Analgesic

What is Analgesic?

Analgesics are the class of drugs that are used medically by patients to relieve pain without causing a loss of consciousness.

The word comes from the Greek an (without) and algein (pain). Analgesic drugs work on the peripheral and central nervous systems. An analgesic is a pain-reducing or relieving remedy. This especially extends to pain relief medications, such as acetaminophen. Drugs classified as NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen, are also used in analgesics.

Table of Contents

• Recommended Videos
• Types of Analgesics
• Important Facts about Opioids and Opiates
• Uses of Analgesics
• Analgesic Side Effects
• Frequently Asked Questions – FAQs

Drugs (medicines) are considered either the primary therapy or an adjunct to another modality. Physicians of all specialties prescribe drugs on a daily basis, and therefore they need to understand the mode and action by which drugs exert their therapeutic effects.

Recommended Videos

Types of Analgesics

Analgesics include opioid and opiate substances and nonopioid medications, which may be prescription or over the counter drugs. Many nonopioid and nonopioid-opioid preparations also work as antipyretics and antiinflammatory agents for a desirable therapeutic effect.

Opioid and opiate medication are strong analgesics capable of reducing pain of any origin. Nonopioids may require a prescription or may be bought. Non Opioids may also be used in co analgesia or as adjuvant therapy. Coanalgesic such as codeine and acetaminophen are most often used for chronic pain but may be used for acute pain that requires opioid use. Adjacent medications such as diazepam, given with opioids are not true analgesics but are used with analgesics to potentiate pain relief and reduce pseudoaddiction.

There are three types of OTC analgesics. One is salicylates, which includes aspirin, one of the most common analgesics. While aspirin is generally safe for most adults, use by children under 16 has been linked to Raye’s syndrome, a rare liver disorder. Long-term use in adults can cause damage to the stomach lining, causing abdominal pain and bleeding. It can also prevent the blood to clot, making it useful for patients suffering from heart attacks and stroke.

Important Facts about Opioids and Opiates

• Opioids and opiates are derivatives of opium or opium like chemicals that produce similar results to elevate pain thresholds and alter pain perception.
• Opiates and opioids have antitussive effects and may cause respiratory depression especially in the elderly.
• Opioids and opiates are used for acute pain of moderate to severe intensity and in terminal illnesses.
• Addiction and psychological dependence may occur with use of strong analgesics for chronic pain. These analgesics are effective and safe for short term usage.
• Around the clock administration of opioids and opiates is used for severe, acute pain and chronic pain of terminal illnesses.

Uses of Analgesics

Opioids and Opiates are used to treat acute pain of moderate to severe intensity, alter the perception of pain by mimicking endorphins to block neurotransmission of painful impulses and increase the pain threshold.

The World Health Organization (WHO) has described a three step analgesic ladder in pharmacologic treatment of pain, using adjuvant analgesics in conjunction with opioids and opiates with each type of pain.

1. Mild pain – Use acetaminophen, aspirin or other nonsteroidal anti inflammatory drugs around the clock.
2. Moderate pain – If pain persists or increases a mild opioid such as codeine or hydrocodone.
3. Severe pain – If pain persists or if it is moderate to severe at outset, give a strong opioid or opiate such as morphine, fentanyl or meperidine. A non opioid medication may also be continued to assist with pain control or discontinued.

Analgesic Side Effects

Side effects, theoretically accompanying analgesia and limiting opioid tolerability, are frequent in pharmacological pain control. The discussion of side effects is part of informed consent, but could favour the effects of nocebo.

Unknowingly, subjects were randomised double-blind to positive vs. control information about side effects contained in a research drug film. In order to test analgesia, sequences of mildly unpleasant heat stimuli administered before and during treatment with diclofenac and atropine were used. As a co-analgesic, Atropine was deceptively presented, but used to cause side effects. 65 percent of participants said during debriefing that they would like to get a constructive message in a therapeutic setting. Although the present findings can not be automatically converted into therapeutic pain settings, they do suggest the significance of clinically researching this form of modulation.