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This topic is a basic overview on painkillers. It is to serve only as a guide. Please take time to read the disclaimer
WHAT ARE PAINKILLERS?
Painkillers (ANALGESICS) are substances that give temporary relief from pain without causing a loss of consciousness. There are two major categories of painkillers: non-narcotic and narcotic.
The most commonly used nonnarcotic painkillers are aspirin and other salicylates, acetaminophen, and nonsteroidal anit-inflammatory drugs such as ibuprofen, which are available in both prescription and nonprescription forms. Nonnarcotic painkillers are by far the most commonly used of all medications. In addition to controlling pain, these analgesics also lower fever and counter inflamation.
Narcotic painkillers include opiates and opioids, which are natural or artificial forms of opium. Codeine, propoxyphene (e.g. Darvon and Wygesic), meperidine (Demerol), and morphine are common examples. These drugs are usually used on a short-term basis to control severe pain.
Many prescription analgesics contain a combination of narcotic and nonnarcotic painkillers. Common combinations include acetaminophen and codeine (e.g. Tylenol with Codeine and Tylox), aspirin and codeine (e.g. Empirin with Codeine), propoxyphene and aspirin (e.g., Darvon Compund-65); and aspirin, caffeine, and butalbital (Florinal). These drugs are used as an alternative to preparations that contain only narcotic ingredients for painful conditions that are not adequately alleviated by nonnarcotic agents.
HOW DO PAINKILLERS WORK?
Opiates and Opioids apparently work through specific receptors in the central nervous system. Aspirin and the other nonprescription drugs are thought to work by blocking the body's production of particular types of prostaglandins, hormone-like substances that are produced throughout the body.
SECONDARY SIDE EFFECTS
The most common side effect of aspirin and the stronger nonsteroidal antiinflammatories is gastrointestinal irritation. This can be minimized by taking them with meals or milk.
Acetaminophen does not cause as many intestinal side effects as aspirin, but it should be used with caution by persons who have liver or kidney disorders. The combination of aspirin and acetaminophen is especially damaging to the kidneys, as is heavy alcohol consumption and long-term acetaminophen use to the liver.
Codeine often causes nausea, dizziness, and constipation. A more serious problem, however, involves the tendency of codeine and other narcotics drugs to produce drowsiness. Thus, these agents should not be taken by anyone who must remain alert. In addition, narcotic drugs should never be taken by anyone who must remain alert. In addition, narcotic drugs should never be taken in combination with alcohol, antihistamines and other allergy or cold pills, anticonvulsants, tranquilizers, muscle relaxants, or any other agent that depresses the central nervous system. Narcotics increase the effects of these drugs on the brain, and a fatal overdose can result from their combined use.
The potentially addictive effect of opiates and other narcotic agents is the major drawback to their long-term use. However, overconcern about addiction has resulted in their underuse in the control of severe pain.
Some painkillers have beneficial secondary effects. for example, low-dose aspirin may help prevent a heart attack or stroke by preventing clot formation. By the same token, aspirin can cause bleeding problems.
OTHER TREATMENTS
Alternative pain therapies that may be used independently or in conjunction with painkillers include: Accupuncture, Acupressure, and Massage. Electrostimulation, by implanting electrodes at certain sites in the body and then stimulating them to prevent pain messages from reaching the brain. Relaxation, Biofeedback, Meditation. Surgery, by destroying nerves responsible for pain sensation.
WHAT CAN BE DONE?
A person who suffers from a chronic pain disorder learns by trial and error how best to manage the pain. If aerobic exercise is tollerated, secretion of endorphins, brain chemicals that are natural painkillers, are released. If you do take a painkiller, make sure that you follow all instructions.
EXAMPLE OF PAINKILLERS
Nonsteroidal anti-inflammatory drugs (NSAIDs) are available in prescription and OTC form. No one has been proved superior, but people respond differently to each, so it may be necessary to try several.
NSAIDs include:
clofenamate (Meclomen)
diclofenac (Voltaren)
ibuprofin (Motrin and OTC Advil, Nuprin, and others)
nabumetone (Relafen)
naproxen (Naprosyn, in both prescription and OTC forms, and Anaprox)
piroxicam (Feldane)
sulindac (Clinoril)
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