Portal:Analgesics
Portal maintenance status: (October 2018)
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Introduction
An analgesic or painkiller is any member of the group of drugs used to achieve analgesia, relief from pain.
Analgesic drugs act in various ways on the peripheral and central nervous systems. They are distinct from anesthetics, which temporarily affect, and in some instances completely eliminate, sensation. Analgesics include paracetamol (known in North America as acetaminophen or simply APAP), the nonsteroidal anti-inflammatory drugs (NSAIDs) such as the salicylates, and opioid drugs such as morphine and oxycodone.
Selected general articles
Parecoxib is a water-soluble and injectable prodrug of valdecoxib. It is marketed as Dynastat in the European Union. Parecoxib is a COX2 selective inhibitor in the same category as celecoxib (Celebrex) and rofecoxib (Vioxx). As it is injectable, it can be used perioperatively when patients are unable to take oral medications. It is approved through much of Europe for short term perioperative pain control much in the same way ketorolac (Toradol) is used in the United States. However, unlike ketorolac, parecoxib has no effect on platelet function and therefore does not promote bleeding during or after surgery. In addition, ketorolac has a much higher gastrointestinal toxicity profile compared to most other nonsteroidal antiinflammatory drugs (NSAIDs) including ibuprofen and naproxen. While banned in many European countries due to concerns about surgical bleeding and stomach ulcers after surgery, ketorolac is the only injectable NSAID in the United States.
In 2005, the U.S. Food and Drug Administration (FDA) issued a letter of non-approval for parecoxib in the United States. No reasons were ever documented publicly for the non-approval, although one study noted increased occurrences of heart attacks following cardiac bypass surgery compared to placebo when high doses of parecoxib were used to control pain after surgery. It is also important to remember that rare but severe allergic reactions (Stevens-Johnson Syndrome, Lyell syndrome) have been described with valdecoxib, the molecule to which parecoxib is converted. Read more...
Lumiracoxib (rINN) is a carboxylic acid COX-2 selective inhibitor nonsteroidal anti-inflammatory drug, manufactured by Novartis and still sold in few countries, including Mexico, Ecuador and the Dominican Republic, under the trade name Prexige (sometimes misquoted as "Prestige" by the media).
Lumiracoxib has several distinctive features. Its structure is different from that of other COX-2 inhibitors, such as celecoxib: lumiracoxib is an analogue of diclofenac (one chlorine substituted by fluorine, the phenylacetic acid has another methyl group in meta position), making it a member of the arylalkanoic acid class of NSAIDs; it binds to a different site on the COX-2 enzyme than do other COX-2 inhibitors; it is the only acidic coxib and has the highest COX-2 selectivity of any NSAID. Read more...
Salicin is an alcoholic β-glucoside. Salicin is produced in (and named after) willow (Salix) bark and acts as an anti-inflammatory agent in the human body. Salicin is also commonly found in the bark of Populus species, and the leaves of willows and poplars. It is also found in castoreum, which was used as an analgesic, anti-inflammatory, and antipyretic. The activity of castoreum has been credited to the accumulation of salicin from willow trees in the beaver's diet, which is transformed to salicylic acid and has an action very similar to that of aspirin. Salicin was the historical origin of aspirin and is chemically related to it. When consumed, the acetalic ether bridge is broken down. The two parts of the molecule, glucose and salicyl alcohol, then are metabolized separately. By oxidizing the alcohol function the aromatic part finally is metabolized to salicylic acid. Salicin tastes bitter like quinine.
Salicin may cause an allergic skin reaction (skin sensitization; category 1). Read more...
Cyclobenzaprine, sold under the brand name Flexeril among others, is a muscle relaxer medication used to relieve skeletal muscle spasms and associated pain in acute musculoskeletal conditions. It is the best-studied drug for this application. It has also been used off-label for fibromyalgia treatment.
As of 2015 the cost for a typical course of medication in the United States is less than US$25. Read more...
Hydrocodone, sold under brand names such as Vicodin and Norco among many others, is a semisynthetic opioid derived from codeine, one of the opioid alkaloids found in the opium poppy. It is a narcotic analgesic used orally for relief of moderate to severe pain, but also commonly taken in liquid form as an antitussive/cough suppressant.
Hydrocodone is an opioid, and acts as a selective agonist of the μ-opioid receptor, the main biological target of the endogenous neuropeptide β-endorphin. Read more...
Dihydromorphine (Paramorfan, Paramorphan) is a semi-synthetic opioid structurally related to and derived from morphine. The 7,8-double bond in morphine is reduced to a single bond to get dihydromorphine. Dihydromorphine is a moderately strong analgesic and is used clinically in the treatment of pain and also is an active metabolite of the analgesic opioid drug dihydrocodeine. Dihydromorphine occurs in trace quantities in assays of opium on occasion, as does dihydrocodeine, dihydrothebaine, tetrahydrothebaine, etc. The process for manufacturing dihydromorphine from morphine for pharmaceutical use was developed in Germany in the late 19th Century, with the synthesis being published in 1900 and the drug introduced clinically as Paramorfan shortly thereafter. A high-yield synthesis from tetrahydrothebaine was later developed. Read more...
Dihydrocodeine is a semi-synthetic opioid analgesic prescribed for pain or severe dyspnea, or as an antitussive, either alone or compounded with paracetamol (as in co-dydramol) or aspirin. It was developed in Germany in 1908 and first marketed in 1911.
Commonly available as tablets, solutions, elixirs, and other oral forms, dihydrocodeine is also available in some countries as an injectable solution for deep subcutaneous and intra-muscular administration. As with codeine, intravenous administration should be avoided, as it could result in anaphylaxis and life-threatening pulmonary edema. In the past, dihydrocodeine suppositories were used. Dihydrocodeine is available in suppository form on prescription. Read more...
Etoricoxib (Arcoxia) is a selective COX-2 inhibitor from Merck & Co. Currently it is approved in more than 80 countries worldwide but not in the US, where the Food and Drug Administration (FDA) has required additional safety and efficacy data for etoricoxib before it will issue approval. Read more...
Camphor (/ˈkæmfər/) is a waxy, flammable, transparent solid with a strong aroma. It is a terpenoid with the chemical formula C10H16O. It is found in the wood of the camphor laurel (Cinnamomum camphora), a large evergreen tree found in Asia (particularly in Sumatra and Borneo islands, Indonesia) and also of the unrelated kapur tree, a tall timber tree from the same region. It also occurs in some other related trees in the laurel family, notably Ocotea usambarensis. The oil in rosemary leaves (Rosmarinus officinalis), in the mint family, contains 10 to 20% camphor, while camphorweed (Heterotheca) only contains some 5%. Camphor can also be synthetically produced from oil of turpentine. It is used for its scent, as an ingredient in cooking (mainly in India), as an embalming fluid, for medicinal purposes, and in religious ceremonies. A major source of camphor in Asia is camphor basil (the parent of African blue basil).
The molecule has two possible enantiomers as shown in the structural diagrams. The structure on the left is the naturally occurring (R)-form, while its mirror image shown on the right is the (S)-form. Read more...
Mefenamic acid is a member of the anthranilic acid derivatives (or fenamate) class of NSAID drugs, and is used to treat mild to moderate pain, including menstrual pain, and is sometimes used to prevent migraines associated with menstruation. It is not widely used in the United States due to its side effects and high cost compared to other NSAID drugs.
Its name derives from its systematic name, dimethylphenylaminobenzoic acid. It was discovered and brought to market by Parke-Davis in the 1960s. It became generic in the 1980s and is available worldwide under many brand names. As of 2015 the cost for a typical course of medication in the United States is more than $200. Read more...
Paracetamol, also known as acetaminophen or APAP, is a medicine used to treat pain and fever. It is typically used for mild to moderate pain relief. Evidence for its use to relieve fever in children is mixed. It is often sold in combination with other medications, such as in many cold medications. In combination with opioid pain medication, paracetamol is also used for severe pain such as cancer pain and pain after surgery. It is typically used either by mouth or rectally, but is also available intravenously. Effects last between 2 and 4 hours.
Paracetamol is generally safe at recommended doses. Serious skin rashes may rarely occur, and too high a dose can result in liver failure. It appears to be safe during pregnancy and when breastfeeding. In those with liver disease, it may still be used, but in lower doses. It is classified as a mild analgesic. It does not have significant anti-inflammatory activity and how it works is not entirely clear. Read more...
Alfentanil (R-39209, trade name Alfenta, Rapifen in Australia) is a potent but short-acting synthetic opioid analgesic drug, used for anaesthesia in surgery. It is an analogue of fentanyl with around 1/4 to 1/10 the potency of fentanyl and around 1/3 of the duration of action, but with an onset of effects 4x faster than fentanyl. Alfentanil has a pKa of approximately 6.5, which leads to a very high proportion of the drug being uncharged at physiologic pH. This unique characteristic is responsible for its rapid onset. It is an agonist at mu opioid receptors.
While alfentanil tends to cause fewer cardiovascular complications than other similar drugs such as fentanyl and remifentanil, it tends to give stronger respiratory depression and so requires careful monitoring of breathing and vital signs. Almost exclusively used by anesthesia providers during portions of a case where quick, fast acting (though not long lasting) pain control is needed (i.e. during a nerve block, head pinning etc..) Alfentanil is administered by the parenteral (injected) route for fast onset of effects and precise control of dosage. Read more...
Proglumide (Milid) is a drug that inhibits gastrointestinal motility and reduces gastric secretions. It acts as a cholecystokinin antagonist, which blocks both the CCKA and CCKB subtypes. It was used mainly in the treatment of stomach ulcers, although it has now been largely replaced by newer drugs for this application.
An interesting side effect of proglumide is that it enhances the analgesia produced by opioid drugs, and can prevent or even reverse the development of tolerance to opioid drugs. This can make it a useful adjuvant treatment to use alongside opioid drugs in the treatment of chronic pain conditions such as cancer, where opioid analgesics may be required for long periods and development of tolerance reduces clinical efficacy of these drugs. Read more...
Hydromorphone, also known as dihydromorphinone, and sold under the brand name Dilaudid, among others, is a centrally-acting pain medication of the opioid class. It is made from morphine. Comparatively, hydromorphone is to morphine as hydrocodone is to codeine – it is a hydrogenated ketone thereof. In medical terms, it is an opioid analgesic, and in legal terms, a narcotic. Hydromorphone is commonly used in the hospital setting, mostly intravenously (IV) because its bioavailability is very low orally, rectally, and intranasally. Sublingual administration (under the tongue) is usually superior to swallowing for bioavailability and effects; however, hydromorphone is bitter and hydrophilic like most opiates, not lipophilic, so it is absorbed poorly and slowly through mouth membranes.
Hydromorphone is much more soluble in water than morphine and, therefore, hydromorphone solutions can be produced to deliver the drug in a smaller volume of water. The hydrochloride salt is soluble in three parts of water, whereas a gram of morphine hydrochloride dissolves in 16 ml of water; for all common purposes, the pure powder for hospital use can be used to produce solutions of virtually arbitrary concentration. When the powder has appeared on the street, this very small volume of powder needed for a dose means that overdoses are likely for those who mistake it for heroin or other powdered narcotics, especially those that have been cut (diluted) prior to consumption. Read more...
Phenadoxone (Heptalgin, Morphidone, Heptazone) is an opioid analgesic of the open chain class (methadone and relatives) invented in Germany by Hoechst in 1947. It is one of a handful of useful synthetic analgesics which were used in the United States for various lengths of time in the 20 or so years after the end of the Second World War but which were withdrawn from the market for various or no known reason and which now are mostly in Schedule I of the United States' Controlled Substances Act of 1970, or (like phenazocine and bezitramide) in Schedule II but not produced or marketed in the US. Others on this list are ketobemidone (Ketogin), dextromoramide (Dimorlin, Palfium and others), phenazocine (Narphen and Prinadol), dipipanone (Diconal, Pipadone and Wellconal), piminodine (Alvodine), propiram (Algeril), anileridine (Leritine) and alphaprodine (Nisentil).
Phenadoxone has a US DEA ACSCN of 9637 and recently has had a zero annual manufacturing quota under the Controlled Substances Act 1970. Its withdrawal from US distribution prior to the promulgation of said act is a large part of its Schedule I designation; it is, however, used as a legitimate medication in other countries and consumption is increasing worldwide as indicated below. Read more...
Paregoric, or camphorated tincture of opium, also known as tinctura opii camphorata, is a traditional patent remedy known for its antidiarrheal, antitussive, and analgesic properties.
According to Goodman and Gilman's 1965 edition, "Paregoric is a 4% opium tincture in which there is also benzoic acid, camphor, and anise oil. ... Paregoric by tradition is used especially for children." Read more...
Methadone, sold under the brand name Dolophine among others, is an opioid used for opioid maintenance therapy, to help with tapering in people with opioid dependence, and for pain. Detoxification using methadone can either be done relatively rapidly in less than a month or gradually over as long as six months. While a single dose has a rapid effect, maximum effect can take five days of use. The pain relieving effects last about six hours after a single dose, similar to morphine's. After long term use, in people with normal liver function, effects last 8 to 36 hours. Methadone is usually taken by mouth and rarely by injection into a muscle or vein.
Side effects are similar to those of other opioids. Commonly these include dizziness, sleepiness, vomiting, and sweating. Serious risks include opioid abuse and a decreased effort to breathe. Abnormal heart rhythms may also occur due to a prolonged QT interval. The number of deaths in the United States involving methadone poisoning declined from 4,418 in 2011 to 3,300 in 2015. Risks are greater with higher doses. Methadone is made by chemical synthesis and acts on opioid receptors. Read more...
Ketoprofen, (RS)-2-(3-benzoylphenyl)-propionic acid (chemical formula C16H14O3) is one of the propionic acid class of nonsteroidal anti-inflammatory drugs (NSAID) with analgesic and antipyretic effects. It acts by inhibiting the body's production of prostaglandin.
As of 2015 the cost for a typical month of medication in the United States is 50 to 100 USD. Read more...
Lacosamide (INN, formerly known as erlosamide, harkeroside, SPM 927, or ADD 234037), is a medication for the adjunctive treatment of partial-onset seizures and diabetic neuropathic pain. It is marketed under the trade name Vimpat. Read more...
Gabapentin (sold under the brand name Neurontin, among others) is a medication which is used to treat partial seizures, neuropathic pain, hot flashes, and restless legs syndrome. It is recommended as one of a number of first-line medications for the treatment of neuropathic pain caused by diabetic neuropathy, postherpetic neuralgia, and central neuropathic pain. About 15% of those given gabapentin for diabetic neuropathy or postherpetic neuralgia have a measurable benefit. Gabapentin is taken by mouth.
Common side effects of gabapentin include sleepiness and dizziness. Serious side effects include an increased risk of suicide, aggressive behavior, and drug reaction with eosinophilia and systemic symptoms. It is unclear if it is safe during pregnancy or breastfeeding. Lower doses are recommended in those with kidney disease associated with a low glomerular filtration rate. Gabapentin is a gabapentinoid: it has a structure similar to that of the neurotransmitter γ-aminobutyric acid (GABA) and acts by inhibiting certain calcium channels. Read more...
Sulindac is a nonsteroidal anti-inflammatory drug (NSAID) of the arylalkanoic acid class that is marketed in the UK & U.S. by Merck as Clinoril. Imbaral (not to be confused with mebaral) is another name for this drug. Read more...
Acetanilide is an odourless solid chemical of leaf or flake-like appearance. It is also known as N-phenylacetamide, acetanil, or acetanilid, and was formerly known by the trade name Antifebrin. Read more...
Opium (poppy tears, with the scientific name: Lachryma papaveris) is the dried latex obtained from the opium poppy (scientific name: Papaver somniferum). Approximately 12 percent of the opium latex is made up of the analgesic alkaloid morphine, which is processed chemically to produce heroin and other synthetic opioids for medicinal use and for illegal drug trade. The latex also contains the closely related opiates codeine and thebaine, and non-analgesic alkaloids such as papaverine and noscapine. The traditional, labor-intensive method of obtaining the latex is to scratch ("score") the immature seed pods (fruits) by hand; the latex leaks out and dries to a sticky yellowish residue that is later scraped off and dehydrated. The word "meconium" (derived from the Greek for "opium-like", but now used to refer to infant stools) historically referred to related, weaker preparations made from other parts of the opium poppy or different species of poppies.
The production methods have not changed since ancient times. Through selective breeding of the Papaver somniferum plant, the content of the phenanthrene alkaloids morphine, codeine, and to a lesser extent thebaine has been greatly increased. In modern times, much of the thebaine, which often serves as the raw material for the synthesis for oxycodone, hydrocodone, hydromorphone, and other semisynthetic opiates, originates from extracting Papaver orientale or Papaver bracteatum. Read more...
A local anesthetic (LA) is a medication that causes reversible absence of pain sensation. When it is used on specific nerve pathways (local anesthetic nerve block), paralysis (loss of muscle power) also can be achieved.
Clinical LAs belong to one of two classes: aminoamide and aminoester local anesthetics. Synthetic LAs are structurally related to cocaine. They differ from cocaine mainly in that they have a very low abuse potential and do not produce hypertension or (with few exceptions) vasoconstriction. Read more...
Nicocodeine (Lyopect, Tusscodin) is an opioid analgesic and cough suppressant, an ester of codeine closely related to dihydrocodeine and the codeine analogue of nicomorphine. It is not commonly used in most countries, but has activity similar to other opiates. Nicocodeine and nicomorphine were introduced in 1957 by Lannacher Heilmittel of Austria. Nicocodeine is metabolised in the liver by demethylation to produce nicomorphine, also known as 6-nicotinoylmorphine, and subsequently further metabolised to morphine. Side effects are similar to those of other opiates and include itching, nausea and respiratory depression. Related opioid analogues such as nicomorphine and nicodicodeine were first synthesized. The definitive synthesis, which involves treating anhydrous codeine base with nicotinic anhydride at 130 °C, was published by Pongratz and Zirm in Monatshefte für Chemie in 1957, simultaneously with the two analogues in an article about amides and esters of various organic acids.
Nicocodeine is almost always used as the hydrochloride salt, which has a free base conversion ratio of .917. In the past, the tartrate, bitartrate, phosphate, hydrobromide, methiodide, hydroiodide, and sulphate were used in research or as pharmaceuticals. Read more...
Carbamazepine (CBZ), sold under the tradename Tegretol, among others, is a medication used primarily in the treatment of epilepsy and neuropathic pain. It is not effective for absence seizures or myoclonic seizures. It is used in schizophrenia along with other medications and as a second-line agent in bipolar disorder. Carbamazepine appears to work as well as phenytoin and valproate.[needs update]
Common side effects include nausea and drowsiness. Serious side effects may include skin rashes, decreased bone marrow function, suicidal thoughts, or confusion. It should not be used in those with a history of bone marrow problems. Use during pregnancy may cause harm to the baby; however stopping it in pregnant women with seizures is not recommended. Its use during breastfeeding is not recommended. Care should be taken in those with either kidney or liver problems. Read more...
Orphenadrine (sold under many brand names worldwide) is an anticholinergic drug of the ethanolamine antihistamine class; it is closely related to diphenhydramine. It is used to treat muscle pain and to help with motor control in Parkinson's disease, but has largely been superseded by newer drugs. It was discovered and developed in the 1940s.
As of 2015, the cost for a typical month of medication in the United States is US$25 to 50. Read more...
Wintergreen is a group of aromatic plants. The term "wintergreen" once commonly referred to plants that remain green (continue photosynthesis) throughout the winter. The term "evergreen" is now more commonly used for this characteristic.
Most species of the shrub genus Gaultheria demonstrate this characteristic and are called wintergreens in North America, the most common generally being the American wintergreen (Gaultheria procumbens). Wintergreens in the genus Gaultheria contain an aromatic compound, methyl salicylate, and are used as a mintlike flavoring. Read more...
Codeine is an opiate used to treat pain, as a cough medicine, and for diarrhea. It is typically used to treat mild to moderate degrees of pain. Greater benefit may occur when combined with paracetamol (acetaminophen) or a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen. Evidence does not support its use for acute cough suppression in children or adults. In Europe it is not recommended as a cough medicine in those under twelve years of age. It is generally taken by mouth. It typically starts working after half an hour with maximum effect at two hours. The total duration of its effects last for about four to six hours.
Common side effects include vomiting, constipation, itchiness, lightheadedness, and drowsiness. Serious side effects may include breathing difficulties and addiction. It is unclear if its use in pregnancy is safe. Care should be used during breastfeeding as it may result in opiate toxicity in the baby. Its use as of 2016 is not recommended in children. Codeine works following being broken down by the liver into morphine. How quickly this occurs depends on a person's genetics. Read more...
Benzylmorphine (Peronine) is a semi-synthetic opioid narcotic introduced to the international market in 1896 and that of the United States very shortly thereafter. It is much like codeine, containing a benzyl group attached to the morphine molecule just as the methyl group creates codeine and the ethyl group creates ethylmorphine or dionine (used as a generic name for that drug just as peronine is for benzylmorphine). It is about 90% as strong as codeine by weight.
This drug, the benzyl ether of morphine, should not be cofused with dibenzoylmorphine, an ester of morphine comparable to heroin. Another morphine ether developed around the same time, benzyldihydromorphine, saw some clinical use in the opening years of the 20th Century. The ethers of morphine and codeine as well as dihydromorphine and dihydrocodeine number close to 100 and include such obscure opioids as formylallopseudoisocodeine. Read more...
Carisoprodol, marketed under the brand name Soma among others, is a prescription drug marketed since 1959. It is a centrally acting skeletal muscle relaxant of the carbamate class and produces all the effects associated with barbiturates. It is a prodrug and is both structurally and pharmacologically related to meprobamate. The major metabolic pathway of carisoprodol involves its conversion to meprobamate.
In the United States, carisoprodol is a Schedule IV controlled substance under the Controlled Substances Act of 1970. The diversion and abuse of the drug has increased in the last decade. It is manufactured and marketed in the U.S. by Meda Pharmaceuticals and, as of 2015[update], the cost for a typical course of the medication was less than US$25. Read more...
Pentazocine, sold under the brand name Talwin among others, is a painkiller used to treat moderate to severe pain. It is believed to work by activating (agonizing) κ-opioid receptors (KOR) and blocking (antagonizing) μ-opioid receptors (MOR). As such it is called an opioid as it delivers its effects on pain by interacting with the opioid receptors. It shares many of the side effects of other opioids like constipation, nausea, itching, drowsiness and a reduced effort to breathe, but unlike most other opioids it fairly frequently causes hallucinations, nightmares and delusions. It is also, unlike most other opioids, subject to a ceiling effect, which is when at a certain dose (which differs from person-to-person) no more pain relief, or side effects, is obtained by increasing the dose any further.
Chemically it is classed as a benzomorphan and it comes in two enantiomers, which are molecules that are exact mirror images of one another. Read more...
Phenacetin (or acetophenetidin) is a pain-relieving and fever-reducing drug, which was widely used between its introduction in 1887 and the 1983 ban imposed by the U.S. Food and Drug Administration. Read more...
Methoxyflurane, marketed as Penthrane, "'Metofane"', and Penthrox, is a halogenated ether that was in clinical use as a volatile inhalational anesthetic from its introduction in 1960 until the late 1970s. It was first synthesized in the late 1940s by William T. Miller and his team of chemists following their involvement in the Manhattan Project.
Methoxyflurane is an extremely potent and highly lipid-soluble anesthetic agent, characterized by very slow induction (onset of action) and emergence (offset or dissipation) times. It is non-flammable, has relatively mild hemodynamic effects, and it does not predispose the heart to rhythm disturbances. It is, however, a significant respiratory depressant. Methoxyflurane has powerful analgesic (pain-relieving) properties at well below full anesthetic doses. It was utilized in self-administration devices for obstetric analgesia, in a manner that foreshadowed the patient-controlled analgesia infusion pumps of today. Read more...
Dextropropoxyphene is an analgesic in the opioid category, patented in 1955 and manufactured by Eli Lilly and Company. It is an optical isomer of levopropoxyphene. It is intended to treat mild pain and also has antitussive (cough suppressant) and local anaesthetic effects. The drug has been taken off the market in Europe and the US due to concerns of fatal overdoses and heart arrhythmias. Its onset of analgesia (pain relief) is said to be 20–30 minutes and peak effects are seen about 1.5–2 hours after oral administration.
Dextropropoxyphene is sometimes combined with acetaminophen. Trade names include Darvocet-N and Di-Gesic, Darvon with APAP (for dextropropoxyphene and paracetamol). The British approved name (i.e. the generic name of the active ingredient) of the paracetamol/dextropropoxyphene preparation is co-proxamol (sold under a variety of brand names); however, it has been withdrawn since 2007, and is no longer available to new patients, with exceptions. The paracetamol combination(s) are known as Capadex or Di-Gesic in Australia, Lentogesic in South Africa, and Di-Antalvic in France (unlike co-proxamol, which is an approved name, these are all brand names). Read more...
Rofecoxib /ˌrɒfɪˈkɒksɪb/ is a nonsteroidal anti-inflammatory drug (NSAID) that has now been withdrawn over safety concerns. It was marketed by Merck & Co. to treat osteoarthritis, acute pain conditions, and dysmenorrhea. Rofecoxib was approved by the U.S. Food and Drug Administration (FDA) on May 20, 1999, and was marketed under the brand names Vioxx, Ceoxx, and Ceeoxx.
Rofecoxib gained widespread acceptance among physicians treating patients with arthritis and other conditions causing chronic or acute pain. Worldwide, over 80 million people were prescribed rofecoxib at some time. Read more...
Fentanyl (also spelled fentanil) is an opioid used as a pain medication and together with other medications for anesthesia. Fentanyl is also made illegally and used as a recreational drug, often mixed with heroin or cocaine. It has a rapid onset and effects generally last less than an hour or two. Medically, fentanyl is used by injection, as a patch on the skin, as a nasal spray, or in the mouth.
Common side effects include vomiting, constipation, sedation, confusion, hallucinations, and injuries related to poor coordination. Serious side effects may include decreased breathing (respiratory depression), serotonin syndrome, low blood pressure, addiction, or coma. In 2016, more than 20,000 deaths occurred in the United States due to overdoses of fentanyl and fentanyl analogues, half of all reported opioid-related deaths. Fentanyl works primarily by activating μ-opioid receptors. It is around 100 times stronger than morphine, and some analogues such as carfentanil are around 10,000 times stronger. Read more...
Remifentanil is a potent, short-acting synthetic opioid analgesic drug. It is given to patients during surgery to relieve pain and as an adjunct to an anaesthetic. Remifentanil is used for sedation as well as combined with other medications for use in general anesthesia. The use of remifentanil has made possible the use of high-dose opioid and low-dose hypnotic anesthesia, due to synergism between remifentanil and various hypnotic drugs and volatile anesthetics. Read more...
Meclofenamic acid (meclofenamate sodium, brand Meclomen) is a drug used for joint, muscular pain, arthritis and dysmenorrhea.
It is a member of the anthranilic acid derivatives (or fenamate) class of NSAID drugs and was approved by the FDA in 1980. Like other members of the class, it is a COX inhibitor and prevents formation of prostaglandins.
Scientists led by Claude Winder from Parke-Davis invented meclofenamate sodium in 1964, along with fellow members of the class, mefenamic acid in 1961 and flufenamic acid in 1963. Read more...
Nicomorphine (Vilan, Subellan, Gevilan, MorZet) is the 3,6-dinicotinate ester of morphine. It is a strong opioid agonist analgesic two to three times as potent as morphine with a side effect profile similar to that of dihydromorphine, morphine, and diamorphine.
Nicomorphine was first synthesized in 1904 and was patented as Vilan by Lannacher Heilmittel G.m.b.H. of Austria in 1957. Read more...
Aspirin, also known as acetylsalicylic acid (ASA), is a medication used to treat pain, fever, or inflammation. Specific inflammatory conditions in which aspirin is used include Kawasaki disease, pericarditis, and rheumatic fever. Aspirin given shortly after a heart attack decreases the risk of death. Aspirin is also used long-term to help prevent further heart attacks, ischaemic strokes, and blood clots in people at high risk. It may also decrease the risk of certain types of cancer, particularly colorectal cancer. For pain or fever, effects typically begin within 30 minutes. Aspirin is a nonsteroidal anti-inflammatory drug (NSAID) and works similar to other NSAIDs but also suppresses the normal functioning of platelets.
One common adverse effect is an upset stomach. More significant side effects include stomach ulcers, stomach bleeding, and worsening asthma. Bleeding risk is greater among those who are older, drink alcohol, take other NSAIDs, or are on other blood thinners. Aspirin is not recommended in the last part of pregnancy. It is not generally recommended in children with infections because of the risk of Reye syndrome. High doses may result in ringing in the ears. Read more...
Clonidine is a medication that is used to treat high blood pressure, attention deficit hyperactivity disorder, anxiety disorders, tic disorders, withdrawal (from either alcohol, opioids, or smoking), migraine, menopausal flushing, diarrhea, and certain pain conditions. It is marketed under many brand names.
The adverse effects include sedation, dry mouth, and low blood pressure. Read more...
Ziconotide (SNX-111; Prialt) is an atypical analgesic agent for the amelioration of severe and chronic pain. Derived from Conus magus, a cone snail, it is the synthetic form of an ω-conotoxin peptide.
In December 2004 the Food and Drug Administration approved ziconotide when delivered as an infusion into the cerebrospinal fluid using an intrathecal pump system. Read more...- Analgecine (brand name AGC) is an analgesic extract that is approved for the treatment of back pain and neuralgia in China. Read more...
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Opium poppies such as this one provide ingredients for the class of analgesics called opiates
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Database
- What are portals?
- List of portals
