The following nonopioid analgesics are important drugs used in the control of pain:
Salicylates Aspirin (acetyl salicylic acid) is the most commonly used analgesicfor the treatment of low to moderately intense pain. Headache, myalgia, arthralgia, and other pains arising from integumental structures other than viscera are particular amenable to aspirin treatment. Chronic use of aspirin does not lead to addiction or tolerance and toxicity is lower than more potent analgesics. It is believed that aspirin inhibits the synthesis of prostaglandins; prostaglandins are known to sensitize pain receptors to noxious stimuli.
Para-amino Phenol Derivative Phenacetin and its active metabolite acetaminophen are effective alternatives to aspirin as analgesics. Acetaminophen (Tylenol) lacks many of the side effects of aspirin and is well tolerated. It, therefore, is used in patients for whom aspirin is contraindicated.
Propionic Acid Derivatives or NSIADs Included in this class are ibuprofen, naproxen, and fenoprofen. These agents are effective for symptomatic relief of pain associated with soft tissue injury and have been used to relieve moderate pain from viscera and bone metastases.
Opioid Analgesics A wide range of agents are available in this class of drugs, including: morphine, heroin (diacetyl morphine), hydromorphone (dihydromorphinone), codeine (methylmorphine), levodromeran methadone, meperidine, and alphaprodine. Although all of these agents produce similar side effects, availability of many of these agents provides flexibility in prescribing these drugs. For example, codeine is prescribed when the pain is not too severe, morphine when pain is severe, and levodromeran when a potent oral analgesic is needed.
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