Pain comes in different intensities and forms. Over-the-counter pain relievers work well for some people but others need prescription pain medications to alleviate their discomfort. Every person's response to pain medication differs, and the health care professionals' task includes tailoring the type of drug needed to relieve the symptom.
Nonsteroidal Anti-inflammatory Drugs
Nonsteroidal anti-inflammatory drugs, or NSAIDs, can reduce fever, inflammation and pain. These drugs work by inhibiting cyclooxygenase enzymes needed in the production of prostaglandins, the hormone-like substance that causes the perception of pain. FamilyDoctor.org reports on two classes of prescription NSAIDs: traditional NSAIDs and cyclooxygenase-2, or COX-2, inhibitors.
Traditional prescription NSAIDs include diclofenac, etodolac and higher doses of over-the-counter NSAIDs, such as ibuprofen and naproxen. It may be necessary to switch to different NSAIDs to find out which one will work best according to the American Chronic Pain association, or ACPA. Adverse reactions to these NSAIDs include upset stomach, increased risk of bleeding and kidney damage.
The ACPA reports that COX-2 inhibitors like celecoxib work in a similar manner as traditional NSAIDs, but have a lower risk of gastrointestinal side effects associated with short-term use. Side effects follow the profile of the typical NSAIDs with the added increased risk of heart attack and stroke, as stated by the National Institutes of Health.
Opioid Drugs
The U.S. Food and Drug Administration, or FDA, describe opioids, also called narcotics, as very powerful products. Opioid medications, which work by changing the body's perception of pain, include hydrocodone, oxycodone, codeine and morphine. These drugs come in different forms and dosages, with different administration routes and durations of action. Caution should be taken to prevent prolonged therapy with these drugs as patients on long-term opioids can develop drug tolerance, increased pain sensitivity, decreased libido, depression, impaired sleep patterns and decreased immune response.
The FDA labels the abuse of opioids as a significant public concern, and they recommend three key steps in using opioids safely. Patients should keep doctors informed about any history of substance abuse, they should follow directions carefully and reduce the risk of drug interactions by limiting their intake of other substances, such as alcohol and antihistamines.
The ACPA reports that 51 percent of all patients taking oral opioids experience at least one adverse effect and estimates that 20 percent stop using their medications because of this. Common adverse reactions to opioid therapy include drowsiness, nausea, and vomiting. The ACPA also states that 40 percent of people on opioids develop constipation and an anticipatory bowel regimen program is typically given along with opioid prescriptions.
Adjuvant Analgesics
Adjuvant analgesics include some antidepressants and anticonvulsants. Originally meant to treat a different problem, these drugs have shown potential in alleviating specific types of pain.
According to the ACPA, antidepressants help with fibromyalgia, headache and pain due to nerve damage, but not for pain brought about by acute injuries. The most common side effects of antidepressants include drowsiness, dry mouth, constipation, urinary retention, and weight gain.
Anticonvulsants help relieve nerve pain. Adverse effects include drowsiness, lower extremity swelling, and impaired balance.
References
- FamilyDoctor.org: Prescription Nonsteroidal Anti-Inflammatory Medicines
- FamilyDoctor.org: Chronic Pain Medicines
- Medline Plus: Pain medications
- American Chronic Pain Association: ACPA Consumer Guide to Pain Medication & Treatment, 2010 Edition
- U.S. Food and Drug Administration: A Guide to Safe Use of Pain Medicine
