Analgesics (pain killers) are an important component of medicine’s ability to reduce suffering.
Multiple analgesics are available and vary from Aspirin (the old favourite) to morphine and its synthetic derivatives.
However all analgesics are not equal. Analgesics and anti-inflammatory drugs are often confused and sometimes not used appropriately. Prednisone is an excellent anti-inflammatory drug but has no direct analgesic effect. It produces results by
reducing inflammation and hence “the process causing pain”. Other anti-inflammatory drugs have been developed to produce a similar effect.
Side effects that can be present with long term Prednisone use.
Aspirin has an excellent analgesic and an excellent anti-inflammatory action. Paracetamol (Panadol) has an excellent analgesic effect but is not as good an anti-inflammatory drug as Aspirin.
Multiple new anti-inflammatory drugs called non-steroidal anti-inflammatories have been produced. However these drugs are not and should not replace analgesics when pain is the only symptom to be relieved.
Multiple analgesics are available (a second article will later be published). They range from simple aspirin to opiates and their derivatives. Various mixtures of these different types of drugs have also been developed to treat complicated and compound pain.
Oral, intravenous, intramuscular, rectal and more recently transcutaneous administration have been developed.
The use of anti-inflammatory drugs for pain is commonly practised with nociceptive pain (pain due to damaged tissue), “sprains, strains and broken bones”. This pain usually settles as the injury heals. Care must be used with the use of these drugs as side-effects such as gastric bleeding, liver damage, heart failure and fluid retention can occur.
On occasion drugs such as tricyclic antidepressants can be used to aid the effect of other analgesics that are being used. When using analgesics ask your doctor how the drug works, what is the usual dosage and the maximum dosage you can use. Take analgesics to prevent chronic pain. Take the tablets on time to prevent pain rather than to treat pain and do not stop the drug or alter the dose unless you have discussed this with your doctor. The proper use of a anlgesics involves an understanding of the drug that you are using, what is its action, how often should it be taken and how may it interact with other drugs that you may be using for other conditions. Always remember that if you are on any anticoagulant drugs such as Warfarin, various analgesics and in particular the anti-inflammatory drugs may compound the effect and may result in bleeding. Always tell your pharmacist what other drugs you are taking when a prescription is presented.
In the second article it will follow the different types of analgesics and their usage will be discussed.
Article by Dr. Maurice Heiner
Consultant Thoracic Physician
Consultant Sleep Physician