Pharmacological Approaches for Pain
A wide range of drugs is used to manage pain resulting from inflammation in response to tissue damage, chemical agents/pathogens (nociceptive pain) or nerve damage (neuropathic pain). Most drugs act by binding to protein targets on cell membranes and affecting the biochemical processes of the body. Protein targets are specific to specific tissues allowing drugs to be precisely targeted at individual organs or cells. Drugs exhibiting high specificity require lower doses and have fewer side effects than those with lower specificity
Originally developed by the World Health Organisation (WHO) to improve management of cancer pain. WHO analgesic ladder is also used for providing stepwise pain relief for pain due to other causes. Medications derived from morphine (or synthetic analogs) mimic the body’s own analgesic system and are strongest and most effective painkillers currently available. They have a similar molecular structure as endogenous opioids (?-endorphine, dynorphin and enkephalins) and produce similar effect. They act in the central nervous system by binding to opioid receptors in the pre- and post-synaptic membrane stopping the passage of neurotransmitters across the nerve synapse which blocks or attenuates the experience of pain.
Opioid medications include morphine, oxycodone, codeine, tramadol, buprenorphine, fentanyl and diamorphine in people with chronic pain opioid medications may be given orally (as a capsule, tablet or liquid) or via a patch (transdermal)