Analgesic

Analgesic

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Analgesic, Pain Medication, Anodyne

  1. Acetaminophen
  2. Nonsteroidal Anti-inflammatory (NSAID)
    1. See NSAID Gastrointestinal Adverse Effects
    2. See NSAID Renal Adverse Effects
    3. COX2 Selective NSAID (Celecoxib)
    4. Acetic acids
      1. Partial cox2-selective (Etodolac, Nabumetone)
      2. Indoles (Indomethacin, Sulindac)
      3. Pyrrolo-pyrroles - Parenteral NSAIDs (Ketorolac)
    5. Fenamate
      1. Anthranilic Acid (Meclofenamate)
      2. Acetic Acid (Diclofenac)
    6. Oxicams (Meloxicam, Piroxicam)
    7. Propionic Acids (Ibuprofen, Naproxen )
    8. Salicylates (Aspirin)
  3. Topical Analgesic
    1. Topical NSAID (diclofenac)
    2. Lidocaine Patch (Lidoderm)
    3. Capsaicin
  4. Corticosteroid
    1. High potency, high antiinflammatory and long acting agents
      1. Betamethasone
      2. Dexamethasone
    2. Moderate potency, moderate antiinflammatory and medium duration agents
      1. Methylprednisolone
      2. Triamcinolone
      3. Prednisolone
      4. Prednisone
    3. Low potency, low antiinflammatory and short duration agents
      1. Hydrocortisone
      2. Cortisone
  1. See Opioid Prescribing Quantity
  2. See Opioid Prescription in Acute Pain
  3. See Opioid Adverse Effect Management
  4. See Narcotic Overdose
  5. Precautions
    1. See Emergency Department Pain Management
    2. See Acute Pain Stepped Oral Analgesics
    3. Non-Opioids are preferred for acute pain
    4. When Opioids are used for acute pain, limit to 3 days in most patients, and <7 days in almost all patients
    5. Avoid Chronic Opioids in non-Cancer Pain
  6. Opioids
    1. Weak Opioids
      1. Codeine (avoid)
      2. Hydrocodone (or in combinations, Vicodin, Lorcet, Vicoprofen)
      3. Tramadol (Ultram)
    2. Strong Opioids (WHO Step 3)
      1. Oxycodone (or in combination, Percocet)
      2. Hydromorphone (Dilaudid)
      3. Morphine Sulfate (MSIR, MS Contin)
      4. Fentanyl
      5. Methadone (Dolophine)
  7. Opioid Agonist-Antagonist
    1. Buprenorphine
    2. Butorphanol (Stadol)
    3. Nalbuphine (Nubain)
    4. Pentazocine (Talwin)
  8. Opioid Antagonist
    1. Naloxone
    2. Naltrexone
    3. Gastrointestinal Opioid Antagonist (e.g. Movantik, Methylnaltrexone, Symproic, Alvimopan)
  • Protocol
  • Approach to acute pain in adults