Pain relievers

The class of painkillers is very wide, and there are many classifications of drugs used in practice. The main analgesics with their own analgesic effect are paracetamol, non-steroidal anti-inflammatory drugs or drugs (NSAIDs and NSAIDs), opioids and local anesthetics.

Drugs that have analgesic properties and are used in the treatment of pain syndromes of various localization include agents for relieving pain associated with a change in the pain threshold, damage (or dysfunction) of the structures of the central and peripheral nervous system, these are flupirtine, drugs from the class of antidepressants, a group of anticonvulsants ... Also, drugs are regularly used that do not have anesthetic effect, but enhance the analgesic effect of other drugs. These include muscle relaxants and antispasmodics.

A strict classification of pain medications is based on the principle of dividing drugs into opioid, non-opioid and combination drugs, including non-opioid and opioid drugs. The rest of the drugs belong to the so-called adjuvant and symptomatic drugs that allow you to achieve the desired effect with minimal side effects and in less time. The most common non-opioid drugs, all of which are non-narcotic, contribute to their free distribution, most often, the over-the-counter dispensing of drugs in the pharmacy network.

A feature of our country, in contrast to the countries of Europe and America, is the lesser spread of the use of paracetamol preparations and the unjustifiably high prescription of antispasmodics. Opioid drugs, most of which belong to narcotic drugs, are much less widespread, which is associated with significant difficulties in the procedure for prescribing and accounting for the circulation of narcotic drugs. However, despite the fact that in our country the registration of narcotic drugs complicates their prescription, in the countries of Europe and America the prescribing procedure is easier, at the same time, the accounting and expert assessment of the social and psychological characteristics of the patient falls on the shoulders of the prescribing doctor, including control of the drug level in blood plasma, registration of prescribed drugs, counting of used ampoules, and so on. A special subclass of drugs made from opioid drugs are potent drugs that do not have narcotic properties due to their low narcogenic potential (low ability to cause psychological dependence), the registration of which is easier, which allows them to be used more widely.

Mechanical and ischemic pain that develops within the framework of nociceptive pain also requires local therapy of the source of pain with the appointment of symptomatic treatment and, possibly, NSAIDs.

Neuropathic pain - in addition to drug therapy for the causes of pain (for example, the use of adequate doses of antiviral drugs for postherpetic neuralgia), a local effect on the source of pain, if any, is necessary (for example, studying the level of compression in tunnel neuropathy, radiculopathy, the use of local treatments: therapeutic blockades, perineural blockade, epidural and foraminal blockade, muscle blockade during compression of the nerve in the muscle-tendon tunnel), as well as the appointment of drugs from the groups of anticonvulsants and antidepressants acting, in addition to nociceptive structures (perceiving and transmitting pain), on antinociceptive structures (suppressing pain).

Dysfunctional pain therapy can also include the appointment of anticonvulsants and antidepressants, but, in addition, it must be carried out with the participation of specialists in related specialties, specialists responsible for the pain area (otorhinolaryngologist, orthodontist for facial pain, for example), and a psychiatrist, whose participation is necessary. to assess affective responses to chronic pain.