What are the main differences between NSAIDs, analgesics and painkillers?

In a sense, when we talk about non-steroidal anti-inflammatory drugs (or NSAIDs), analgesics and painkillers, we are referring to one large category of medicines.

In fact, in principle, all these drugs have been studied to treat pain syndromes and, as we will see better in the course of this article, the big substantial difference lies precisely in the type of pain that each of them must treat.

To simplify matters and try not to get confused, below we show you the main categories by which painkillers, also known as analgesics, are divided:

• The antipyretic analgesics;
• NSAIDs, acronym for Non -Steroidal Anti-Inflammatory Drugs;
• The opioid analgesics.

It is of fundamental importance to remember that all painkillers do not have the objective of solving the cause that triggered the pain, but rather have the function of relieving the latter, whatever its nature.

Let’s now analyze each of these categories so as to understand not only what they are for and when we have to take these drugs, but also, and above all, any contraindications and/or side effects that could occur by taking them, for example, in the wrong way.

Antipyretic analgesics: what are they for?

Let’s start with the first class of painkillers that we have mentioned: the antipyretic analgesics. Antipyretic drugs are commonly known as that class of medicines which are used in the case of fever , in fact they are useful for reducing body temperature.

Unlike the other medicines that we will discuss in the next paragraph, these medicines are only used to relieve pain and have no anti-inflammatory function. One of the main exponents of this category, paracetamol , has an anti-inflammatory effect, even if it is minimal.

The paracetamol-based formulations that we can find on the market are:

• Tachypirin;
• Tachiflu ;
• Acetamol.

What are non-steroidal anti-inflammatory drugs (NSAIDs) used for?

Non -steroidal anti-inflammatory drugs, or NSAIDs, as we can easily deduce from the name, are used to relieve not only the pain, but also the inflammatory state which is often the basis of the painful syndrome itself.

The category of NSAIDs is very broad and, as we will see later, they are mainly drugs that many of us know, even if only by hearsay. Precisely because of the vastness of medicines that are placed within this category, it is more convenient to classify them according to their mechanism of action and chemical structure.

The classification of NSAIDs is therefore as follows:

• I FANS Arilpropionici;
• COX-2 selective NSAIDs;
• I FANS Arylsulfonammides;
• NSAIDs derived from Phenamatis;
• Salicylated FANS;
• The Winemakers;
• Non-acidic NSAIDs;
• Proteolytic enzymes;
• I FANS Arilacetici.

This is therefore the classification of NSAIDs based on their chemical structure and, intuitively, each of these will have a different selectivity of action. One of the main characteristics of NSAIDs is that they do not require a prescription to be purchased.

In fact, you can easily go to the pharmacy and ask for the non-steroidal anti-inflammatory drug you need, without showing your doctor’s prescription. However, this does not exclude the fact that these medicines, like all the others, should be taken in moderation and only when there is actually a need.

When are opioid analgesics prescribed? What are they for?

The third and last class of painkillers that we will tell you about today is that of opioid analgesics , a category of medicines that perform the function of relieving pain, like the others on the other hand, but by directly stimulating the endogenous opioid receptors.

These medicines require a doctor’s prescription to be purchased at the pharmacy. That is to say, we cannot take them without a prescription drawn up by the attending physician.

This is due to the fact that opioid analgesics can lead to a wide range of more or less serious side effects and, in order to take them, your doctor must first make sure that you will not experience these effects.

What are the most popular medicines that fall into these classes?

As we have already said at the beginning of the article, among the antipyretic painkillers, we find above all paracetamol , a widely used medicine, thanks above all to its high gastric tolerability and, for this reason, it can also be taken during a delicate period such as pregnancy.

NSAIDs include the following medicines:

• Voltaren , widely used for problems such as back pain;
• Momendol, popular for the treatment of problems such as menstrual pain, tooth pain and many other conditions;
• Aulin , known above all for treating headaches, but not only;
• Tachipirina , more widespread for the treatment of flu symptoms and feverish states;
• Froben , used for the treatment of rheumatological, orthopedic, but also gynecological and many other problems;
• Aspirin , like Tachipirina, is useful for the treatment of flu and/or feverish states, but also for headaches, tension pains, and so on;
• Oki is used for the treatment of any type of inflammatory state with painful symptoms, including those that appear after surgery;
• Celebrex is useful in the presence of conditions in which there is an increase in the production of prostaglandins, for example in the case of rheumatoid arthritis;
• Buscofen , useful for the treatment of pain associated with menstruation, but not only.

These are just some of the NSAIDs that we can find on the market and that help us overcome particularly painful uncomfortable situations, starting from a simple headache up to the pain we perceive following surgery.

Finally, as regards opioid painkillers, we certainly remember those mentioned below:

• Codeine , a drug that is used for its antitussive properties;
• Methadone which, in addition to being an excellent analgesic, is also used as a replacement therapy for drug addiction;
• Morphine , mainly used after surgery;
• Oxycodone which is often combined with Naloxone, for the treatment of very painful situations.

As with any other type of drug, even in the case of painkillers, whatever they are, we can experience side effects and there are specific contraindications, i.e. conditions in which they cannot be taken. Let’s go see what they are.

What are the side effects and contraindications of antipyretic analgesics?

When we talked about antipyretic analgesic drugs, such as paracetamol, we mentioned the fact that it is a drug highly tolerated by our body, to the point of being admitted even during the period of pregnancy.

However, this does not exclude that side effects may not occur, especially if the medicine is not taken correctly. In fact, it has been shown that abuse of paracetamol can not only increase the risk of ulcers and bleeding, but also of heart attacks and strokes.

Fortunately, however, these side effects are also quite rare, however, among the most common we have:

• Kidney intoxication;
• Liver intoxication;
• Abdominal pain with diarrhea;
• Urticaria;
• hypotension;
• Leukopenia, i.e. the decrease in leukocytes in the blood;
• Neutropenia, which is a decrease in certain types of white blood cells;
• Allergic reactions of various types;
• The thrombocytopenia.

As regards the contraindications of paracetamol, it is advisable to avoid taking the drug in the following cases:

• In the case of liver failure;
• In the case of renal insufficiency;
• Glucose 6 phosphate dehydrogenase enzyme deficiency;
• In case of hypersensitivity to the same active ingredient;
• High grade hemolytic anemia.

What are the side effects and contraindications of NSAIDs?

Also in the case of NSAIDs , obviously, the side effects are different according to the type of drug, or rather, according to the active ingredient we are using. In fact, even if these are drugs that do not require a prescription, this does not exclude the possibility of experiencing side effects.

Among the side effects common to all types of NSAIDs are those mentioned below:

• diarrhea;
• Gastrointestinal ulceration, bleeding or perforation;
• nausea;
• Vomit.

In practice, these are side effects that mainly affect our gastrointestinal system. However, in the case of abuse of NSAIDs , the risk of stroke or myocardial infarction increases.

What are the side effects and contraindications of opioid pain relievers?

Finally, regarding the possible side effects of opioid painkillers, we have the following:

• Vomit;
• Miosis, or rather, the abnormal narrowing of the pupils;
• Respiratory depression, especially when large doses are taken;
• A feeling of sleepiness;
• sedation;
• A state of confusion.

Last but not least, this class of drugs can also cause addiction and habituation, precisely because they have a direct effect on the nervous system, in the same way as drugs.