analgesika

Analgesika are medicines that relieve pain without causing loss of consciousness. They are used for acute and chronic pain, including headaches, dental pain, musculoskeletal injuries, postoperative pain, and cancer-related pain. They are categorized into non-opioid analgesics, opioid analgesics, and adjuvant analgesics, and are often used in combination with non-pharmacological measures.

Non-opioid analgesics include non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and acetylsalicylic acid, as well as acetaminophen (paracetamol). NSAIDs reduce pain and inflammation by inhibiting cyclooxygenase enzymes and prostaglandin synthesis. Paracetamol provides analgesia and fever relief with minimal anti-inflammatory effect. Safety considerations: NSAIDs may cause gastrointestinal, renal, or cardiovascular issues; paracetamol can cause severe liver injury at high doses.

Opioid analgesics, such as morphine, codeine, fentanyl, and oxycodone, act on mu-opioid receptors in the nervous system to reduce pain signals. They are effective for moderate to severe pain but carry risks of respiratory depression, constipation, sedation, and potential dependence with long-term use. Dosing and monitoring are essential.

Adjuvant analgesics include certain antidepressants (amitriptyline, duloxetine), anticonvulsants (gabapentin, pregabalin), and corticosteroids. They are particularly useful for neuropathic pain or as part of multimodal therapy and may enhance other analgesics.

In clinical practice, analgesia follows guidelines that tailor choice and dose to pain intensity, cause, and patient factors, aiming for adequate relief with the lowest effective dose and minimal adverse effects.