- Section 1 The worldwide status of palliative care
- Section 2 The challenge of palliative medicine
- Section 3 Service delivery issues in palliative care
- Section 4 The interdisciplinary team
- Section 5 Ethical issues
- Section 6 Communication and palliative medicine
- Section 7 Assessment tools and Informatics
- Section 8 Common symptoms and disorders
- Section 9 Common symptoms and disorders: pain
- 9.1 Principles of drug therapy: focus on opioids
- 9.2 Pathophysiology of pain in cancer and other terminal illnesses
- 9.3 Definition and assessment of chronic pain in advanced disease
- 9.4 Opioid therapy: optimizing analgesic outcomes
- 9.5 Opioid therapy: managing risks of abuse, addiction, and diversion
- 9.6 Non-opioid analgesics
- 9.7 Adjuvant analgesics
- 9.8 Interventional approaches for chronic pain
- 9.9 Neurostimulation in pain management
- 9.10 Rehabilitation medicine approaches to pain management
- 9.11 Psychological and psychiatric interventions in pain control
- 9.12 Complementary therapies in pain management
- 9.13 Paediatric pain control
- Section 10 Common symptoms and disorders: gastrointestinal symptoms
- Section 11 Common symptoms and disorders: skin problems
- Section 12 Issues in populations with cancer
- Section 13 Cancer pain syndromes
- Section 14 Cancer-associated disorders
- Section 15 Issues in populations with non-cancer illnesses
- Section 16 Issues of the very young and the very old
- Section 17 Psychosocial and spiritual issues in palliative medicine
- Section 18 The terminal phase
- Section 19 Research in palliative medicine
(p. 567) Non-opioid analgesics
- Chapter:
- (p. 567) Non-opioid analgesics
- Author(s):
Per Sjøgren
, Frank Elsner
, and Stein Kaasa
- DOI:
- 10.1093/med/9780199656097.003.0096
Non-opioid analgesics encompass the non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol (acetaminophen). The NSAIDs include acetylsalicylic acid (ASA, aspirin), dipyrone (metamizole), and numerous other drugs in diverse classes. The NSAIDs have potent anti-inflammatory, analgesic and antipyretic activity, and are among the most widely used drugs worldwide. In palliative medicine, they represent the first step of the World Health Organization’s analgesic ladder used for mild pain and they are an important supplement to opioids and adjuvant drugs at higher steps of the ladder. The disadvantages of non-opioid analgesics include a ceiling effect for pain relief and the risk of side effects. NSAIDs are also associated with an increased risk of adverse gastrointestinal, renal, and cardiovascular effects and hepatotoxicity can result from overdosing with paracetamol. This chapter describes the clinical pharmacology of NSAIDs, their classification, molecular mechanisms of action and adverse effects, as well as some recent developments aimed at designing effective anti-inflammatory agents with improved safety and tolerability profiles.
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- Section 1 The worldwide status of palliative care
- Section 2 The challenge of palliative medicine
- Section 3 Service delivery issues in palliative care
- Section 4 The interdisciplinary team
- Section 5 Ethical issues
- Section 6 Communication and palliative medicine
- Section 7 Assessment tools and Informatics
- Section 8 Common symptoms and disorders
- Section 9 Common symptoms and disorders: pain
- 9.1 Principles of drug therapy: focus on opioids
- 9.2 Pathophysiology of pain in cancer and other terminal illnesses
- 9.3 Definition and assessment of chronic pain in advanced disease
- 9.4 Opioid therapy: optimizing analgesic outcomes
- 9.5 Opioid therapy: managing risks of abuse, addiction, and diversion
- 9.6 Non-opioid analgesics
- 9.7 Adjuvant analgesics
- 9.8 Interventional approaches for chronic pain
- 9.9 Neurostimulation in pain management
- 9.10 Rehabilitation medicine approaches to pain management
- 9.11 Psychological and psychiatric interventions in pain control
- 9.12 Complementary therapies in pain management
- 9.13 Paediatric pain control
- Section 10 Common symptoms and disorders: gastrointestinal symptoms
- Section 11 Common symptoms and disorders: skin problems
- Section 12 Issues in populations with cancer
- Section 13 Cancer pain syndromes
- Section 14 Cancer-associated disorders
- Section 15 Issues in populations with non-cancer illnesses
- Section 16 Issues of the very young and the very old
- Section 17 Psychosocial and spiritual issues in palliative medicine
- Section 18 The terminal phase
- Section 19 Research in palliative medicine