Non Opioid Analgesics

Non Opioid Analgesics

Non opioid analgesics which include the nonsteroidal anti- inflammatory drugs such as aspirin, ibuprofen, diclofenac and ketorolac are used for the management of acute and chronic pain. These agents inhibit prostaglandin synthesis and have varying analgesic, antipyretic, and anti-inflammatory properties. Acetaminophen (paracetamol) lacks significant anti-inflammatory activity.

Analgesia is due to blockade of prostaglandin synthesis, which sensitizes and amplifies nociceptive input. Some types of pain, particularly pain that follows orthopedic and gynecological surgery, respond very well to these agents, suggesting an important role for prostaglandins.

All undergo hepatic metabolism and are renally excreted. Dosages should therefore be reduced in patients with hepatic or renal impairment. Acetaminophen has the fewest side effects but is a hepatotoxin at very high doses. Isoniazid, zidovudine, and barbiturates can potentiate acetaminophen toxicity. Aspirin and NSAIDs most commonly produce stomach upset, heartburn, nausea, and dyspepsia; some patients develop ulceration of the gastric mucosa, which appears to be due to inhibition of prostaglandin-mediated mucus and bicarbonate secretion. Other side effects include dizziness, headache, and drowsiness. With the exception of acetaminophen