Analgesics
are medications used for the treatment of pain. These generally
fall into the categories of nonsteroidal anti-inflammatory medications
and opioids.
- Nonsteroidal
anti-inflammatory medications: this class of medications
works by inhibiting the enzyme cyclooxygenase (COX) which is involved
in the synthesis of prostaglandins and thromboxanes. These
enzymes occur in two different forms, COX-1 and COX-2. COX-1
occurs in most tissues and platelets, and protects the mucosal
lining of the stomach. COX-2 is seen in brain, kidney and
inflamed tissue.
This class of medications may cause gastrointestinal ulceration
and hemorrhage. They may also inhibit platelet function
and therefore prolong bleeding time (making bleeding more difficult
to stop).
All of these medications are given by mouth, with the exception
of ketorolac tromethamine (toradol), which is given either intravenously
or intramuscularly.
Celecoxib (Celebrex) and rofecoxib (Vioxx) selectively inhibit
COX-2, and therefore appear to leave the bleeding time unaffected,
and probably cause fewer ulcers.
- Opioids:
This class of medications is used for moderate to severe pain,
and cancer pain. These narcotics may cause patients to develop
a physical and psychological dependence, in which they need greater
and greater doses to achieve the same effect. In large doses,
opioids may suppress respiration.
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Glossary 
