Everything about Non-Opioid Analgesics you should know.

Introduction

Non Opioid / Non narcotic analgesics are the analgesics that are commonly used medicines that help relieve mild to moderate pain without causing addiction.

In simple terms, these are the painkillers most of us use in daily life — like paracetamol or ibuprofen.

They are widely preferred because they are effective, safer than opioids, and easily available.

Before we jump to how non opioid analgesics work, we should know about how we feel pain in our body. Let’s understand this in simple steps

Steps involved in creation and propagation of pain in our body

Step 1: Something happened in our body like cut, burn, Fracture, Inflammation and other possible causes of tissue damage.
Step 2: This Cut or burn etc activate special pain receptors in our body known as Nociceptors.
Step 3: Damaged tissue cells & inflammatory cells release chemicals like prostaglandins, Histamine and others.
Step 4: These chemical sensitize nociceptors, making pain stronger.
Step 5: Pain travels via nerve fibers to spinal cord and then upwards toward brain.
Step 6: Brain interprets pain.

So, now we know that it is prostaglandins who sensitize pain receptors and we feel pain. Thus to cure pain we need to stop this chemical and one way is let us stop producing Prostaglandins in our body and here comes COX (cyclooxygenase) in the picture, COX is the enzyme which is responsible for formation of prostaglandins.

To Summarize what we learned so far is:

• Pain is created when some tissue gets damaged by any means like cut, burn, fracture etc.
• Pain activates pain receptors also known as Nociceptors.
• Damaged tissue cells & inflammatory cells release chemicals like prostaglandins.
• COX enzyme is responsible for the formation of prostaglandins.
• To cure pain in our body it is required to prevent formation of prostaglandins.

Mechanism of action of Non Opioid Analgesics

Non-opioid analgesics inhibit the COX enzyme (COX-1 and/or COX-2). Inhibiting COX enzyme prevents formation of prostaglandins. Due to reduction in formation of prostaglandins, pain signal formation at site of damaged tissue is reduced and hence relief from pain

Overview

• Non-opioid (non-narcotic) analgesics are pain-relieving drugs used to treat mild to moderate pain.
• These drugs do not cause addiction or dependence, unlike opioid analgesics.
• Pain occurs when body tissues are damaged due to conditions such as cuts, burns, fractures, or inflammation.
• Tissue damage leads to the activation of pain receptors called nociceptors.
• Damaged tissues release chemical mediators such as prostaglandins, which sensitize nociceptors and increase pain intensity.
• Pain signals travel from the site of injury through nerve fibers to the spinal cord and then to the brain, where pain is perceived.
• Prostaglandins play a key role in enhancing pain sensation.
• Non-opioid analgesics relieve pain by inhibiting the cyclooxygenase (COX) enzyme.
• Inhibition of COX results in reduced formation of prostaglandins.
• Reduced prostaglandin levels lead to decreased pain receptor sensitization and effective pain relief.

Examples of Non-Opioid Analgesics

Ibuprofen, Aspirin (Acetylsalicylic acid), Ibuprofen, Diclofenac, Naproxen, Indomethacin, Nimesulide, Aceclofenac

What more to learn next

• COX-1, COX-2 Enzyms.
• Side effects of Non Opioid Analgesics.
• What are NSAIDs.
• Which Analgesic in what pain?
• Why we should not overuse Non Opioid Analgesics.
• Selective and Non-Selective NSAIDs
• Why nimesulide is ban in some countries?
• Why aspirin is used as blood thinners?
• Why Proton pump inhibitors are recommended along with these analgesics?
• What is paracetamol?
• Are Non Opioid Analgesics safe for pregnant and breast feeding women?

I hope this explanation was helpful to you. In upcoming posts, we will discuss topics such as prostaglandin formation, COX-1 and COX-2 enzymes, and NSAIDs in more detail. These topics will be linked as separate posts for better understanding. Stay tuned for updates on next topics.