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23 May 2016

Anti-inflammatory Drugs, Analgesics and Anesthetics: The Difference and Clarifications

difference between anti-inflammatory drugs and analgesics


Lots of medical students usually get confused and something’s interpret these drugs wrongly. They confuse anti-inflammatory drugs with analgesics and analgesics with anesthetics. In this post am going to simplify each category of drug sequentially for better understanding and clarification.


Anti-inflammatory drugs

These are drugs that inhibit the synthesis and release of inflammatory chemicals. It is the release of these chemicals that triggers redness, swelling, heat, pain and loss of function which are regarded as the five cardinal signs of inflammation.

Anti-inflammatory drugs are of two types; steroidal and non-steroidal (NSAID). Their ability to relieve pain and fever (especially NSAIDs) has also made them to be referred as analgesics and antipyretics (drugs that reduces fever) respectively. Anti-inflammatory drugs act by inhibiting prostaglandin (natural product of inflamed white blood cells) synthesis and release and because prostaglandin protects the stomach and support the platelets and blood clothing, these drugs can promote bleeding and cause peptic ulcer.

Steroids in form of eye drops are used in the treatment of severe long-term eye allergic symptoms (recommended only in most severe allergic eye conditions especially when other drugs fail to arrest the situation). Ketorolac or acular is a NSAID that is highly approved for treatment of itchy eyes.

Note: Anti-inflammatory drugs have three major effects; anti-inflammatory effect, analgesic effect and antipyretic effect.

Analgesics

These are drugs that relieve pain. They are classified into non-opioid analgesics and opioid (narcotics) analgesics. Opioids relieve pain by decreasing the brain awareness of the pain (i.e. acting on special pain receptors in the central nervous system). Non-opioids on the other hand relieve pain by altering the chemical changes that normally take place wherever body tissue are injured or damaged (i.e. they act directly on injured body tissues).

All non-opioid analgesics are anti-inflammatory drugs except acetaminophen (paracetamol or phenacetin). Hence non-opioids can act as anti-inflammatory drugs, analgesics and antipyretics while opioids have only analgesics effect.

Note: Technically anti-inflammatory drugs are not part of analgesics family but are considered as analgesics in practice.

Opioid analgesics are used in the treatment of either short-term or long-term relief of severe pain such as general post-operative pain or other specific conditions. On the other hand non-opioids are used for short-term pain relief and for modest pain such as headache, muscle strain, bruising, sinus pressure, arthritis or pain from injury, fracture or tear.

Examples of non-opioid drugs include; acetaminophen, aspirin, indomethacine, ibuprofen, fenoprofen, naproxen, diclofenac, e.t.c. Examples of opioid drugs include; tramadol, codein, morphine, pethidine, pentazocine, meperidine, methadone, e.t.c.

Anesthetics

These are drugs that causes numbing or cessation of sensation (feelings). It can be either local (loss of sensation o targeted part of the body while maintaining consciousness) or general anesthesia (loss of sensation in all parts of the body and loss of consciousness as well).

Local anesthetics prevent the transmission of nerve impulses without causing unconsciousness. They have the suffix “-caine” in their names. Examples include; cocaine, procaine, lidocaine, proparacaine, tetracaine, prilocaine, dibucaine, mepivacaine, ropivacaine, levobupivacaine, bupivacaine, amethocaine, e.t.c.

Topical anesthetics are used in optometry and ophthalmology to numb the surface of the eye (the outermost layers of the cornea and conjunctiva) in order to;
  1. Perform a contact/applanation tonometry
  2. Remove superficial foreign bodies
  3. Perform ocular surgeries
  4. Perform a schimer’s test

Photo Credit: bodybuildingninja.com
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2 comments:

  1. Confusing somehow especially anti-inflammatory drugs and analgesics since both have similar functions

    ReplyDelete

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