There are many types of analgesics available as both over-the-counter and prescription medicines for pain. Each has a particular pharmacologic action. The most commonly used analgesics are acetaminophen, non-steroidal anti-inflammatories and opioids. Some medicines used for other purposes such depression also have analgesic effects. Any medication has the potential to cause side effects, which may be due to age, sex, weight, and overall medical condition or drug interactions. Some side effects occur because a person’s genetic variants affect drug metabolism.
Uses and Side Effects of Acetaminophen and Non-Steroidal Anti-Inflammatories
Acetaminophen and medicines classified as non-steroidal anti-inflammatories are used to reduce fever and relieve mild to moderate pain such as headaches, osteoarthritis and minor injuries. Over-the-counter NSAIDs include aspirin, ibuprofen and naproxen, which are marketed under several brand names. Some NSAIDs such as celecoxib are available only by prescription. For these drugs, a doctor will prescribe an appropriate dose for a defined period of use. NSAIDs have anti-inflammatory properties that reduce swelling, which is often a significant factor in pain and discomfort. Acetaminophen does not relieve inflammation.
For minor pain, acetaminophen and over-the-counter NSAIDs can be taken on an as-needed basis. Acetaminophen usually has few side effects but can cause a rare allergic reaction. Prolonged use of acetaminophen can cause liver damage. Potential side effects associated with NSAIDs include heartburn, nausea, indigestion, irritation of the stomach lining and internal bleeding. All NSAIDs except aspirin increase the risk of stroke, blood clots and heart attack. Longer use and higher doses increase the risk. Because of the potential for side effects, long-term use should be monitored by a healthcare professional.
Uses and Side Effects of Opioids
Opioids are used to treat post-surgery pain, cancer or moderate to severe pain that does not respond well to other drugs. Opioids include codeine, tramadol and morphine. Opioids are the most commonly prescribed type of drug in the U.S.
Not all people get pain relief from opioids. For others, normal doses cause severe side effects or toxicity. Variations in an individual’s genetic makeup can affect how opioids act in the body. Doctors often use a trial-and-error method when prescribing opioids to determine how a patient will react. Minor side effects of opioids include drowsiness, lightheadedness, nausea, constipation, confusion and retention of urine. Serious side effects include respiratory distress or coma. Prolonged use of opioids may cause physical dependence.
Understand Your Risk for Side Effects with the Rxight® Genetic Test
Pharmacogenetics examines how a person’s genetic characteristics affect the assimilation of specific drugs. Genetic variants may affect the rate of metabolism of a drug, which can cause severe side effects or reduce the therapeutic benefit.
How Does Pharmacogenetic Testing Work?
Genetic testing takes a sample of a person’s DNA to look at genetic variants that may affect drug assimilation. When a clinician knows that a patient has a genetic variant that can cause an adverse reaction, another medication can be substituted. Pharmacists trained in pharmacogenetics can help patients understand which medications and dosages are compatible with their unique genetic characteristics. Patients can take medications with confidence when they know that the risk of adverse effects is minimized.