Pain management central analgesics

The peripherally acting and centrally acting analgesics are the mainstay of pain management in outpatient practice. The most useful agents in each class are discussed in the following sections. 

Flupirtine (23) administered as the maleate, is a centrally active, nonaddicting analgesic shghtly more potent than aspirin and is especially useful m the management of postoperative and dental pain [20]... 

Hydrocodone bitartrate is an opioid analgesic combination that inhibits synthesis of prostaglandins, binds to opiate receptors in CNS, and peripherally blocks pain impulse generation produces antipyresis by direct action on the hypothalamic heat-regulating center causes cough suppression by direct central action in the medulla and may produce generalized CNS depression. They are indicated in the management of mild to moderate pain. 

Morphine is perhaps the most extensively used analgesic for the management of acute pain associated with injury, neuropathic conditions and cancer. Morphine acts on the central nervous system by activating membrane opioid receptors. The pharmacological effects of morphine vary enormously with dosage. Small doses induce euphoria and sedation, whereas high doses cause pupil dilation, irregular respiration, pale skin, a deep sleep and eventual death within 6-8 h due to respiratory paralysis (Hesse 2002). Even at moderate doses, morphine causes constipation, loss of appetite, hypothermia, a slow... 

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