💊Analgesic is a drug that selectively relieves pain by acting in the CNS or on the peripheral pain mechanisms without significantly altering consciousness.

💊They are divided into 2 groups:

1. Opiod/Narcotic/Morphine like
2. Non-opiod/Non-Narcotic/antipyretic (Aspirin like drugs)

The antipyretic analgesics & NSAID’s are more commonly employed for dental pain because tissue injury and inflammation due to abscess, caries, tooth extraction etc. is major cause of acute dental pain.

🔆 CLASSIFICATION:

🔆 ANALGESIC/NSAID’s IN DENTISTRY:

• The antipyretic analgesics used mainly for dental pain is Paracetemol.
• Paracetemol (Acetaminophen) is most frequently used to relieve toothache in Pregnancy. It has week anti-inflammtory effect & causes no teratogenesis in the developing fetus.
• Pain during invasive dental procedures is alloyed by a local anesthesic before & after is treated with NSAID’s.

💊 NSAID’s use during Pregnancy: (The devastating effects to the infant) 👇🏻

🔆Use of OPIOIDS in Dental Pain:

• Less used than analgesics
• Mostly codeine is used for dental patients because other opioids cause dullness & short lasting pain.
• Other alternative Opioid Analgesics used are – Tramadol, Pentazocine.

💊MORPHINE – Depressant actions‼️

🔻Adverse effects:

1. Sedation, mental clouding, lethargy, nausea, vomitting, diarrhoea.
2. Respiratory depression, blurring of vision.
3. Allergic conditions, rashes, urticaria, itching, swelling.
4. May develop tolerance & dependance.

🔻Contraindications:

1. Urinary retention – infants & elderly
2. Asthma patients
3. Hypotensive states
4. Hypovolaemic states

💊NSAID’s :

1. Analgesic, antipyretic, anti-inflammatory effect.
2. Effectively relieves inflammatory tissue, injury related pain, signs of inflammation like pain, tenderness, swelling are suspected.
3. Cellular metabolism is increased & due to increased Glucose utilization there is decrease in blood sugar.
4. Has teratolytic & mild-antiseptic properties
5. Irritates gastric mucosa
6. Interferes with platelet aggregation & bleeding time prolonged.

🔻Adverse effects:

• Nausea, vomiting, diarrhoea, blood loss in stools.
• Haemolysis in G6PD deficient patients.
• Nephrotoxicity & hepatotoxicity in long term use.
• Allergic reactions – rashes, urticaria, photosensitivity.
• Pregnancy & Infancy – Refer Image 3

🔻Contraindications:

• Nursing and pregnancy
• Serious bleeding
• Allergy/Asthma/Angioedema
• Impaired renal function
• Drug (anticoagulant)

Dr. Mehnaz Memon🖊

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References:

1. Flowcharts: Classification of Drugs with DOC by Vikas Seth (Third Edition)
2. KD TripathiEssentials of Medical Pharmacology 7th Edition; Internet