Different classes of analgesics

1. Analgesic combinations, including narcotic analgesic combinations

Description: Contain analgesics in combination with other analgesics, or with other substances that enhance the analgesic effect (such as caffeine) or induce sleep or other desired effects. Includes narcotic analgesic combinations.

2. Antimigraine agents

Description: These medicines are used to relieve the pain that arises from migraine headaches. There are several different classes of drugs that can relieve a migraine such as ergots, triptans, and NSAIDs. Some are available in combination with caffeine (caffeine can enhance the effectiveness of other ingredients and has analgesic properties).

3. Cox-2 inhibitors

Description: Cox-2 inhibitors are a type of nonsteroidal anti-inflammatory drug (NSAID) that specifically blocks COX-2 enzymes. COX-2 enzymes are responsible for releasing prostaglandins after infection or injury. NSAIDs that favor COX-2 enzymes have a higher risk of cardiovascular effects but less gastrointestinal effects

4. Acetaminophen and miscellaneous analgesics

Description: Miscellaneous analgesics are ones that are unique in the way that they work. An example is acetaminophen, which is still thought to work on cyclo-oxygenase (COX) enzymes, but in a different way to NSAIDs.

5. Narcotic analgesics

Description: Narcotic analgesics work by binding to opioid receptors, which form part of the opioid system that controls pain, pleasurable and addictive behaviors. The main opioid receptor that narcotic analgesics bind to is the mu receptor.

6. Nonsteroidal anti-inflammatory drugs (NSAIDs)

Description: NSAIDs block cyclo-oxygenase enzymes which are responsible for the production of prostaglandins.  NSAIDs that favor COX-1 enzymes are more likely to cause gastrointestinal side effects; those that favor COX-2 enzymes have a higher risk of cardiovascular effects but less gastrointestinal effects.

7. Salicylates

Description: These are substances that are found naturally in some plants (such as white willow bark and wintergreen leaves) or derived from salicylic acid. Not all have pain relieving effects, some are used as food preservatives and antiseptics. Those that do relieve pain work in a similar way to NSAIDs.

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