The Classification Of Painkillers

The main goal of painkillers lies in the name: They should relieve pain. They are definitely useful for many different types of pain.

The word analgesic comes from Greek and means “denial or absence of pain”. Therefore, the general classification of painkillers is also called analgesics.

According to the International Association for the Study of Pain (ISAP), pain is an “unpleasant sensory and emotional experience “. This association with the experience of pain usually has to do with either real or potential harm.

We most often distinguish between two different types of pain: acute and chronic. They are different in terms of sensory experience and also in terms of the emotional experience they evoke. Thus, they also require a distinction when it comes to the classification of painkillers that will work.

Acute pain comes from an injury in, for example, skin tissue, and disappears when the wound heals. Overall, it is difficult to find a specific tissue injury that involves chronic pain. Chronic pain, on the other hand, lasts a long time. Two examples of chronic pain are migraines and osteoarthritis.

As we suggested earlier, the emotional component is different when it comes to acute and chronic pain.

In acute pain, it is common to experience irritability, anxiety and anger.
In connection with chronic pain, one sees a tendency to depression or depressive episodes.

Often, these emotional symptoms can also be treated.

Classification of analgesics: Primary analgesics

The main purpose of painkillers is to relieve pain, and they are definitely useful for many types of pain. Since there are different types of pain, the classification of painkillers is broken down into three main groups.

Antipyretic analgesics

Do you know the classification of painkillers?

Painkillers also have other functions. Although the vast majority are also antipyretics and anti-inflammatory, this group is the exception.

An example of a painkiller for fever is paracetamol . Thus, it does not reduce inflammation, but reduces both pain and fever.

Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs owe their function to the blockage they cause on the enzyme cyclooxygenase (COX). Furthermore, these drugs prevent COX from synthesizing the substances related to the inflammatory process, thus stopping it. Examples of NSAIDs are acetylsalicylic acid ( aspirin ) and ibuprofen .

However, there are also different types of COX, each with a function, and there are also painkillers that block each type specifically. These medicines are called selective COX inhibitors (selective iCOX). Examples of these drugs are celecoxib and rofecoxib .

Opioids

Opioid painkillers activate opioid receptors. In general, when an opioid receptor is activated, it inhibits nerve transmission. Thus , an activated opioid receptor reduces nerve transmission of pain.

There are different types of opioids based on effectiveness and other properties. Here we find:

Full agonists : These are the most effective, and their best examples are morphine , codeine and methadone .
Partial agonists are somewhat less effective. An example is buprenorphine .
Agonist Antagonists : These activate certain opioid receptors and block others. The best example of such a drug is pentazocine .

Mixed : These usually have completely different functions than most opioids. An example is tramadol .

Be aware that opioids often cause side effects such as nausea, constipation or sedation.

Classification of analgesics: Secondary analgesics

The primary goal of secondary analgesics is not necessarily to relieve pain. They were actually designed to alleviate other conditions or conditions. Nevertheless, they relieve another type of specific pain.

Antidepressants

As we have already explained, it is common to associate depressive symptoms with pain, and especially chronic pain. Antidepressants can be beneficial in that regard. One of the most commonly used antidepressants is amitriptyline .

Antiepileptics

Antiepileptic drugs reduce nerve transmission. When you use these drugs, the nerve transmission of pain is reduced. Carbamazepine and lamotrigine are the most common.

Muscle relaxing

Muscle relaxants can relieve muscle pain. If the origin of the pain is muscular, these drugs will relax the affected muscles and reduce the pain. In addition, they can help resolve the damage in these cases.

Overall, the most common muscle relaxants are diazepam , gabapentin and topiramate .

Local anesthetic

Local anesthetics block nerve transmission in the area where they are administered. By using a local anesthetic in the area where the pain occurred, the pain will either disappear or subside.

In addition, these painkillers can also work in structures where the pain “moves”, and the painful impulse hits higher nerve centers. In this way, the pain will not be as intrusive, at least in part.

Overall, the most popular local anesthetics are lidocaine and pilocaprine .

Corticoids

This group of drugs (also called adrenal cortex hormones) has an effect comparable to NSAIDs in the sense that they work by inhibiting or reducing inflammation. Then, as the inflammation subsides, so does the pain caused by it.

Prednisone is a common choricosteroid.