14.2 Nonopioid Analgesics
3 min read•june 18, 2024
are crucial pain relievers that don't involve opioids. They include and , each with unique benefits and risks. These medications work by targeting different pathways in the body to reduce pain and inflammation.
Understanding how these drugs work helps nurses choose the right option for patients. Acetaminophen is gentler on the stomach but can harm the liver. NSAIDs are great for inflammation but may cause stomach issues. Proper dosing and patient education are key to safe use.
Nonopioid Analgesics
Characteristics of nonopioid analgesics
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- Acetaminophen ()
- Acts on the central nervous system to provide pain relief and reduce fever ()
- Decreases the production of pain-causing substances () in the brain and spinal cord
- Lacks significant ability to reduce inflammation in the body
- Gentler on the stomach lining compared to NSAIDs, less likely to cause ulcers or bleeding
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- Provide pain relief, lower fever, and decrease inflammation in the body
- Work by blocking enzymes ( and ) that produce inflammation-causing prostaglandins
- COX-1 inhibition maintains protective functions in the stomach lining, blood clotting, and kidneys
- COX-2 inhibition targets pain and inflammation pathways
- Common NSAIDs include (, ), (), and celecoxib (Celebrex)
Mechanism of Action
- (COX) enzymes convert into prostaglandins
- NSAIDs inhibit COX enzymes, reducing prostaglandin production
- Salicylates (e.g., aspirin) irreversibly inhibit COX enzymes
- Prostaglandin reduction leads to analgesic, , and effects
Comparisons of nonopioid analgesics
- Acetaminophen
- Best for mild to moderate pain and reducing fever
- Can cause liver damage if taken in high doses or for extended periods
- Avoid use in patients with severe liver disease or a history of alcohol abuse
- Ibuprofen and Naproxen
- Effective for mild to moderate pain, inflammation, and fever
- May cause stomach irritation, ulcers, bleeding, and kidney problems
- Not recommended for patients with a history of stomach ulcers, severe kidney or liver disease, or during the last 3 months of pregnancy
- Celecoxib (COX-2 selective NSAID)
- Prescribed for , , and acute pain management
- Carries a higher risk of heart problems and kidney impairment compared to other NSAIDs
- Avoid use in patients allergic to or those who recently had heart bypass surgery
Nursing considerations for nonopioid analgesics
- Evaluate the patient's pain level and characteristics to select the most appropriate pain medication
- Check the patient's drug history and known allergies before administering any medication
- Watch for potential side effects and adverse reactions
- Acetaminophen: Monitor with long-term use through blood tests
- NSAIDs: Assess for signs of stomach bleeding and check periodically
- Give NSAIDs with food or milk to reduce stomach irritation
- Modify the dose for patients with kidney or liver impairment
- Teach patients about proper dosing, potential side effects, and important precautions
Patient education for nonopioid analgesics
- Stress the importance of taking the medication exactly as prescribed by the healthcare provider
- Warn patients not to take more than the recommended dose
- Acetaminophen: Limit daily intake to 4 grams (4000 mg) to prevent liver damage
- NSAIDs: Adhere to the prescribed dose to minimize stomach and kidney risks
- Encourage patients to inform their healthcare provider about any side effects or concerns they experience
- Recommend avoiding alcohol while taking acetaminophen due to increased liver damage risk
- Remind patients to disclose all current medications, including over-the-counter drugs and supplements, to their healthcare provider
- Offer clear written instructions and educational resources for patients to refer to at home
Key Terms to Review (37)
Acetaminophen: Acetaminophen is a widely used over-the-counter medication primarily used as an analgesic (pain reliever) and antipyretic (fever reducer). It is a key term in the context of drug classifications, pharmacokinetics, pain management, and non-opioid analgesics.
Advil: Advil is a brand name for ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) used to reduce fever, pain, and inflammation. It works by inhibiting the production of prostaglandins, chemicals in the body that promote inflammation and pain.
Aleve: Aleve is a brand name for naproxen, a nonsteroidal anti-inflammatory drug (NSAID) used to reduce inflammation and alleviate pain. It works by inhibiting the enzyme cyclooxygenase (COX), which is involved in the production of prostaglandins.
Anti-inflammatory: Anti-inflammatory refers to the ability of a substance to reduce inflammation, a natural immune response characterized by redness, swelling, heat, and pain. These substances work by inhibiting the production or activity of inflammatory mediators, such as prostaglandins and leukotrienes, which drive the inflammatory process.
Antipyresis: Antipyresis is the process of reducing or lowering an abnormally high body temperature, also known as a fever. It is a crucial therapeutic intervention in the management of various medical conditions where fever is a prominent symptom.
Antipyretic: An antipyretic is a medication or substance that reduces fever by lowering the body's temperature. It works by acting on the hypothalamus, the part of the brain that regulates body temperature, to reset the body's temperature set point to a lower level.
Antipyretics: Antipyretics are medications used to reduce fever by acting on the hypothalamus to regulate body temperature. They are commonly included in nonopioid analgesics and are essential for managing fevers associated with infections or other medical conditions.
Arachidonic Acid: Arachidonic acid is a polyunsaturated fatty acid that plays a crucial role in the inflammatory response and the mechanism of action of certain non-opioid analgesics. It is a key precursor in the production of eicosanoids, a group of lipid-derived signaling molecules that mediate various physiological and pathological processes.
COX-1: COX-1, or cyclooxygenase-1, is an enzyme that plays a crucial role in the production of prostaglandins, which are important mediators of the inflammatory response. This enzyme is constitutively expressed in various tissues and is responsible for the physiological functions of prostaglandins, such as maintaining the integrity of the gastrointestinal tract and regulating platelet aggregation.
COX-2: COX-2, or cyclooxygenase-2, is an enzyme that plays a crucial role in the inflammatory response and the production of prostaglandins, which are lipid-based signaling molecules involved in pain, fever, and inflammation. COX-2 is the primary target for many non-steroidal anti-inflammatory drugs (NSAIDs) and is a key factor in the context of understanding the inflammatory response and the use of analgesics.
COX-2 inhibitors: COX-2 inhibitors are a class of drugs that selectively inhibit the enzyme cyclooxygenase-2 (COX-2), which plays a key role in inflammation and pain. They are used to reduce inflammation and alleviate pain without affecting COX-1, an enzyme that protects the stomach lining.
Cyclooxygenase: Cyclooxygenase (COX) is an enzyme that catalyzes the conversion of arachidonic acid into prostaglandins, prostacyclin, and thromboxanes. It is a key player in the inflammatory response and the primary target of nonsteroidal anti-inflammatory drugs (NSAIDs) and certain pepsin inhibitors.
Gastric Ulceration: Gastric ulceration refers to the formation of sores or lesions in the lining of the stomach. This condition can lead to significant discomfort and complications if left untreated, making it an important consideration in the context of nonopioid analgesics, which are commonly used to manage pain associated with gastric ulcers.
Hepatotoxicity: Hepatotoxicity is the occurrence of liver damage due to exposure to certain substances, including drugs. It can lead to serious health complications and requires careful monitoring.
Hepatotoxicity: Hepatotoxicity refers to the potential for certain drugs, chemicals, or other substances to cause liver damage or dysfunction. It is a critical consideration in the development and use of various medications and treatments.
Ibuprofen: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used to reduce inflammation, pain, and fever. It is a key medication in the context of various medical topics, including the inflammatory response, pain management, hypertension treatment, and diuretic therapy.
Kidney Function: Kidney function refers to the vital role the kidneys play in maintaining homeostasis within the body. The kidneys filter blood, remove waste and excess water, regulate fluid balance, and help control blood pressure, red blood cell production, and calcium absorption.
Liver Function: Liver function refers to the essential roles the liver plays in the body, including metabolic, digestive, and detoxification processes. As a vital organ, the liver is responsible for a wide range of critical functions that maintain overall health and homeostasis.
Motrin: Motrin is a brand name for the drug ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain, reduce inflammation, and lower fever. It works by inhibiting the enzyme cyclooxygenase (COX), which decreases the formation of prostaglandins involved in pain and inflammation.
Naprosyn: Naprosyn is a brand name for naproxen, a nonsteroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation. It is commonly prescribed for conditions such as arthritis, muscle aches, and menstrual cramps.
Naproxen: Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce inflammation, pain, and fever. It is a widely prescribed medication that has applications in the treatment of various inflammatory conditions, as well as in the management of pain associated with different medical scenarios.
Naproxen sodium: Naproxen sodium is a nonsteroidal anti-inflammatory drug (NSAID) commonly used to reduce inflammation and alleviate pain. It works by inhibiting the production of prostaglandins, which are chemicals responsible for pain, fever, and inflammation.
Nonopioid analgesic: Nonopioid analgesic is a type of medication used to relieve pain without the use of opioid compounds. These drugs are often used to treat mild to moderate pain and have a lower risk of addiction compared to opioids.
Nonopioid Analgesics: Nonopioid analgesics are a class of pain-relieving medications that do not contain opioids. They work by reducing inflammation, inhibiting pain signal transmission, and modulating pain perception in the central nervous system, providing relief for various types of pain without the risk of opioid dependence or addiction.
Nonsteroidal Anti-Inflammatory Drugs: Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of medications that reduce inflammation, pain, and fever without the use of steroids. They work by inhibiting the production of prostaglandins, which are chemicals involved in the inflammatory response. NSAIDs are commonly used to treat a variety of conditions, including arthritis, menstrual cramps, headaches, and injuries.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that reduce inflammation, pain, and fever without the use of steroids. They inhibit cyclooxygenase enzymes (COX-1 and COX-2), which are involved in the production of prostaglandins.
NSAIDs: NSAIDs, or Non-Steroidal Anti-Inflammatory Drugs, are a class of medications that are widely used to reduce inflammation, alleviate pain, and lower fever. They work by inhibiting the production of prostaglandins, which are key mediators of the inflammatory response. NSAIDs are commonly employed in the management of various conditions, including arthritis, menstrual cramps, headaches, and post-operative pain.
Osteoarthritis: Osteoarthritis is a degenerative joint disease characterized by the breakdown of cartilage, the protective cushion between bones in a joint. This leads to pain, stiffness, and reduced mobility in the affected joint, often the knees, hips, or hands.
Pediatric clients: Pediatric clients are children and adolescents who require medical care, including pharmacological treatments. Special considerations must be made for their unique physiological and developmental needs.
Pediatric dosage: Pediatric dosage is the specific amount of medication prescribed to children, taking into account their age, weight, and developmental stage. It ensures both efficacy and safety in treating various pediatric conditions.
Prostaglandins: Prostaglandins are a group of lipid compounds derived from arachidonic acid that act as local hormones, mediating a wide range of physiological and pathological processes in the body. They are involved in inflammation, pain, fever, and various other regulatory functions.
Reye’s syndrome: Reye's syndrome is a rare but serious condition that causes swelling in the liver and brain, primarily affecting children and teenagers recovering from a viral infection. It has been associated with the use of aspirin or salicylate-containing medications.
Rheumatoid Arthritis: Rheumatoid arthritis is an autoimmune disorder that primarily affects the joints, causing inflammation, pain, and progressive damage. It is a chronic condition that can have significant impacts on a person's quality of life and overall health.
Sulfa Drugs: Sulfa drugs, also known as sulfonamides, are a class of synthetic antimicrobial agents that have been used to treat a variety of bacterial infections. These medications work by inhibiting the synthesis of folic acid, a essential vitamin for bacterial growth and reproduction, making them effective in combating certain types of bacteria.
Tramadol: Tramadol is a synthetic opioid analgesic used to treat moderate to moderately severe pain. It functions by altering the way the brain and nervous system respond to pain.
Tylenol: Tylenol, also known as acetaminophen, is a nonopioid analgesic used to relieve mild to moderate pain and reduce fever. It is commonly available over-the-counter and is often used when opioids are not necessary.
Ultram: Ultram, also known as tramadol, is a prescription medication used to treat moderate to moderately severe pain. It acts on the central nervous system to relieve pain.