Central nervous system pain relievers

When you have a mild headache or toothache, over-the-counter pain relievers are often enough to make you feel better. But if your pain is more severe, like cancer pain, your doctor may recommend CNS pain relievers.

Analgesics are drugs that reduce or eliminate the sensation of pain without affecting the cause of the pain. CNS depressants relieve pain by binding to proteins called opioid receptors on nerve cells in the brain, spinal cord, intestines, and other organs of the body. When this happens, opioids block the pain pathways sent from the body through the spinal cord to the brain. While they can be effective pain relievers, opioids carry some risks and can be highly addictive. The risk of addiction is higher when opioids are used for long-term chronic pain management.
CNS depressants can be part of an effective pain management plan, but to help avoid side effects and the risk of addiction, they should only be used under your doctor's prescription and supervision. doctor.

Specific effects on opioid receptors Strong analgesia, selective and visceral analgesia. Has a sedative effect, induces sleep. Reduces intestinal motility. Exciting and addictive.

Based on the mechanism of action, CNS analgesics are divided into 3 main groups:
Opioid receptor agonists: natural opioids (morphine, codeine...) and synthetic opioids (pethidine, methadone,...) Partial agonists and mixed agonists on opioid receptors: pentazocine, nalorphine, nalbuphine, butorphanol,... Antagonists on opioid receptors: naloxone, naltrexone.

Codeine and tramadol are opioid analgesics indicated in the treatment of moderate to severe pain when the use of peripheral analgesia is ineffective. These drugs are often included in the preparation in combination with paracetamol to increase the effectiveness of pain relief. The common undesirable effects of these 2 drugs are nausea, vomiting, drowsiness, dizziness, dry mouth, constipation. Pregnant women should not take the drug during the first and third trimesters of pregnancy. Do not use for a long time for lactating women, if you have to take the drug, you should stop breastfeeding.
Strong opioid analgesics such as morphine, oxycodone, fentanyl are indicated in severe pain, difficult to treat, especially pain in cancer. Long-term use of the drug increases the risk of drug dependence and addiction. Drugs are classified as addictive drugs, so they should be managed very closely, only used when prescribed and carefully considered by a doctor.
In summary, adverse effects of these drugs include constipation, drowsiness, nausea, and vomiting. Other serious side effects may include: euphoria; confusion; illusion; respiratory failure; increased intracranial pressure; urinary retention; withdrawal syndrome upon abrupt discontinuation of the drug. For pregnant or lactating women, morphine can be prescribed if absolutely necessary. However, it should be noted that withdrawal syndrome can appear in children when using the drug for a long time. Therefore, before using the group of CNS pain relievers, it is necessary to consult and prescribe from a doctor.