Nonsteroidal anti inflammatory drugs. Non opioid analgesics
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a subset of non-opioid analgesics that relieve pain without the risk of addiction and dependence associated with opioids. These drugs are primarily used to manage pain, reduce inflammation, and lower fever.
Classification
- 1. NSAIDs:
- Non-selective COX inhibitors:
- Aspirin
- Diclofenac
- Ibuprofen
- Piroxicam
- Tenoxicam
- Selective COX-2 inhibitors:
- Meloxicam
- Celecoxib
- Lumiracoxib
- 2. Acetaminophen (Paracetamol)
- 3. Topical Analgesics:
- Lidocaine
- Capsaicin
- 4. Antidepressants:
- Amitriptyline
- Duloxetine
- 5. Anticonvulsants:
- Gabapentin
Pharmacodynamics
- Non-selective NSAIDs inhibit both COX-1 and COX-2 enzymes, reducing the production of prostaglandins involved in inflammation, pain, and fever.
- Selective COX-2 inhibitors specifically target the COX-2 enzyme, providing anti-inflammatory and analgesic effects with a lower risk of gastrointestinal side effects compared to non-selective NSAIDs.
- Acetaminophen (paracetamol) reduces pain and fever likely by inhibiting COX enzymes in the brain, with minimal anti-inflammatory effects.
- Topical analgesics like lidocaine provide localized pain relief by blocking sodium channels, while capsaicin reduces pain by depleting substance P from sensory neurons.
- Antidepressants modulate neurotransmitters such as serotonin and norepinephrine, providing pain relief and improving mood in chronic pain conditions.
- Anticonvulsants like gabapentin stabilize neuronal membranes and inhibit excitatory neurotransmitters, effectively reducing neuropathic pain.