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Pharmacological Pain Management
Managing pain is sometimes simple and other times very complex, always depending on the underlying cause of pain.
A wide variety of medications are used to treat pain. They can be used individually or in combination. They can be given orally or even directly injected into the pain producing site. The selection of medication is based on the type of pain being treated.
The most commonly used medications for pain management include:
Non-steroidal anti – inflammatory drugs (NSAIDs) – are the most common pain management medications used worldwide. They are used for the treatment of different types of pain starting from headaches, toothache, arthritis, back pain, etc. NSAIDs work on the chemical level, blocking the effects of Cox-1 and Cox-2 enzymes. These two enzymes play a key role in the production of prostaglandins. Using NSAIDs will block the work of these enzymes already mentioned, leading to less production of prostaglandins in the body, which will result in less swelling, inflammation and pain. Most of NSAIDs medications work by blocking the two types of enzymes at the same time. The most common known and widely used NSAID medications include:
- Naproxen, etc.
But, are NSAIDs safe to use? Why are they so familiar and widely used worldwide? Most people don’t have any side effects when using NSAID medications to treat pain, regardless of its origin. However, like any other medication even NSAID have their possible side effects. NSAID possible side effects include:
- Allergic reactions
- Gastrointestinal problems
- High blood pressure due to a reduction of blood flow in the kidneys
- Kidney damage, etc.
Compound analgesics – are a combination of two drugs, combines together in a single tablet. Usually, compound analgesics contain a NSAID like Paracetamol or Aspirin and a weak opiate like Codeine. They can be used as a single medication or combined with NSAIDs.
Like any other medications, even compound analgesics have their possible side effects like allergic reactions, nausea, vomiting, diarrhea, altered with constipation, drowsiness, etc. They should be used carefully when you need to drive or even operate different kind of machines while working.
Opioids – also known as narcotics are medications used to treat mild to moderate pain. These types of medications can have serious side effects if not used as prescribed by your doctor. Opioids can’t be used without a prescription.
How do opioid medications work? If you do need stronger medications to treat your pain, like opioids you need to carefully take them, just as prescribed by your doctor. Opioids do bind with opioid receptors located in the human brain, spinal cord and other areas of the human body. Once opioids are connected to their receptors, the pain messages to the brain are reduces, leading to a less feeling of pain. Some of the most commonly known and used opioids include:
- Naloxone, etc.
If you do need opioids for pain management, you should visit your doctor regularly. As they are stronger painkillers they tend to have various side effects like nausea, vomiting, diarrhea, altered with constipation, drowsiness, etc. Opioids should not be used combined with alcohol and other medications like sleeping pills, certain types of antidepressants and antihistamines. Other problem while taking opioids is their ability to create tolerance and addiction.
Antidepressants – are medications that tend to increase the levels of certain chemicals in the brain, improving mood and regulating pain signals. Lower doses of antidepressants are usually recommended for treatment of chronic pain. They are not used for treatment of acute pain.
Like any other medications, antidepressants have their side effects and they should be used carefully, just as prescribed by your doctor. Common side effects include: allergic reaction, dry mouth, dizziness, nausea, vomiting, headache, diarrhea, altered with constipation, drowsiness, weight gain, etc.
The most common used antidepressants for the treatment of pain are tricyclic antidepressants, like Amitriptyline, Gabapentin, Pregabalin, etc.
You should never stop taking suddenly tricyclic antidepressants.
Anticonvulsants – are used for the treatment of chronic pain, regardless of its origin. These drugs are typically used for treatment of epilepsy, in order to control the seizures. However, it seems that anticonvulsants also have an effect when used for the treatment of nerve pain. The most commonly known and used anticonvulsant is Carbamazepine.
Like any other medication, anticonvulsants have their possible side effects like confusion, skin rash, headaches, nausea, vomiting, weight loss or even weight gain, loss of appetite, abdominal pain, etc.
Keep in mind that you should not immediately stop taking anticonvulsants. If you do want to stop taking them, you should do it gradually over a long period of time, avoiding this way, withdrawal symptoms, like nausea, vomiting, pain, headaches, insomnia, sweating, anxiety, etc.
Muscle relaxants – are medications sometimes prescribed for pain treatment. These medications tend to treat the muscles spasms which can cause pain and interfere with normal functioning of the affected part of the human body.
Muscle relaxants are not recommended for pregnant women, people with and alcohol addiction or a history of drug abuse and depression.
Possible side effects of muscle relaxant medications include dry mouth, dizziness, drowsiness, urinary retention, etc. These medications also tend to form an addiction so they should be used carefully just as prescribed.
Muscle relaxants should be used for a short period of time, better before going to bed.
Topical analgesics – are creams, sprays, lotions, ointments, gels, patches or rubs administrated locally, directly to the skin in order to relief the pain. These analgesics offer almost the same effects as oral analgesics but with minimal adverse systemic effects. Topical analgesics usually have analgesic, anesthetic and antipruritic effects.
The most advanced pain management center, Brooklyn pain management doctors and specialists at Pain Physicians NY offer unique, individualized approach. We are using the most effective pain management options utilizing the latest technologies available in USA.