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sick trigger posted:there's been some research to suggest codeine and paracetamol can be effective when used together to treat pain, but absolutely the main reason they're sold otc together is so people can have access to codeine while making it difficult to abuse (without damaging your liver with the paracetamol). It's a dumbass system that has definitely caused more harm than preventing a few junkies getting their fix would ever be worth. Paracetamol or NSAIDs work on similar pathways (both inhibit the formation of prostaglandins, mediating pain transmission) while codeine binds directly to opioid receptors, inhibiting nerve cells and preventing them from firing effectively. The problem is, opioids affect a number of different cells which can cause all sorts of depressive functions including your respiratory centers. A lot of these negative effects aren't linear dose-dependent, you can take a whole lot of opioids without any ill effect and then taking a tiny bit more will tip you over the line toward respiratory distress. Unfortunately, with pain, people will keep taking more and more medication until their pain goes away but different pain medications have different times to peak effectiveness. You typically reach peak plasma concentrations of paracetamol within 10-60 minutes with a half life of 1-3 hours while an opioid has a half life of 3-4 hours with a variable peak plasma concentration. The logic is that, with a combination medication, the codeine is the most "effective" medication but for most sources of pain, the paracetamol will have an effect fast enough that people can tolerate their pain enough that they won't keep dosing themselves before the medication has had a chance to work its effect. You also get a wider range of pain conditions treated through combination therapy; some pain doesn't respond well to one so the inclusion of a second pain reliever ensures that the pain is managed. Also, the synergistic effect can't be underestimated; there are concepts called "equivalent" dose which is a research term to describe how much of a medication will produce the effect of a quantity of another medication. It's theoretical when you're comparing between drug classes because the pain relief provided by an opioid is of a different character than the pain relief provided by an NSAID or paracetamol however, using our best estimates of equivalent doses, a synergistic effect has been noted in combination studies that exceed what you would expect of both drugs exerting their individual effect (I hope that sentence isn't too convoluted). The mechanisms are hideously difficult and are not adequately proven however the best theory suggests that main signals are modulated, in part, by communication between different parts of the pain pathway such that interfering at one point can down-regulate the expression of the pathway at a different point. If you inhibit the pain pathway at the prostaglandin, arachidonic acid part of the pathway, it communicates its effect to the part of the pain pathway modulated by opioid receptors such that agonising those receptors will have an even stronger effect because you've already primed the body to think "okay, we're trying to inhibit this pathway". I am aware that the research of this synergistic effect isn't "settled" but this is still the most widely accepted model. Also, you don't need to do an acid-base extraction to separate codeine from paracetamol; they dissolve in water at different temperatures. **edit** quote:Codeine doesn't work on me. At all. No, really. Some people are born without the enzyme CYP2D6 which converts codeine into morphine, without which the medication stays functionally inert. Fun fact, recent research has also shown us that <too much> CYP2D6 in the liver can render codeine ineffective because it breaks the medication down too fast to be effective Serrath fucked around with this message at 06:16 on Oct 2, 2015 |
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Oct 2, 2015 06:08
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HookShot posted:This is interesting, whenever I go to the dentist it always takes 4-5 times the regular amount of whatever the freezing gel they use is before my mouth actually loses feeling. Would that be the same reason? Probably not, most topical gels like that don't enter circulation and don't need to be metabolised in the liver, they get taken up by whatever cells they're applied to and, when taken up by free nerve endings in the mouth, depolarize the cell causing it to be unable to be stimulated and transmit signals. I don't know why you'd need more except to say there's probably some anatomical variation; you might have more nerve endings or the endings present have a lower threshold for depolarizing. 4-5 times is a lot, though; unless your dentist is using a different drug than a sodium channel blocker, they can get pretty dangerous if you absorb enough through a surface area that it enters your circulation including arrhythmias
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Oct 2, 2015 07:10
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freebooter posted:There are no "official channels" hth I have a question in good faith; what is Australia's policy with respect to people who apply for refugee status after flying in? I know that flights don't generally operate out of the countries where refugees generally travel but is there a mechanism in place preventing an Iraqi or Afghanistan citizen from flying from Indonesia to Australia and then claiming asylum? I mean, obviously there's some system stopping them otherwise they wouldn't be attempting the maritime crossing but what specific roadblocks is Australia putting up? Is it that Australia won't extend a tourist visa to people who may claim asylum? And, if that's what it is, how do they ascertain whether or not someone is likely to?
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Oct 5, 2015 08:42
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freebooter posted:As far as Afghanistan is concerned, we don't extend any visas whatsoever to any Afghan citizens, and there's nothing they can do about it. Tough poo poo. Very basic question, then; who stops you from boarding a plane if you don't have a visa? Does the country of origin maintain airport staff to check the visa status of people boarding flights or is that a responsibility of the airline? Is it ever the case that an airline doesn't do its due diligence, allows a refugee to board, he lands in Australia and applies for asylum the moment he steps off the plans? And, if someone did that, where would they end up? **edit** quote:f you don't have the right passport and the right visa you will not be allowed onto a plane that is going to Australia I'm just wondering who stops you, that's all; I imagine someone does but I'm wondering if it's the country of origin, the airline, or if Australia maintains a security presence overseas. I guess I've never come to Australia without a visa but I've traveled a lot and there are a lot of countries where you can apply for your visa after landing, in the airport... I guess Australia doesn't have a system like that but I'm curious how they stop people from doing this... Serrath fucked around with this message at 09:06 on Oct 5, 2015 |
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Oct 5, 2015 09:00
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When people in the political sphere talk about changing the policy on penalty rates, are they generally talking across the board or are they usually just singling out hospitality/retail? Because there are a lot of fields (e.g., police, medicine, paramedics) that fall under the umbrella of penalty rates but every news article talks about hospitality/retail, implying that these debates are about them specifically. Is there a movement to change penalty rate agreements with paramedics or nurses within this push? If not, why not, what is the logic conservatives use to suggest that retail workers don't deserve extra pay for having to work Sunday but medical doctors do (I know it's about punishing the poor but I'm wondering if they've made any effort to rationalize the policy beyond that axiom). My friend is a paramedic and I'm (presumably) going to be doing a lot of evening/weekend shift work when I graduate from my current program; I know that most areas of the hospital and ambulance service will howl like banshees if there is even a hint that the current pay structure is under threat...
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Oct 6, 2015 03:46
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Birb Katter posted:This is the thin edge of the wedge because hospitality can't stand up for themselves / don't have the same social standing as workers compared to emergency services etc There must be an argument that the conservatives are using to justify the double standard, though... how do they sell this policy, it's obviously hypocritical; how do they respond when they're asked why they're maintaining this standard for one profession and not another? Even when they're being disingenuous, they usually at least provide <an> explanation.
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Oct 6, 2015 03:53
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Cleretic posted:They're not. They never mention other industries, probably because they know that picking a fight with nurses or whatever is never gonna look good for them. So they take aim at hospitality, then lose anyway and the penalty rate discussion skulks back into the shadows. Maybe my political literacy is low or maybe I'm missing something but this seems to open their argument up to a very obvious line of attack... they go on record to make an exhaustive case as to why penalty rates are bad and why the law needs to be changed and then they level those arguments at hospitality and retail workers when, in reality, those arguments could be used against nurses, medical interns, police officers. I recognize that they seem to lose this argument but I never hear anyone press them on why they're not trying to push these policies on anyone but a very narrow minority of workers who enjoy penalty rates. If they believed all the arguments they made about why penalty rates shouldn't be a thing, it seems ideologically inconsistent to go after retail workers alone (and I know they're just using this excuse as a vehicle to pass policies to denigrate people without any influence, it just feels like the hypocrisy is a bit more naked than usual). Has anyone ever challenged someone in this administration with that argument? Made them answer why they're not going after the penalty rates of other industries? I'd be really interested to know how they spin it if they're put on the spot...
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Oct 6, 2015 04:09
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Royal Children's Hospital doctors refuse to return children to detentionquote:Doctors at the Royal Children's Hospital are refusing to send back asylum seeker children to detention centres amid a showdown with the Immigration Department.
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Oct 10, 2015 23:32
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Seems Turnbull announced a timetable for a same sex marriage plebiscite and vows to hold one within 100 days of the next election, should his party win. Not knowing a lot about plebiscites, is it fair to assume that formally announcing this policy and announcing a timeline exactly the same as Labor's policy to vote on Same Sex Marriage within 100 days of a Labor government nullifies much of the difference between these two parties?
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Oct 21, 2015 11:13
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WhiskeyWhiskers posted:The arguments against the innovation are not especially novel. Pretty much every one of these reasons were put forward as reasons to deny women the vote a century ago. Too easily influenced (by their husbands), not enough information or experience, not responsible enough, not even interested in voting.
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Oct 31, 2015 05:32
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