Analgesics: Difference between revisions

Line 28:

The mechanism of paracetamol is, by contrast, still debated. It is a weak inhibitor of COX-1 and COX-2 and its effect appears to be exerted mainly within the central nervous system; several explanations have been proposed, including a once-suggested "COX-3" variant and an action of its metabolite AM404, but no single account is currently established.<ref name="przybyla2021"/>

Opioids bind opioid receptors — especially the µ-opioid receptor — in the nervous system; the relationship between this binding and their analgesic and other effects is addressed in [[:Category:Opioids]]. The skeletal muscle relaxants are a varied group whose mechanisms are not all well established; baclofen, for example, is understood to act at GABA receptors in the spinal cord, but the detail of its action as a muscle relaxant is described in the literature as incompletely understood.<ref name="witenko2014"/> Adjuvant analgesics — including certain antidepressants and anticonvulsants — are used mainly for neuropathic pain.

Opioids bind opioid receptors — especially the µ-opioid receptor — in the nervous system; the relationship between this binding and their analgesic and other effects is addressed in [[:Category:Opioids]]. The skeletal muscle relaxants are a varied group whose mechanisms are not all well established; [[baclofen]], for example, is understood to act at GABA receptors in the spinal cord, but the detail of its action as a muscle relaxant is described in the literature as incompletely understood.<ref name="witenko2014"/> Adjuvant analgesics — including certain antidepressants and anticonvulsants — are used mainly for neuropathic pain.

== Members ==

Line 34:

== Safety ==

Reported adverse effects differ markedly between the families, and figures in the literature are population estimates that vary between studies. NSAIDs are associated with gastrointestinal effects including ulceration and bleeding, with effects on kidney function, and with cardiovascular risk that varies by agent and dose. Paracetamol is generally well tolerated at recommended doses but is associated with serious liver injury in overdose. The muscle relaxants are commonly associated with sedation and dizziness; some, such as dantrolene, carry a warning regarding serious liver injury, and others, such as carisoprodol, have a recognized potential for dependence. The opioids carry distinct risks, including respiratory depression and the potential for dependence, and are discussed separately. Individual response and tolerability are reported to vary considerably between people.

Reported adverse effects differ markedly between the families, and figures in the literature are population estimates that vary between studies. NSAIDs are associated with gastrointestinal effects including ulceration and bleeding, with effects on kidney function, and with cardiovascular risk that varies by agent and dose. Paracetamol is generally well tolerated at recommended doses but is associated with serious liver injury in overdose. The muscle relaxants are commonly associated with sedation and dizziness; some, such as dantrolene, carry a warning regarding serious liver injury, and others, such as [[carisoprodol]], have a recognized potential for dependence. The opioids carry distinct risks, including respiratory depression and the potential for dependence, and are discussed separately. Individual response and tolerability are reported to vary considerably between people.

== References ==

MDElliottMD (talk | contribs)