Pain: the use of paracetamol in multimorbid patients

Abstract

Introduction: More than one third of Italians have at least 2 chronic comorbidities, and this percentage is more than 50% after the age of 75 years. The presence of comorbidities has as a consequence politreatments, with a high probability of drug interactions and adverse events.Methods: Medical literature about physiopathology of pain and its treatments was reviewed and combined with expert opinion of the authors. Results: Pain is “An unpleasant sensory and emotional experience associated with, or resembling that associated with, actual or potential tissue damage”. Chronic pain is one of the main factors that impact on quality of life and is the leading reason why patients seek medical care.Pain can represent a defense against potential or real damage to the body, but chronic pain becomes a disease itself, with a profound negative impact on quality of life. Paracetamol is a drug with analgesic and antipyretic action widely used both alone and in combination with other medications. It is an effective and safe drug, and can be used in infants and elderly, in patients in whom NSAIDs are contraindicated, in pregnant or breastfeeding women. A large number of studies have recognized the efficacy and safety of paracetamol in treating pain, and the drug is included in the WHO’s List of Essential Medicines. EULAR, AAOS and NICE guidelines recommend paracetamol as the first-choice analgesic in several condi- tions like osteoarthritis or post-surgical pain. Conclusions: Paracetamol, due to its efficacy, safety of use, poor interaction with other drugs, appears to be the first- choice treatment of painful syndromes in the elderly patient.