Pain Medications

There are a lot of pain medications easily available at any pharmacy, grocery store or convenience store and others that are commonly prescribed. I decided to write a guide for myself to keep them straight! All of this information was gleaned from the internet, mostly wikipedia, but I wanted an easy reference that would answer the most basic questions I and my patients have most regularly.

Common terms associated with pain medications:

1. Anti-inflammatory: reduces inflammation, the body’s defense mechanism to bring wound repair material to the injured site. There are two forms of inflammation; our western diet tends to force the body into the less desirable form.
2. Analgesic: anti-pain, generally affects the nervous system and keeps the pain signal from reaching the brain. Some drugs act on the central nervous system (brain, brainstem and spinal cord) others act on the peripheral nervous system.
3. Anti-pyretic: reduces fever, the bodies increased temperature response to infection killing foreign organisms by cooking them.
4. Vasoconstrictor: a substance which causes blood vessels to constrict (get smaller, therefore decreased blood flow).
5. Narcotic: originally any psychoactive drug that caused drowsiness and sleep. In analgesics it refers to opioid drugs (see below). Legally it refers to any prohibited drug.
6. Steroid: there are many different types. Naturally they are produced in the human body. In analgesia they are usually synthetic corticosteroids, used mostly for treating different inflammatory conditions. They can suppress the immune system and cause osteoporosis.

The main classifications of pain meds are:

1. non-steroidal anti-inflammatory drugs (NSAIDs): analgesic, anti-pyretic, anti-inflammatory – works on the peripheral nervous system, has a similar anti-inflammatory effect as corticosteroids. Can inhibit healing of fractures. Causes or aggravates gastrointestinal conditions. Some can increase risk of vascular problems such as heart attack and stroke.
2. acetaminophen / paracetamol: analgesic – works on the central nervous system rather than the peripheral nervous system, does have some anti-inflammatory properties, but they are very weak, so overall not classified as an NSAID. Most commonly overdosed over-the-counter analgesic, especially when used with alcohol. Can cause liver damage and some kidney damage.
3. opioids: analgesic – addictive, acts on the central and peripheral nervous system as well as the GI tract. Decreases pain by decreasing pain perception and reaction and increasing pain tolerance level. Many patients have said that they could still feel the pain, but just didn’t care. Has psychological effects.
4. barbiturates: analgesic and other – central nervous system suppressants that can cause many different effects. Physically and psychologically addictive.
5. benzodiazepines: muscle relaxant and other – often used instead of barbiturates, can still be addictive.
6. ergotamines: vasoconstrictor – used to treat acute migraine attacks, usually in combination with caffeine. Vasoconstriction is not confined to the head so it can cause decreased blood flow to other parts of the body causing chest pain and cold hands / feet.
7. triptans: restrict blood vessels in the head and inhibits inflammation. Used to treat migraine and cluster headaches. Most common adverse effect is causing headache!
8. others: Some pain, like nerve pain can be treated with drugs made for other conditions such as antidepressants or anticonvulsants.

The most commonly used pain medications:

1. Ibuprofen: (Motrin, Advil) – NSAID – has a mild anti-clotting effect and some vasodilation properties. 400 mg per dose and 1200 mg per day is max recommended for non-prescription use. Used also to treat swelling.
2. Acetaminophen / Paracetamol: (Tylenol) – In an analgesic classification by itself because it is similar to an NSAID in many ways, but has a weak anti-inflammatory effect and works in the central nervous system rather than the peripheral nervous system.
3. Acetylsalicylic acid: (Aspirin) – NSAID – found in willow bark. Also has an anti-clotting effect. Can cause ulcers and excessive bleeding.
4. Naproxen: (Aleve, Naprosyn) – NSAID – One of the NSAIDs with lowest risk for vascular side effects. Often used to treat stiffness.
5. Morphine: – opioid – Named after the Greek god of dreams because it is one of the original narcotics (causing sleep). Acts directly on the central nervous system to relieve pain. Highly addictive.
6. Hydrocodone: – opioid – derived from codeine. Often used in combination with NSAIDs or acetaminophen. Often used to treat cough (antitussive).
7. Colecoxib: (Celebrex) – NSAID – increases risk of heart attack, stroke or other vascular problems. Increases risk of upper GI tract problems.
8. Codeine: – opioid – morphine derivative. Often used in combination with Tylenol, Aspirin, or Ibuprofen.
9. Oxycodone: (OxyContin) – opioid – Acts directly on the central nervous system to relieve pain. Often used in combination with NSAIDs or acetaminophen.
10. Tramadol: – opioid – Codeine derivative. Used also for restless leg syndrome, motor neuron disease and fibromyalgia.

General Advice:

1. READ the fine print! Make sure any drug is not known to react with any condition you are known to have or any other drug / medication you are on.
2. Pain, fever and inflammation are all defense mechanisms of your body and have an important place in the healing and repair process. Treat them as little as possible, and not at all if you can.

Alphabetized Trade Name List:

Advil (ibuprofen)

Aleve (naproxen)

Aspirin (acetylsalicylic acid)

Cafergot (ergotamine, caffeine)

Celebrex (colecoxib)

Diazepam/Valium (benzodiazepine)

Fioricet  (barbiturate / acetaminophen / caffeine)

Imitrex (triptan)

Lorazepam  (benzodiazepine)

Maxalt (triptan)

Motrin (ibuprofen)

Naprosyn (naproxen)

Norco (hydrocodone / acetaminophen)

OxyContin (oxycodone)

Tylenol (acetaminophen)

Vicodin (hydrocodone / acetaminophen)

References: http://en.wikipedia.org/wiki: /NSAID, /Analgesic, /Narcotic, /Opioid, /Ibuprofen, /Colecoxib, /Naproxen, /Morphine, /Oxycodone, /Hydrocodone, /Steroid, /Corticosteroid, /Barbiturates, /Benzodiazepine, /Ergotamine

Posted in Conditions and tagged inflamation, medication, pain, prescriptions