Simple analgesics (non-opioid analgesics)
- What are simple analgesics?
- What are simple analgesics used for?
- How do the simple analgesics work?
- Precautions
- Side effects of simple analgesics
What are simple analgesics?
Simple or non-opioid analgesics are a diverse group of drugs that include anti-inflammatory drugs (non-steroidal anti-inflammatory drugs or NSAIDs) and paracetamol.
Most anti-inflammatory drugs also have the ability to relieve fever and antiplatelet (anti-clotting) properties. Paracetamol has the ability to reduce fever, but has minimal anti-inflammatory effects and no effect on blood clotting. Paracetamol is the preferred option for fever and mild-to-moderate pain as it has fewer adverse effects.
What are simple analgesics used for?
NSAIDs, including aspirin, are indicated for:
- Fever
- Mild-to-moderate pain due to inflammation and tissue injury
- Migraine and tension headache
- Period pain
- Pain caused by bone cancer
- Rheumatoid arthritis, including juvenile rheumatoid arthritis
- Osteoarthritis
- Rheumatic fever
- Pain caused by an attack of gout (not aspirin)
Paracetamol is indicated for:
- Mild-to-moderate pain
- Fever
- Migraine and tension headache
How do the simple analgesics work?
Anti-inflammatories relieve pain and inflammation within the body by decreasing the production of pro-inflammatory chemicals known as prostaglandins. Prostaglandins are normally produced in response to tissue damage, and are known to play a major role in the processes of inflammation, pain and fever.
Paracetamol also works by reducing the synthesis of prostaglandins.
Precautions
Asthmatics:
- In some asthmatics anti-inflammatory medicines can trigger an asthma attack.
- If you suffer from asthma you should consult your doctor before taking any non-steroidal anti-inflammatory medication.
Crohn’s disease:
- Crohn’s disease can be exacerbated by anti-inflammatory medication.
- If you suffer from Crohn’s disease you should consult your doctor before taking any non-steroidal anti-inflammatory medication.
History of peptic ulcer disease (stomach ulcers):
- Anti-inflammatory medication can increase the risk of further ulceration or bleeding.
- If you have a history of peptic ulcer disease you should consult your doctor before taking any non-steroidal anti-inflammatory medication.
Heart Failure and High Blood Pressure:
- Heart failure and high blood pressure may be exacerbated with the use of anti-inflammatories.
- If you suffer from heart disease or high blood pressure you should consult your doctor before taking any non-steroidal anti-inflammatory medication.
Pregnancy:
- Non-steroidal anti-inflammatories are ADEC pregnancy category C.
- Before taking anti-inflammatory medication pregnant women, should discuss the benefits and risks with their doctor.
Breastfeeding:
- For the effects of Statins on breastfeeding, consult your healthcare professional.
Children
- Children under 18 years should not use aspirin as there is a risk of Reye’s syndrome.
Paracetamol
Pregnancy and breastfeeding:
- Safe to use
- ADEC category A
Side effects of simple analgesics
NSAIDS: Most common side effects are mild. Listed below are the common (≥1%) and infrequent (<1%) side effects of non-steroidal anti-inflammatory medications (NSAIDS). You may not experience any side effects.
Common:
- Nausea, dyspepsia
- Ulceration or bleeding of the stomach or intestines
- Diarrhoea
- Headache
- Dizziness
- Salt and fluid retention(oedema)
- High blood pressure
Uncommon:
- Ulceration of the oesophagus
- Rectal irritation (with suppositories)
- Heart failure
- Confusion
- Asthma attacks
- Rash
Speak to your doctor if you experience or are concerned about any of these or other side effects.
Paracetamol: Reports of side effects are rare at recommended doses. The following side effects have been reported:
- Dyspepsia
- Allergic reactions and blood disorders
Speak to your doctor if you have any concerns regarding the use of paracetamol.
References
- Australian Medicines Handbook. Non-opioid analgesics[online]AMH Pty Ltd 2007[cited Feb 8, 2008] http://www.amh.net.au
- MIMs Online. [online]MIMS Australia Pty Ltd 2007.[Cited Feb 8, 2008] http://www.mims/com.au
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