An Imperfect Arsenal
Given that side effects can be significant and that morphine has no effect on some people, pain treatments are sorely limited.
By Rachael Moeller Gorman // Spring 2007
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DRUG TYPE |
PAIN TARGET |
HOW IT WORKS |
POSSIBLE SIDE EFFECTS |
| OPIATES: include morphine, codeine, oxycodone |
Nociceptive, inflammatory; some neuropathic, idiopathic pain relief | Activates the mu-opioid receptor system | Drowsiness, nausea and vomiting, constipation, dependence |
| Nonsteroidal anti-inflammatory drugs (NSAIDS):aspirin, ibuprofen, naproxen |
Inflammatory pain | Dampens the body’s inflammatory response by inhibiting COX-2 enzyme (COX-1 is inhibited as well) | Ulcers because of COX-1 inhibition, gastric hemorrhage, Reye’s syndrome in children (aspirin) |
| COX-2 inhibitors: celecoxib |
Inflammatory pain, especially arthritis | An NSAID; inhibits only COX-2 enzyme | With long-term use, possible increase in risk of heart attacks and stroke |
| Paracetamol/ acetaminophen |
Mild acute pain | Activates cannabinoid receptors | Liver damage |
| Anticonvulsants: carbamazepine, pregabalin, gabapentin, lamotrigine | Some neuropathic and idiopathic pain | Dampens the excitability of the central nervous system | Dizziness, drowsiness, vomiting |
| Tricyclic antidepressants: amitriptyline | Some neuropathic and idiopathic pain | Inhibits reuptake of certain neurotransmitters | Vomiting, drowsiness, anxiety, insomnia, headaches |
| Serotonin/ Norepinephrine Reuptake Inhibitors (SNRIs): duloxetine | Some neuropathic and idiopathic pain | Inhibits reuptake of certain neurotransmitters | Upset stomach, nausea, dry mouth, constipation |
| Drug Mixtures: acetaminophen + oxycodone = Percocet; hydrocodone + acetaminophen = Vicodin | Moderate acute pain | Travels various pathways to attack pain | Various, depending on mixture |
