Types of Pain Medications

Different Classes of Analgesics With Unique Mechanisms

Aug 1, 2009 Anthony Lee

Drugs for controlling pain exist in a variety of forms. How do different types of pain medications work?

Pain is one of the most common ailments people experience, if not the most common. It is a symptom for which medication is often the prime method of treatment. There are many types of pain medications (analgesics) that are available to patients, each with its own mechanism of action. Doctors take into account a variety of factors, such as the cause of pain and its severity, in order to choose the appropriate analgesic for a patient.

Nonsteroidal Anti-Inflammatory Drugs

The nonsteroidal anti-inflammatory drugs (NSAIDs) are a familiar class of analgesics because of their availability as over-the-counter medications in drugstores. These drugs, which include ibuprofen (Motrin) and naproxen (Aleve) among many others, have the ability to relieve pain, suppress inflammation, and reduce fever. These analgesic, anti-inflammatory, and anti-pyretic properties are explained by the drugs' ability to block cyclooxygenase (COX), an enzyme in various tissues that produce the chemical mediators responsible for inflammation, associated pain, and fever.

Of note, aspirin is a member of the NSAID class and the earliest one discovered. Although it shares the same properties as other NSAIDs, the drug also has anti-platelet properties, a feature that lends itself to be used as treatment for heart attacks and strokes. In addition, the drug acetaminophen, often known under the trade name Tylenol, reduces pain and fever but not inflammation, thereby excluding itself from the NSAID class.

Corticosteroids

Although corticosteroids are not generally considered pain medications, they are anti-inflammatory medications. They can help treat pain caused by inflammatory processes. For example, a patient with arthritis may benefit from injections of steroids into the inflamed joint.

Opioids

The opioid analgesics, also termed narcotics, relieve pain by binding to opioid receptors in the central nervous system. Many of these drugs, such as morphine, fentanyl, and oxycodone, act as agonists to produce the effect of analgesia. The potency of these opioids allow them to be used for moderate to severe pain. However, there is also the risk for potential for dependency and addiction in some patients.

Some opioids have properties as antagonists, binding to opioid receptors to prevent the analgesic effect. Opioids that are agonist-antagonists can provide pain relief but only to a certain extent. The opioid drug methadone is one such example and is notable for treating heroin withdrawal by binding to opioid receptors without the full agonist effect that leads to opioid dependency.

Neurological Analgesia

There are certain drugs that are primarily used for neurologic and psychiatric conditions but have a role as therapy for neuropathic pain. This type of pain occurs without any external pain triggers such as heat or sharp points. Medications commonly used for neuropathic pain include the antidepressant amitriptyline (Elavil) and the anticonvulsant gabapentin (Neurontin).

Anesthetic Nerve Blockade

In certain cases, pain relief may need to be achieved with a nerve blockade. An anesthetic medication, such as lidocaine, can be injected into a nerve branch such that a body region becomes desensitized to pain. For example, an injection of anesthetic around the spinal cord produces pain relief in areas in the lower half of the body.

References

The copyright of the article Types of Pain Medications in General Medicine is owned by Anthony Lee. Permission to republish Types of Pain Medications in print or online must be granted by the author in writing.

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