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AnalgesicAka: Oral Analgesic, Acute Pain Control

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  1. See Also
    1. Chronic Pain Management
    2. Pediatric Analgesics
    3. Chronic Narcotic Guideline
  2. Approach to acute pain in adults
    1. Step 1: Acetaminophen with or without Ibuprofen
      1. Acetaminophen 1000 mg orally every 6 hours
        1. Considered best first-line oral analgesic
        2. Safe and effective for most mild to moderate pain
        3. Does not have antiinflammatory activity
      2. Ibuprofen 400 mg orally every 6 hours
        1. GI safety similar to Placebo up to 1200 mg/day
        2. More effective in dental pain and Dysmenorrhea
        3. Antiinflammatory activity starts at 600 mg doses
    2. Step 2
      1. Advance to higher Ibuprofen or Naproxen dosages or
      2. Hydrocodone-Acetaminophen (Vicodin)
        1. Dose 7.5/750 to 10/1000 every 6 hours prn
    3. Step 3
      1. Switch to another NSAID class or COX2-Inhibitor or
      2. Oxycodone (Roxicodone) or
      3. Oxycodone with Acetaminophen (Percocet)
    4. Step 4
      1. Morphine (immediate release) 10 mg q4 hours prn
      2. Convert to SR when daily dose established
  3. Adjunctive medications to consider if pain persists
    1. See Chronic Pain Management
    2. Tricyclic Antidepressants (e.g. Amitriptyline)
    3. Anticonvulsants (e.g. Gabapentin)
  4. Avoid analgesics with poor efficacy
    1. Codeine (e.g. Tylenol #3)
    2. Propoxyphene (Darvon, Darvocet)
    3. Tramadol (Ultram)
  5. References
    1. Sachs (2005) Am Fam Physician 71(5):913
    2. (2000) Med Lett Drugs Ther 42:73

Analgesics (C0002771)

Definition (MSH)Compounds capable of relieving pain without the loss of CONSCIOUSNESS.
Definition (CSP)compounds capable of relieving pain without the loss of consciousness or without producing anesthesia.
Definition (NCI)Drugs that reduce pain. These drugs include aspirin, acetaminophen, and ibuprofen.
Definition (NCI)Natural or synthetic compound mixtures, Analgesic Preparations relieve pain by altering the perception of nociceptive stimuli without loss of consciousness. Analgesic compounds may act at opioid receptors (morphine-like drugs) or at other central or peripheral sites (non-steroidal anti-inflammatory agents). (NCI04)
Definition (NCI)Compounds that alleviate pain without loss of consciousness. Analgesics act by various mechanisms including binding with opioid receptors and decreasing inflammation. Choice of analgesic may be determined by the type of pain. These compounds include opioid, non-opioid and adjuvant analgesic agents.
ConceptsPharmacologic Substance (T121)
EnglishAnalgesic, Analgesic Agent, Analgesic Agents, Analgesic Drugs, Analgesic Preparation, Analgesic product, Analgesics, Anodynes, miscellaneous analgesic
Spanishanalgésico, analgesico, producto analgésico, producto analgesico
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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