Every sports team has a medicine cabinet as part of its equipment, at home and on the road.
In addition to the antihistamines, decongestants, antibiotics and other drugs for treatment of colds, viruses, ailments and illnesses that afflict athletes and nonathletes alike, the sports doctor has at his disposal several categories of drugs that are particularly useful in treating athletic ailments.
All drugs have a chemical name; a generic name which is often a contraction or abbreviation for the full chemical name and one or more brand names.
The example, acetaminiophen is a white, ordorless, crystalline powder with a slightly bitter taste that has been clinically shown to be effective in relieving pain and reducing fever.
It is better known as Tylenol, the trade name of McNeil Consumer Products. The identical chemical is sold by other companies under the brand names Panitone, Tempra and Valadol. It is sold by other laboratories under its generic name, acetaminophen, usually at a much lower price than the brand names.
With these principles in mind, consider some of the categories of drugs that have a prominent place in the sports medicine chest:
"Analgesia" is defined as "control of pain without loss of consciousness." Analgesic agents work on the central nervous system, primarily the part of the brain that receives and translates pain impulses from nerve endings in various parts of the body. Generally speaking, they ease pain without blocking it.
The most commonly used pain relievers are mild analgesics available over the counter, without prescription.
Most of these are either aspirin-based (Bufferin, Excedrin, Empirin, etc.) or acetaminophen-based (Tylenol, Datril, etc.).
Aspirin has an anti-inflammatory property - that is it not only helps relieve symptomatic pain, but also can reduce the inflammation causing it. However, it can cause stomach upset and bleeding in some individuals.
Acetaminophen lacks inflammatory action, but is less likely to cause stomach irritation.
Many analgesic preparations contain portions of aspirin, phenacitin (an aspirin-like compound), and cafeine, and are known to doctors and pharmacists as "APC." Empirin Compound, for instance, contains 227 mg. of aspirin, 162 mg. of phenacitin, and 32 mg. of caffeine.
Both aspirin-based and acetaminophen-based preparations also are frequently combined with various amounts of codeine, a more potent analgesic. Preparations containing codeine become prescription substances, and can cause physical dependence after prolonged use.
Also widely used as pain remedy in sports in Darvon, an analgesic called propoxyphene, in combination with APC.
The second type of "painkiller" used in sports, much less frequently because they are more dangerous and inappropriate for most types of injuries, are local anesthetics.
"Anesthesia" is defined as "loss of sensation with or without loss of consciousness." General anesthetics figuratively put a patient to sleep. Local anesthetics numb an area of the body by preventing the nerve endings in that area from sending pain impulses to the brain.
The main local anesthetics used in sports are Novocain (procaine), Xylocaine (lidocaine) and Marcaine (bupivacaine), which usually are injected directly into an area of pain to cause immediate and complete cessation of feeling. All are derivatives of cocaine. The primary difference between them is their duration: Novocain is the shortest-acting, Marcaine the longest.
A great danger is using local anesthetics is that the athlete can badly aggravate an injury without knowing it because he has no pain to alert him to the damage taking place.
Another danger is that injection of local anesthetic can occasionally cause permanent loss of sensation.
Anti-inflammatory agents do not relieve pain, per se, by preventing the sending or interpretation of impulse through the central nervous system. Rather, they work on an injury - a damaged muscle, tissue, joint, tendon, etc. - to reduce the swelling and inflammation.
Anti-inflammatories can be taken orally or injected.
Cortisone and the more potent hydrocortisone, which are manufactured by a number of companies under various trade names, are widely used in sports medicine.
Cortisone can have undesirable side effects, including disturbance of the body's distribution of certain minerals, notably potassium and sodium; fluid retention, and depletion of calcium after prolonged use, which can leave bones vulnerable to spontaneous fractures.
Another prominent anti-inflammatory is Butazolidin (phenylbutazone), which is widely used to treat racehorses as well as human athletes. A recent issue of "Science" magazine reported that ""Bute" tops the current National Football League prescription list, with an average seasonal intake of 24 to 40 pills (100 mg. each) per player.
Ulcers, liver or heart disease, hearing loss, blood diseases, and problems of almost every organ are listed as possible side effects. Still, many physicians consider Butazolidin and similar drugs acceptable and useful when used with care and properly monitored.
One anti-inflammatory agent which is not legal, but which is used in sports by some trainers and phycians, is DMSO (dimethylsulfoxide). A byproduct of paper and pulp production, it is easily manufactured and obtained, especially since it is routinely used in veterinary medicine.
Doctors in the early 1960s found that DMSO showed remarkable healing properties in many soft tissue injuries. But the Food and Drug Administration banned its use in humans in 1965 after research revealed that three species of animals developed eye problems following its use. DMSO was cleared last year for use only in humans suffering from interstitial cystitis, a bladder ailment, but some physicians are pressing the FDA to removed its general ban.
These drugs are used primarily to treat muscle spasms (often violent involuntary contractions), which can be excruciatingly painful, especially in the neck or lower back.
Among the most commonly prescribed for athletes are valium (dizepam), which has both tranquilizing and muscle-relaxing properties; Soma (carisoprodol); Flexeril (cyclobenzaprine), and Robaxin (methocarbamol).
These are recommended only for short-term use, and in the prescribed dosage. In overdoes, they can act as sedatives.