Effective pain management is a complex task that requires a many-sided approach using different methods and medicines. In most cases, pharmacotherapy is the most convenient and effective method of managing physical suffering.
The list of pain medications includes several hundred names. All these medications can be divided into the following groups:
- Mild analgesics
- Weak opioid analgesics
- Opioid drugs
Pharmacotherapy of physical suffering and discomfort begins with the use of mild analgesics. If the medication turns ineffective, powerful analgesics are prescribed. This approach provides a stepwise selection of analgesics from a weaker to a stronger one.
The list of pain medications is headed by Acetaminophen (Paracetamol). This is the most famous and often used mild analgesic in the US and Europe.
Pain treatment begins namely with Acetaminophen in headache, migraine, neuralgia, as well as in pain caused by injuries, rheumatic diseases and colds.
Acetaminophen has many advantages, the most important of which are:
- Over-the-counter sales
- Rapid relief of soreness
- Well tolerated by patients
- Excellent efficiency and safety profile
- Possibility of taking with other medicines
Acetaminophen does not possess a significant anti-inflammatory effect, which can be attributed to the shortcomings of this medication.
Pain can be caused or accompanied by inflammation. If this is the case, it is recommended to use Nonsteroidal Anti-Inflammatory Drugs (NSAIDs). Drugs of this type possess anti-inflammatory, antipyretic and analgesic effects.
Today, patients have an access to a wide range of medicines for inflammation and pain. The list of NSAIDs contains dozens of pain medications, including:
- Ketorolac
- Etodolac
- Ketoprofen
- Diclofenac
Ketorolac is an effective analgesic, yet it does have several drawbacks. Due to the risks of gastrointestinal and cardiovascular side effects, this medication is prescribed only for short-term use.
Ketorolac solution for injection should be used for up to 2 days. The maximum duration of treatment with Ketorolac tablets is 5 days.
Etodolac is included in the list of pain medications, intended for long-term use. This medicine allows monitoring chronic or acute pain of inflammatory origin.
The use of Etodolac is limited to a narrow range of indications:
- Rheumatoid arthritis
- Osteoarthritis
Etodolac is not indicated for the treatment of physical suffering in patients under 18 years of age. During the period of use of this NSAIDs, the elderly often experience gastrointestinal and other side effects.
Ketoprofen gel is used to treat soreness in patients over 12 years of age, adults and the elderly. The gel alleviates physical suffering and reduces inflammation, associated with soft tissue injuries.
Ketoprofen capsules are recommended to relieve suffering in people with rheumatoid diseases. Patients, who take Ketoprofen, notice increase in mobility and an improvement in life quality.
Diclofenac takes pride of place in the list of pain medications. This drug is used to control all grades of inflammation and pain in a wide range of conditions.
Indications for Diclofenac use are:
- Migraine attacks
- Diseases of the joints
- Acute locomotor disorders
- Inflammation and pain in minor surgery
Diclofenac is used in conjunction with other pain medications, including with stronger ones (e.g. Codeine). Combined use of drugs will allow controlling mild or moderate soreness.
If mild analgesics fail to alleviate physical suffering, weak opioid analgesics are prescribed. Drugs of this type are indicated for the management of acute or chronic pain caused by bone fractures, injuries, soft tissue burns and severe diseases.
The list of pain medications, used to treat moderate to severe physical suffering, includes:
- Codeine
- Dihydrocodeine
- Tramadol
Weak opioid analgesics are usually taken 3-4 times a day. The doses should be taken at approximately equal time intervals. This allows maintaining a stable concentration of medications in the blood and providing a long-term pain relief.
For analgesia, sustained-release capsules can be used, like Maxitram SR (Tramadol). If this is the case, pain medications are taken 2 times a day, usually in the morning and in the evening. A minimum of 8 hours should pass between the dosing.
In some countries, you can buy Codeine oral solution. This medicine is not used to treat pain. It is indicated to reduce the symptoms of dry or irritating cough.
Weak opioid analgesics can cause euphoria, depression, hallucinations, drowsiness, nightmares, headache and other side effects.
All medications of this type are available for sale on prescription. If they don’t provide pain management, more powerful pain medications should be used.
The list of opioid drugs includes:
- Pethidine
- Levorphanol
- Methadone
- Morphine
- Pentazocine
- Buprenorphine
- Hydromorphone
These drugs are used to relieve moderate to severe pain. If soreness is acute, patients are prescribed tablets, oral solution or solution for injections. Capsules and sustained-release tablets allow you controlling chronic pain.
The frequency of opioid drugs intake depends on the indications and the therapeutic response. As a rule, a minimum interval of 3 hours should be observed between the doses.
The use of opioid drugs is associated with an increased risk of side effects. The list of side effects of opioids includes respiratory depression, involuntary muscle contractions, drowsiness, dizziness, insomnia, constipation, nausea, anorexia and dry mouth.
During the use of opioids, a physical or psychological dependence on these drugs may develop. Therefore, opioids should be taken as little time, as possible.
The list of pain medications includes opioids supplied in the form of transdermal patches, like Bupeaze (Buprenorphine). Such patches are attached to the skin and gradually release the active substance.
Transdermal patches that include opioids are suitable for the treatment of chronic pain, for example, in cancer. During the period of the patches use, side effects do not manifest as often as they do, when people use tablets or injections.