|DB00193||Tramadol||Tramadol is approved for the management of moderate to severe pain in adults.[FDA label]
As an off-label indication, tramadol has been investigated to be used for the treatment of premature ejaculation.[A173986]|
|DB00295||Morphine||Morphine is used for the management of chronic moderate-to-severe pain.[A176050]
Opioids, including morphine, can manage pain effectively when used for a short amount of time. The use of opioids for longer periods needs to be monitored as they can develop a physical dependence, addiction disorder and drug abuse.[L5728]|
|DB00327||Hydromorphone||Hydromorphone is indicated for the management of moderate to severe acute pain and severe chronic pain. Due to its addictive potential and overdose risk, hydromorphone is only prescribed when other first-line treatments have failed.[A176468]
The WHO has proposed a three-step ladder for the management of pain in which it is suggested to start with a non-opioid medication followed by addition of weak opioids to the non-opioid treatment for moderate pain and finishing in the use of strong opioids such as hydromorphone along with the existing regimen for cases of severe pain.[A176471]
Off-label, hydromorphone can be administered for the suppression of refractory cough.[A176468]|
|DB00333||Methadone||For the treatment of dry cough, drug withdrawal syndrome, opioid type drug dependence, and pain.|
|DB00454||Meperidine||Used to control moderate to severe pain.|
|DB00497||Oxycodone||For the treatment of diarrhoea, pulmonary oedema and for the relief of moderate to moderately severe pain.|
|DB00611||Butorphanol||For the relief of moderate to severe pain.|
|DB00647||Dextropropoxyphene||For the relief of mild to moderate pain|
|DB00652||Pentazocine||For the relief of moderate to severe pain.|
|DB00813||Fentanyl||For the treatment of cancer patients with severe pain that breaks through their regular narcotic therapy.|
|DB00844||Nalbuphine||For the relief of moderate to severe pain.|
|DB00921||Buprenorphine||For the treatment of moderate to severe pain, peri-operative analgesia, and opioid dependence.|
|DB01209||Dezocine||Indicated in the treatment of moderate to severe pain.|
|DB01551||Dihydrocodeine||Dihydrocodeine is used for the treatment of moderate to severe pain, including post-operative and dental pain . It can also be used to treat chronic pain , breathlessness and coughing.
In heroin addicts, dihydrocodeine has been used as a substitute drug, in doses up to 2500mg/day to treat addiction. [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2014322/]
|DB06738||Ketobemidone||For the treatment of all types of severe pain, such as postoperative, cancer, kidney stones and fractures.|
|DB00318||Codeine||Codeine sulfate is a form of this drug that is commonly used. It is available in tablet form [FDA label] and indicated for the relief of mild to moderately severe pain, where the use of an opioid analgesic is appropriate [FDA label].
The solution form is used by itself or combined in a syrup with other drugs and is used as a cough suppressant in adults aged 18 and above [L5521], [L5524]. |
|DB00708||Sufentanil||The indications for this drug are as follows:
1. As an analgesic adjunct in the maintenance of balanced general anesthesia in patients who are intubated and ventilated.
2. As a primary anesthetic agent for the induction and maintenance of anesthesia with 100% oxygen in patients undergoing major surgical procedures, in patients who are intubated and ventilated, such as cardiovascular surgery or neurosurgical procedures in the sitting position, to provide favorable myocardial and cerebral oxygen balance or when extended postoperative ventilation is anticipated.
3. For epidural administration as an analgesic combined with low dose (usually 12.5 mg per administration) bupivacaine usually during labor and vaginal delivery
4. The sublingual form is indicated for the management of acute pain in adults that is severe to warrant the use of an opioid analgesic in certified medically supervised healthcare settings, including hospitals, surgical centers, and emergency departments.
|DB00802||Alfentanil||For the management of postoperative pain and the maintenance of general anesthesia.|
|DB00854||Levorphanol||For the management of moderate to severe pain or as a preoperative medication where an opioid analgesic is appropriate.|
|DB00899||Remifentanil||For use during the induction and maintenance of general anesthesia.|
|DB00956||Hydrocodone||For relief of moderate to moderately severe pain. Also used for the symptomatic relief of nonproductive cough, alone or in combination with other antitussives or expectorants.|
|DB01081||Diphenoxylate||For as adjunctive therapy in the management of diarrhea|
|DB01192||Oxymorphone||For the treatment of moderate-to-severe pain.|
|DB01227||Levacetylmethadol||For the treatment and management of opiate dependence. It is sometimes used to treat severe pain in terminal patients.|
|DB01433||Methadyl acetate||Used mainly in the treatment of narcotic dependence.|
|DB01452||Diamorphine||Diamorphine, as a prescription medication in the United Kingdom, is indicated for use in the treatment of severe pain associated with surgical procedures, myocardial infarction or pain in the terminally ill and for the relief of dyspnoea in acute pulmonary edema [L4999].|
|DB01466||Ethylmorphine||Ethylmorphine is an analgesic used for pain relief.|
|DB01535||Carfentanil||Carfentanil is similar (but more potent) to the opioid analgesic fentanyl. It is used as a tranquilizer for large animals.|
|DB01565||Dihydromorphine||Dihydromorphine is an opioid analgesic used for moderate to severe pain relief.|
|DB11130||Opium||Opium and its derivatives are the most commonly used medications for the treatment of acute and chronic pain. Opium and its alkaloid-derivatives can also be used as tranquilizers, antitussives and in the treatment of diarrhea.[T138] The direct use of opium is not common nowadays but the use of some of its derivatives such as morphine and codeine, as well as the use of a tincture of opium for severe diarrhea can be seen in medical practice.[T139]
Illegal use of opium has been registered to be for both recreational and medicinal purposes.[A32182]|
|DB11609||Normethadone||For use in the treatment of cough when other less potent treatments have failed [FDA Label].|
|DB01459||Bezitramide||A narcotic analgesic once used for the treatment of severe chronic pain. [A14383] |
|DB06204||Tapentadol||The immediate-release formulation of tapentadol is indicated for the relief of moderate to severe acute pain. The long-acting formulation serves as a continuous, around-the-clock analgesic that is indicated for the relief of moderate to severe chronic pain or neuropathic pain associated with diabetic peripheral neuropathy. |
|DB00704||Naltrexone||Used as an adjunct to a medically supervised behaviour modification program in the maintenance of opiate cessation in individuals who were formerly physically dependent on opiates and who have successfully undergone detoxification. Also used for the management of alcohol dependence in conjunction with a behavioural modification program.|
|DB09272||Eluxadoline||For the treatment of irritable bowel syndrome with diarrhea (IBS-D).|
|DB00945||Acetylsalicylic acid||**Pain, fever, and inflammation**
Acetylsalicylic acid (ASA), in the regular tablet form (immediate-release), is indicated to relieve pain, fever, and inflammation associated with many conditions, including the flu, the common cold, neck and back pain, dysmenorrhea, headache, tooth pain, sprains, fractures, myositis, neuralgia, synovitis, arthritis, bursitis, burns, and various injuries. It is also used for symptomatic pain relief after surgical and dental procedures [FDA label].
The _extra strength_ formulation of acetylsalicylic acid is also indicated for the management migraine pain with photophobia (sensitivity to light) and phonophobia (sensitivity to sound)[FDA label].
ASA is also indicated for various other purposes, due to its ability to inhibit platelet aggregation. These include:
Reducing the risk of cardiovascular death in suspected cases of myocardial infarction (MI) [FDA label].
Reducing the risk of a first non-fatal myocardial infarction in patients, and for reducing the risk of morbidity and mortality in cases of unstable angina and in those who have had a prior myocardial infarction [FDA label].
For reducing the risk of transient ischemic attacks (TIA) and to prevent atherothrombotic cerebral infarction (in conjunction with other treatments) [FDA label].
For the prevention of thromboembolism after hip replacement surgery [FDA label].
For decreasing platelet to platelet adhesion following carotid endarterectomy, aiding in the prevention of transient ischemic attacks (TIA) [FDA label].
Used for patients undergoing hemodialysis with a silicone rubber arteriovenous cannula inserted to prevent thrombosis at the insertion site [FDA Label].
**Important note regarding use in acute clinical situations**
In the setting of acute myocardial infarction, or before percutaneous interventions, the extended release form of acetylsalicylic acid should not be used. Use immediate-release formulations in scenarios requiring rapid onset of action [Label, F4405]. The extended-release form is taken to decrease the incidence of mortality and myocardial infarction (MI) for individuals diagnosed with chronic coronary artery disease (CAD), including patients with previous myocardial infarction (MI) or unstable angina or with chronic stable angina. Additionally, the extended-release form is used to decrease the risk of death and recurrent episodes of stroke in patients with a history of stroke or TIA [F4405].
|DB01050||Ibuprofen||Ibuprofen is the most commonly used and prescribed NSAID. It is very common over the counter medication widely used as an analgesic, anti-inflammatory and antipyretic.[A39096]
The use of ibuprofen and its enantiomer [DB09213] in a racemic mix is common for the management of mild to moderate pain related to dysmenorrhea, headache, migraine, postoperative dental pain, spondylitis, osteoarthritis, rheumatoid arthritis, and soft tissue disorder.[A39097]
Due to its activity against prostaglandin and thromboxane synthesis, ibuprofen has been attributed to alteration of platelet function and prolongation of gestation and labor.[A39092]
As ibuprofen is a widely used medication, the main therapeutic indications are:
* Patent Ductus Arteriosus - it is a neonatal condition wherein the ductus arteriosus (blood vessel that connects the main pulmonary artery to the proximal descending aorta) fails to close after birth causing severe risk of heart failure. The prostaglandin inhibition of ibuprofen has been studied for the treatment of this condition as it is known that prostaglandin E2 is responsible for keeping the ductus arteriosus open.[A39100]
* Rheumatoid- and osteo-arthritis - ibuprofen is very commonly used in the symptomatic treatment of inflammatory, musculoskeletal and rheumatic disorders.[A39176]
* Cystic fibrosis - the use of high dosages of ibuprofen has been proven to decrease inflammation and decreasing polymorphonuclear cell influx in the lungs.[A39177]
* Orthostatic hypotension - ibuprofen can induce sodium retention and antagonize the effect of diuretics which has been reported to be beneficial for patients with severe orthostatic hypotension.[A1651]
* Dental pain - ibuprofen is used to manage acute and chronic orofacial pain.[A10901]
* Minor pain - ibuprofen is widely used to reduce minor aches and pains as well as to reduce fever and manage dysmenorrhea. It is very commonly used for the relief of acute indications such as fever and tension headaches.[A39092]
* Investigational uses - efforts have been put into developing ibuprofen for the prophylaxis of Alzheimer's disease, Parkinson disease, and breast cancer.[A39092]|
|DB01183||Naloxone||For the complete or partial reversal of narcotic depression, including respiratory depression, induced by opioids including natural and synthetic narcotics, propoxyphene, methadone and the narcotic-antagonist analgesics: nalbuphine, pentazocine and butorphanol. It is also indicated for the diagnosis of suspected acute opioid overdose. It may also be used as an adjunctive agent to increase blood pressure in the management of septic shock.|
|DB09214||Dexketoprofen||For short-term treatment of mild to moderate pain, including dysmenorrhoea, musculoskeletal pain and toothache [L1302]. |