====== Analgesic ====== An analgesic, or painkiller, is any member of the group of [[drug]]s used to achieve [[analgesia]]. The word analgesic derives from Greek ἀν-, "without", and ἄλγος, "pain". ===== Types ===== Three types of [[pain]] [[medication]] 1. [[Nonopioid analgesic]] a) [[Nonsteroidal anti-inflammatory drug]]: [[aspirin]], [[ibuprofen]], [[acetaminophen]] 2. [[Opioid]]s a) agonists b) partial agonists c) mixed agonists/antagonists. 3. drugs that are not strictly analgesics, but which act as adjuvants when added to any of the above: tricyclic antidepressants, anticonvulsants, caffeine, hydroxyzine, corticosteroids. ---- [[Opiate]]s and [[acetaminophen]] are preferred [[analgesic]] agents, and [[gabapentin]] is a contextual third choice, in neurocritically ill patients. Other agents are rarely prescribed. The discordance in physician self-reports and objective audits suggest that pain management optimization studies are warranted. ((Zeiler FA, AlSubaie F, Zeiler K, Teitelbaum J, Bernard F, Skrobik Y. Analgesia in Neurocritical Care: An International Survey and Practice Audit. Crit Care Med. 2016 Mar 15. [Epub ahead of print] PubMed PMID: 26983164.)). Analgesic drugs act in various ways on the peripheral and central nervous systems. They are distinct from anesthetics, which reversibly eliminate sensation, and include [[paracetamol]] (known in the US as acetaminophen or simply APAP), the [[Nonsteroidal anti-inflammatory drug]]s (NSAIDs) such as the salicylates, and opioid drugs such as morphine and oxycodone. In choosing analgesics, the severity and response to other medication determines the choice of agent; the World Health Organization (WHO) pain ladder specifies mild analgesics as its first step. Analgesic choice is also determined by the type of pain: For neuropathic pain, traditional analgesics are less effective, and there is often benefit from classes of drugs that are not normally considered analgesics, such as tricyclic antidepressants and anticonvulsants.