Pain Management

Pharmacological Approaches for Pain

Pain relieving drugs, otherwise called analgesics, include nonsteroidal anti-inflammatory drugs, acetaminophen, narcotics, antidepressants, anticonvulsants, and others. NSAIDs and acetaminophen are available as over-the-counter and prescription medications, and are frequently the initial pharmacological treatment for pain. These drugs can also be used as adjuvants to the other drug therapies, which might require a doctor's prescription. NSAIDs include aspirin, ibuprofen Motrin, Advil, Nuprin, naproxen sodium, and ketoprofen, Orudis KT. These drugs are used to treat pain from inflammation and work by blocking production of pain-enhancing neurotransmitters, such as prostaglandins. Acetaminophen is also effective against pain, but its ability to reduce inflammation is limited. Narcotics handle intense pain effectively and are used for cancer pain and acute pain that does not respond to NSAIDs and acetaminophen. Narcotics are classified as either opiates or opioids and are available only with a doctor's prescription. Opiates include morphine and codeine, which are derived from opium, a substance naturally found in some poppy species. Opioids are synthetic drugs based on the structure of opium. This drug class includes drugs such as oxycodone, methadone, and meperidine. Although antidepressant drugs were developed to treat depression, it has been discovered that they are also effective in combating some chronic headaches, cancer pain, and pain associated with nerve damage. Antidepressants that have been shown to have analgesic (pain reducing) properties include amitriptyline Elavil, trazodone and imipramine. Anticonvulsant drugs share a similar background with antidepressants. Developed to treat epilepsy, certain anticonvulsants were found to relieve pain as well. Drugs such as phenytoin and carbamazepine are prescribed to treat the pain associated with nerve damage.