli peppers, capsaicin is also one of the most effective ingredients for topical pain relief. When first applied, capsaicin creams cause a warm tingling or burning sensation. This gets better over time. Users may need to apply these creams for a few days up to a couple of weeks before they will notice relief from pain.
Topical analgesic products are available in a variety of formulations, including gels, ointments, creams, lotions, and patches in single-entity or combination formulations. Topical heat therapy patches are also available in various sizes for treating joint and muscle pain and provide eight to 12 hours of continual, portable heat therapy.
OTC topical analgesics are intended to be used for mild to-moderate pain for no longer than seven days. The factors that a pharmacist may consider when recommending a topical analgesic include dosage form, cost, ease of use of product, as well as the patient’s medical history, including possible allergies.
W W H A M
Who? Anyone suffering from pain, musculoskeletal problems or fever.
How long has the patient had the symptoms? Dependent on the condition suffered.
Action already taken? Pain relief.
Medication? Apply topical products only to intact skin. Areas treated with counterirritants should not be covered with tight bandages or occlusive dressings. Patients on anticoagulation therapy should be advised not to use topical products that contain salicylates, because concomitant use has been associated with prolonged prothrombin time.
Cystitis?
Uva-ursi and Echinacea Cystitis oral drops is a traditional herbal medicinal product used to help relieve minor urinary complaints associated with relieve minor urinary complaints associated with cystitis in women such as: • Burning sensation when urinating • Frequent urination Things to note
• Suitable for adult women 18+ • Take 15 drops in a little water 2 – 5 times daily • It is not recommended to take this product for more than 7 days • Take product at fi rst sign of symptoms • Can often be recommended for those who cannot take conventional cystitis remedies cannot take conventional cystitis remedies that contain sodium citrate
Available from: Wholefoods Wholesale Unit 3 Kylemore Ind Estate, Killeen Rd, Dublin 10. T: 01 6262315 F: 01 6261233 W: www.wholefoods.ie
A.Vogel Uva-ursi & Echinacea Cystitis oral drops Active ingredients: Each 15 drop dose contains: 357.5 mg of tincture from fresh Arctostaphylos uva-ursi (L.) Spreng, herba (Bearberry herb) and 120 mg of tincture from fresh Echinacea purpurea (L.) Moench, herba (Purple Conefl ower herb). Indications: Traditional herbal medicinal product used to help relieve minor urinary complaints associated with cystitis in women, such as burning sensation during urination and/or frequent urination, exclusively based upon long-standing use. For women aged 18 and over only. Dosage and administration: For oral short-term use only. Take 15 drops in a little water 2-5 times daily. Do not take this product for more than 7 days. If symptoms persist, worsen or do not improve after 4 days, a qualifi ed healthcare professional should be consulted. Contraindications: Hypersensitivity to the active substance(s), to plants of the Asteraceae (Compositae) family, to Bearberry or to any of the excipients. Echinacea extracts must not be used in cases of progressive systemic disorders, autoimmune diseases, immunodefi ciencies, immunosuppression and diseases of the white blood cell system. Patients with current or previous kidney disorders or restricted fl uid intake. Not to be used during pregnancy and lactation. Warnings and Precautions: Do not exceed stated dose. If symptoms such as fever, spasms, acute urinary retention, dysuria, urinary incontinence, or blood in urine occur, a healthcare professional should be consulted. There is a possible risk of anaphylactic reactions in atopic patients. Atopic patients should consult their doctor before using Echinacea. Not to be used in men. Uvae ursi folium may cause a greenish-brown colouration of the urine. Contains a small amount of alcohol (213mg per 15 drop dose). Interactions: Not to be used concomitantly with immunosuppressant medications. Should be avoided in patients taking medicines known to interact with alcohol. Side effects: Gastrointestinal symptoms (e.g. nausea, vomiting and stomach ache have been reported). Hypersensitive reactions may occur. Echinacea can trigger allergic reactions in atopic patients. Association with autoimmune diseases has been reported. The alkylamides present can affect the buccal mucosa which may be experienced as tingling, irritation and numbness in the mouth. The frequency of adverse reactions is not known. Legal classifi cation: P. Registration number: TR2309/021/001. Registration holder: A.Vogel Ireland Ltd, 48 Upper Drumcondra Road, Dublin 9, Ireland D09 F3C7. Date of preparation: November 2020.
