Analgesic Com

Analgesics/Anti-Inflammatory Agents
ANALGESICS
They are drugs that selectively relieve pain without significantly altering consciousness.
ANAESTHESIA
Anaesthesia means loss of sensation. An Anaesthetic agent is one which brings about loss of all modalities of sensation, particularly
pain, along with a reversible loss of consciousness.
PAIN
Also known as “ALGESIA” is an unpleasant sensory and emotional experience associated with actual or potential tissue damage.
CLASSIFICATION OF ANALGESICS
They are divided into 2 groups; those that act on the CNS are known as Opioid Analgesics, while those that act on the PNS are known
as Non Opioid Analgesics or Non-steroidal anti-inflammatory drugs (NSAIDs)
Opioids
They are obtained from poppy {papaver somniferous} capsule called “opium”, known from earliest times. They are capable of
relieving severe pain in a conscious state.
Types of Opioids
Natural Opium alkaloids
 Morphine
 Codeine.
Semi synthetic opiates
 Diacetylmorphine
 Oxymorphone
 Pholcodeine
Synthetic opioids
 Pethidine
 Fentanyl
 Methadone
 Dextropropoxyphene
 Ethoheptazine
 Tramadol
Uses of Opioids/Narcortics
1. Relief of moderate to severe pain e.g. myocardiac infection (heart attack or stroke), cancers, burns, fractures, or post-surgical
traumas.
2. Pre-operative medication to reduce anxiety and enhance the effect of general anesthesia.
3. Relief of persistent cough
4. Relief of severe diarrhea and cramping
5. Detoxification treatment of narcotic addiction (Methadone can only be used to treat narcotic addiction but it cannot be used
to treat severe pain)
6. As an obstetric analgesia
Non-Steroidal Anti-Inflammatory Drugs

They are also called non-narcotic/ non-opioid analgesics. They act primarily on peripheral pain mechanism, they are also used to
suppress the symptoms of inflammation associated with rheumatic disease while some are also used to relieve pain (analgesic) and
fever (antipyretic). They are devoid of the undesirable side effects of narcotic agents. They are used to treat mild to moderate pain.
Class/Drug MOA Indications Route/Dose Side Effects Contraindication Nursing Responsibility

Salicylates inhibiting the synthesis of Rheumatic fever Oral Tinnitus Peptic ulcer Don’t administer on empty
(ASPIRIN) prostaglandin thereby Rheumatoid arthritis Rectal Peptic ulcer Asthmatic patient stomach
reducing pain impulses Osteoarthritis Nausea Anemia
Colds 600mg 3x Daily Vomiting Don’t administer to peptic
They reduce fever by Headache Dizziness ulcer patients
stimulating the Minor aches and pains Gastric distress
hypothalamus, to send signals Do not administer to
for increased sweating which children below 12
leads to cooling effect when
sweat evaporates Do not administer in latter
stages of pregnancy
Aspirin permanently inhibits
platelet aggregation Not more than 13 tablets in
divided doses in 24hrs
unless recommended by a
physician
Paracetamol It alters the response of heat Fever Oral Rashes Hypersensitivity to Avoid over dosage in
(Acetaminophen) regulating centre in the Headache IM Liver damage paracetamol patients
hypothalamus and raises the Muscle ache Renal impairment
pain threshold General pain Adult – 1000mg Do not administer to
Drug of choice for tds patients with hypersensitive
treating fever in Children – reaction
children and headache 500mg tds
in pregnant women. Toddlers – 1tsp
tds
Pentazocine It has depressive effect on the For relief of all types Oral Dizziness Hypersensitivity Patients should be warned
sensory nerve cells and and degrees of pain in IM Nervousness reaction not to drive or operate
sensory centre in the brain acute and chronic Subcutaneous Nausea Impaired heavy machinery
causing a sedative or drowsy disorders either Vomiting renal/hepatic
effect with reduced pain and associated with minor Single IM dose Diarrhea function
discomfort. surgery, trauma, acute of 30mg-60mg
labor or colic. in two divided
doses
Tramadol It binds to opiate receptors in Moderate to severe Oral Fatigue Acute intoxication Should not be administered
the CNS, causing inhibition of acute and chronic pain IM Allergic reaction with alcohol or with hypnotics
ascending pain pathway Painful diagnostic Suppository Palpitations hypnotics
altering the perception of and measures IV Vomiting Patients to avoid driving or
response to pain Surgery Dry mouth operating heavy machinery
Tablets 15-30mg
2x daily Used with caution in
patients with head injury
IM 15-30mg
STAT. Don’t combine with other
CNS depressants to avoid
over dosing.
Anesthetic Agents
These are drugs used to induce anesthesia, in other words they are drugs used to achieve a temporary loss of sensation or
awareness.
Types of Anesthetic Agents
1. General anesthetic agents

2. Regional anesthetic agents
Regional Anesthesia
This involves only a part of the body and there is no loss of consciousness e.g.
1. Local anesthesia
2. Epidural anesthesia
3. Spinal anesthesia
These drugs paralyze the sensory nerve in the region they are applied to so that the passage of painful stimuli towards the spinal
cord becomes impossible. Eg lidocaine, prilocaine
Local Anesthesia
These are drugs that produce insensibility to pain by reversible local action paralyzing the nerve supply when injected into the tissue.
Class/Drug MOA Indications Route/Dose Side Effects Contraindication Nursing Responsibility

Lidocaine it paralyses the nervous tissue Labour pains IM Hypotension Hypersensitivity to Find out about
Lignocaine in the nerve roots thereby Severe pain due to skin IV Bradycardia the drug hypersensitivity to the drug
(Xylocaine) hindering the transmission of lesions Respiratory
sensory impulses from the Urethral anaesthesia 10 -20ml of 0.5- arrest Observe vital signs
periphery to sensory tract to Removal of foreign 1% preparation Irritability especially the blood
the brain thus preventing pain bodies Agitation pressure.
sensation

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Analgesics/Anti-Inflammatory Agents

Non-Steroidal Anti-Inflammatory Drugs

Class/Drug MOA Indications Route/Dose Side Effects Contraindication Nursing Responsibility

Types of Anesthetic Agents

1. General anesthetic agents

Class/Drug MOA Indications Route/Dose Side Effects Contraindication Nursing Responsibility

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