Sunday, December 17

Pain Medications

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Drugs used to control pain range from mild, over-the-counter (OTC) preparations such as acetaminophen to potent general anesthetics. They include:

  • nonopioid analgesics, antipyretics, and nonsteroidal anti-inflammatory drugs (NSAIDs)

  • opioid agonist and antagonist drugs

  • anesthetic drugs.

Nonopioid analgesics, antipyretics, and NSAIDs

Nonopioid analgesics, antipyretics, and NSAIDs are a broad group of pain medications. They’re discussed together because, in addition to pain control, they also produce antipyretic (fever control) and anti-inflammatory effects. These drugs may be used alone or in combination with other medications. They have a ceiling effect (maximum dose above which there’s no added benefit) and don’t cause physical dependence.


Opioid agonist and antagonist drugs

The word opioid refers to derivatives of the opium plant or to synthetic drugs that imitate natural narcotics. Opioid agonists (also called narcotic agonists) include opium derivatives and synthetic drugs with similar properties. They’re used to relieve or decrease pain without causing the person to lose consciousness.

Some opioid agonists may also have antitussive effects that suppress coughing and antidiarrheal actions that can control diarrhea.

Opioid agonists

Opioid agonists include:

  • codeine

  • fentanyl

  • hydrocodone

  • hydromorphone

  • levorphanol

  • meperidine

  • methadone

  • morphine sulfate (including morphine sulfate sustained-release tablets and intensified oral solution)

  • oxycodone

  • oxymorphone

  • propoxyphene

  • remifentanil

  • sufentanil.

Mixed opioid agonist-antagonists

Mixed opioid agonist-antagonists attempt to relieve pain while reducing toxic effects and dependency. The mixed opioid agonist-antagonists include:

  • buprenorphine

  • butorphanol

  • nalbuphine

  • pentazocine hydrochloride (combined with pentazocine lactate, naloxone, aspirin, or acetaminophen).

Anesthetic drugs

Anesthetic drugs can be divided into three groups’general anesthetics, local anesthetics, and topical anesthetics.

Inhale or inject?

General anesthetic drugs are further subdivided into two main types: those given by inhalation and those given intravenously


Inhalation anesthetics

Commonly used general anesthetics given by inhalation include:

  • desflurane

  • enflurane

  • halothane

  • isoflurane

  • nitrous oxide

  • sevoflurane.


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