Painkillers in general
In detail, painkillers are drugs that prevent the person from perceiving the sensation of “pain“, although in many cases the trigger is still present. Depending on where the drugs are effective, a distinction is made between the so-called peripherally (i.e. outside our central nervous system, for example on the finger, the legs or in the stomach) effective painkillers and the centrally (i.e. in the spinal cord or directly in the brain) effective central painkillers.
The drugs that act outside the central nervous system are further divided into acidic and non-acidic active ingredients (according to their chemical formula) and antispasmodic substances. In the brain, the large group of opiates with its main representative morphine and its derivatives, as well as a few other substances, act. Due to this multitude of different groups, one is able to stop the pain directly at its source, or later in the spinal cord or even in the brain. Very useful is also often a combination of drugs of different targets, which then inhibit every possible point of pain development and transmission to suppress pain even more effectively.
What painkillers are available?
The range of painkillers available is very diverse and different analgesics are used for the different causes of pain. Not all painkillers are freely available and so most of them have to be prescribed by a doctor’s prescription. Most opiates even require a prescription for narcotics.
This is subject to special conditions and is intended to prevent the abuse of opiates. A group of drugs that are supposed to prevent pain directly at the point of origin are the non-steroidal, acidic painkillers (NSAIDs), which are named by their chemical appearance. These include the very well-known active ingredients acetylsalicylic acid (e.g.
Aspirin®, ASS), ibuprofen (e.g. Nurofen®, Neuralgin®) naproxen (e.g. Dolormin®) and diclofenac (e.g. Voltaren®).
The non-steroidal painkillers act on the production of hormones that are released in the event of injury to alert the immune system, the prostaglandins. The enzyme that plays a role in this formation is called cyclooxygenase. Because of this mode of action, this group of painkillers is very well suited for the treatment of pain caused in this way, such as minor injuries or even joint pain.Since prostaglandins also play a role in fever and inflammation, these drugs also have an excellent effect on fever and inflammation.
In addition to the acidic painkillers there are also the chemically non-acidic painkillers with their two main representatives paracetamol (Ben-u-ron®) or metamizole (Novalgin®). They have a similar mode of action to the acidic analgesics but differ in their ability to be effective against inflammation at the same time. Metamizol (Novalgin®) still has the outstanding property of being simultaneously antispasmodic.
This property makes it the optimal drug for treating cramp-like abdominal pain, as is the case with biliary or renal colic, for example. At the same time, it is also the most effective drug from the entire group of non-opiate analgesics available by prescription. Paracetamol is the drug of choice for children in particular, as many other active ingredients such as acetylsalicylic acid (Aspirin®) are prohibited for children.
Opiates do not act at the site of the pain, they only prevent the signal from being transmitted in the spinal cord and perceived in the brain. Drugs from the opiate family act at so-called opiate receptors. These are located along the pain-conducting nerve pathways in the spinal cord and brain.
The body itself also produces a type of opiate, the so-called endorphins. In the case of severe injuries, these ensure that the body inhibits its own pain pathways and the pain does not become too great. Only these endorphins ensure that people do not notice their injuries properly after serious accidents or that women can survive a birth without passing out from pain. By the administration of additional opiates as a drug, this system is maximally activated and the pain does not reach the brain at all or is additionally weakened there.
