TYPES (KINDS) OF PAIN MEDICATIONS
Types of pain medication. Analgesics are medications used to relieve discomfort related to an illness, injury, or surgery. Because the pain process is complex, there are many types and classifications of analgesics that provide relief through a variety of physiological mechanisms. For example, medications that work for nerve pain are likely to have a different mechanism of action than medications for arthritis pain.
Types of pain medication
Nonsteroidal anti-inflammatory drugs (NSAIDs) act on substances in the body that can cause inflammation, pain, and fever.
Corticosteroids are often administered by injection at the site of musculoskeletal injuries. They have a potent anti-inflammatory effect. They can also be taken orally to relieve pain, for example. B. in arthritis.
Acetaminophen raises the body’s pain threshold but has little effect on inflammation.
Also known as narcotic analgesics, opioids alter pain messages in the brain.
Muscle relaxants reduce pain in tense muscle groups, possibly through a calming effect on the central nervous system.
Anxiolytics act on pain in three ways: they reduce anxiety, relax muscles, and help patients cope with pain.
Some antidepressants, particularly tricyclics, can reduce pain transmission through the spinal cord.
Some anticonvulsants also reduce pain associated with neuropathies, possibly by stabilizing nerve cells.
WHAT DISEASES ARE PAIN MEDICATIONS USED FOR?
Virtually all diseases, as well as most injuries and surgeries, involve some level of pain.
It is not surprising, then, that analgesics, also known as painkillers, are among the most commonly used medications in the United States.
For mild symptoms such as muscle sprains or headaches, over-the-counter pain relievers are usually sufficient.
Prescription pain relievers, especially opioid analgesics, are generally reserved for moderate to severe pain, such as that following surgery, trauma or certain diseases, such as cancer or rheumatoid arthritis.
Other common “painful” situations in which analgesics are used include labor, back pain, fibromyalgia and urinary tract infections.
WHAT ARE THE DIFFERENCES BETWEEN THE DIFFERENT TYPES OF PAIN MEDICATIONS?
Analgesics can be divided into two categories:
Over-the-counter medications include various mild anti-inflammatory drugs (ibuprofen, naproxen) and acetaminophen. These are intended primarily for short-term acute pain – menstrual cramps, tension headaches, minor sprains – i.e., what are colloquially referred to as “everyday ailments.” Over-the-counter analgesics, especially acetaminophen, are also sometimes used to treat chronic pain, such as those used by B. for arthritis. These drugs also have an antipyretic effect and are often used for this purpose.
The arsenal of prescription painkillers is enormous. It also includes some NSAIDs that are more potent than their OTC relatives, as well as opioid analgesics. And then there are some unconventional analgesics, drugs that were not originally developed as pain relievers but have been shown to relieve pain under certain conditions. Examples of analgesics for fibromyalgia include an anticonvulsant (pregabalin [Lyrica]) and an antidepressant (duloxetine hydrochloride [Cymbalta]).
A key difference between anti-inflammatory and opioid analgesics is that the former have a “ceiling effect”; A continued increase in dose does not lead to a simultaneous increase in pain relief. One of the reasons opioids are so useful in treating chronic pain is that the dose can be increased as tolerance to the dose develops. In fact, the dose of opioids can be increased indefinitely, knowing that higher doses may be associated with unpleasant and/or even dangerous side effects.
WHAT ARE THE STRONGEST PAIN MEDICATIONS?
Opioid analgesics are usually the strongest pain relievers. The gold standard drug in this class is morphine; other opioids are above or below in pain relief potential. At the bottom of the list is codeine, which is often prescribed in combination with acetaminophen, for example. B. to relieve pain after dental treatment.
Codeine is only 1/10 stronger than morphine.
Opioids stronger than morphine include hydromorphone (Dilaudid) and oxymorphone (Opana).
However, the most potent opioid in public use is fentanyl, which in its intravenous form is 70 to 100 times more potent than morphine. Fentanyl is also available as an extended-release patch (Duragesic) and a tablet to dissolve in the mouth (Actiq).
Sufentanil is even more effective than fentanyl, but is currently only administered intravenously.
However, a transdermal patch containing sufentanil is in clinical trials.
WHAT ARE THE SIDE EFFECTS OF PAIN MEDICATIONS?
All NSAIDs carry a risk of gastrointestinal ulcers and bleeding.
A new class of anti-inflammatory drugs, COX-2 inhibitors, has been developed to reduce this risk. However, they did not eliminate it.
On the other hand, another major problem has emerged with these drugs: the possibility of serious and fatal vascular problems with long-term use, including heart attacks and strokes.
Most users of acetaminophen experience few or no side effects.
However, the drug can damage the liver, especially if taken in excess or in combination with alcohol.
Opioid analgesics often cause drowsiness, dizziness and respiratory depression. However, these side effects usually disappear with continued use. However, constipation, another common side effect, often persists. In addition, taking opioids can lead to addiction or dependence. Other possible side effects of opioid analgesics include: Types of pain medication
Euphoria, dysphoria, agitation, seizures, hallucinations.
Decrease in blood pressure and heart rate
Muscle stiffness and twitching
nausea and vomiting
Mixed opioid agonist-antagonists
Patients may experience opioid withdrawal symptoms when taking a single opioid analgesic, such as B. morphine, along with an opioid agonist antagonist. These medications include pentazocine (Talwin Nx, Talacen, Talwin Compound), butorphanol, and nalbuphine (Nubain).
The main side effect of muscle relaxants is drowsiness. In addition, taking carisoprodol (Soma) can be addictive because it becomes a barbiturate-like drug in the body; cyclobenzaprine (Flexeril) can cause dry mouth, constipation, confusion, and balance problems; methocarbamol (Robaxin) causes urine to turn green, brown, or black; metaxalone (Skelaxin) and chlorzoxazone (Parafon Forte, DSC) should be used with caution in people with liver problems. Types of pain medication
There is also a risk of sedation with anti-anxiety medications, especially when combined with certain other medications (such as opioid pain relievers) or alcohol.
Other possible side effects include mental changes, headaches, nausea, blurred vision, restlessness and nightmares.
Chest pain and palpitations are also possible.
Some of the antidepressants used for pain relief are the older tricyclics. They have many side effects classified as anticholinergic, including
blurred vision, and
Other possible side effects include
low blood pressure,
weight gain and
Some of the newer antidepressants also relieve pain and reduce the risk of anticholinergic problems. However, serotonin and norepinephrine reuptake inhibitors (SNRIs) can cause the following common side effects:
Side effects of anticonvulsants used to treat pain usually go away over time. They include
swelling of the lower limbs.
In general, short-term and/or low-dose use of corticosteroids has few side effects. However, prolonged use of corticosteroids can cause serious side effects, which include:
Adrenal insufficiency – a condition in which the body cannot respond adequately to physical stress.
Cataracts and Glaucoma (glaucoma)
high blood sugar
suppression of the immune system
local tissue damage
WHAT ARE THE WARNINGS/CAUTIONS FOR PAIN MEDICATIONS?
Acetaminophen can be toxic to the liver and should be used with caution, if at all, in people with liver disease. The maximum recommended dose of acetaminophen is 4 grams in 24 hours, but the dose may need to be reduced for moderate to heavy alcohol use. NSAIDs may cause stomach bleeding. To reduce this possibility, they should be taken with food.
These drugs may cause kidney failure in people with kidney or liver disease. In addition, some NSAIDs increase the risk of cardiovascular events. Opioid analgesics can be addictive. Driving or operating machinery can be dangerous when taking these painkillers, as they can cause drowsiness. Opioids can slow breathing. Combining opioids with alcohol or other centrally acting drugs can enhance this effect.
There have been deaths and serious side effects with the use of fentanyl transdermal patches. Fentanyl patches are not recommended as initial treatment for inexperienced opioid users. Heat from the sun, hot baths or hot dishes may accelerate the release of fentanyl from the patches.
Oral fentanyl has only one indication: treatment of paroxysmal pain attacks in opioid-using cancer patients who have developed tolerance to opioids. Inappropriate use of oral fentanyl tablets resulted in deaths.
Methadone can affect the heart. Patients scheduled for methadone treatment should first undergo an electrocardiogram to detect abnormalities. Most muscle relaxants cause drowsiness. Methoxalone and chlorzoxazone should be used with caution in people with liver disease. Dantrolene may be toxic to the liver. Taking carisoprodol can lead to addiction.
Anxiolytics or anti-anxiety medications, particularly the benzodiazepine class, can cause drowsiness. Stopping these medications abruptly can lead to seizures and possibly death.
Some antidepressant medications can cause drowsiness. Older antidepressants (tricyclics) interact with a variety of medications, sometimes fatally, and can affect the heart. Types of pain medication
Patients taking anticonvulsants and newer antidepressants should be monitored for signs and symptoms of suicidal thoughts. Oral corticosteroids used to treat acute inflammation generally should not be stopped abruptly. The dose is usually tapered over time and patients should follow instructions carefully. Types of pain medication
LIST OF PAIN MEDICATIONS
The following are examples of over-the-counter pain relievers:
Ibuprofen (Advil, Motrin IB)
The following are examples of prescription medications:
Nonsteroidal anti-inflammatory drugs (NSAIDs).
Indomethacin (Indocin, Indo-Lemmon)
Mefenamic acid (Ponstel)
Naproxen (Naprosyn, Anaprox)
Acetaminophen with codeine (Tylenol #2, #3, #4)
Fentanyl transdermal patches (Duragesic)
Buy Hydrocodone with Acetaminophen (Lortab Elixir, Vicodin)
Hydrocodone with ibuprofen (Vicoprofen)
Meperidine (Demerol, Merpergan)
Morphine and delayed-release morphine (MS-Contin, Avinza, Kadian)
Buy Oxycodone extended release (OxyContin)
Oxycodone with acetaminophen (Percocet)
Shop for Oxycodone with aspirin (Percodan)
Oxycodone with ibuprofen (Combunox)
Oxymorphone (Opana, Opana ER)
propoxyphene with aspirin, propoxyphene with acetaminophen
Tapentadol (Nucynta, Nucynta ER)
Tramadol, Tramadol with acetaminophen (Ultram, Ultracet)
Mixed opioid agonists/antagonists
Pentazocine/naloxone (Talwin NX)
Chlorzoxazone (Parafon Forte, DSC)
methylprednisolone (Medrol, A-Methapred, Depo Medrol, Solu Medrol)
Triamcinolone (Allernaze, Aristospan 5 mg, Aristospan Injectable 20 mg, Kenalog 10 Injectable, Kenalog Nasacort AQ)