Relief of pain is a problem which is difficult to handle in rheumatic diseases and multidisciplinary approach is necessary. Drugs play an important role in the control of pain. There are different groups of drugs which are relevant:
Analgesics. In general – work fast, short duration of relief. However long-lasting formulations are available. 1.1. Non-opioid analgesics – Weak to medium effect. Often as a supplement to stronger analgesics. Give no addiction. 1.2. Opioid analgesics – Strong effect. May give addiction, important to have in mind when treating pain in chronic diseases.
Non steroidal antiinflammatory drugs/coxibs. Reduce both pain and stiffness, tenderness and swollen joints. However, interaction problems with other drugs, may affect renal function, platelet function and and give gastrointestinal (GI) problems. The new class coxibs have however reduced the GI-and the platelet-problems.
Psychotropic drugs – e.g. antidepressants, antipsychotics, antiepileptica, anxiolytica. Useful among others in neurogenic pain.
Strategies of pharmacological treatment of pain: Acute (e.g. postoperative pain) and chronic pain need different strategies.
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