Hi. I'm Maurice Scott, and I'm a palliative care physician at the University of Colorado Anschutz Medical Campus. I look forward to spending a few minutes with you to review how to treat pain with medicines. In this module, we will learn about medications that can help pain, but are not Opioids. In the next module we will learn about Opioids which are often needed to treat more severe pain. As you've learned in the past modules, physical pain can be very uncomfortable. It can lead to a lot of suffering and a very low quality of life. Oftentimes, medicines along with the physical approaches you learned about in the previous modules, can be used to bring pain down to a comfortable level. When I answered this question, it seemed as if I could list many more than just three. I thought of medicines like Advil, Motrin, Aleve, Tylenol, Excedrin, Mobic, Toradol, Ibuprofen and several others. However, a lot of the medicines I named work in similar ways, and can be grouped into different types or classes of medicine. You will soon see that there are only a handful of different classes of medicines that we use. It is important to learn which medicines belong to which class. If you use two medicines from the same class at the same time, you will not get twice the amount of pain relief. However, you can have an increased chance of side effects. When something is sore or hurting there is often inflammation in the area. Think of someone you know who has arthritis in their knee. If you look closely at their knee, you may find the four signals of inflammation, pain, swelling, redness, and warmth. Sometimes, inflammation happens on the inside of the body, and you might only have a couple of the inflammation signals. You might only feel the pain or notice the swelling, but nothing else. Often, a medication that reduces inflammation will help with the pain, because pain and inflammation go together. The first class of pain relieving medications we will look at are called steroids. Steroids are strong medications with several side effects that we will discuss in a later video. Prednisone and Dexamethasone are two medicines that reduce inflammation. Although they are different medicines, they are in the same class of medicine. They are both steroids. These steroid medications are not the type of steroids that bodybuilders use to get strong inbuilt muscle. They act like something your body naturally makes called Corticosteroids. Corticosteroids are produced by hormone glands that sit on top of the kidneys. When released from this gland, Corticosteroids stop or ease inflammation that causes pain. If the body receives extra doses of Corticosteroids for medicines like Prednisone or Dexamethasone, inflammation goes down even faster, and pain that came from the inflammation is eased. The next class of medications we will look at are non-steroidal anti-inflammatory drugs or NSAIDs: Ibuprofen, Advil, Motrin, Aleve, Mobick and Toradol are all generic or trade names for this class of medication. Like steroids, NSAIDs work to decrease inflammation in the body. So, they work to ease pain. NSAIDs are specially designed to stop a process in the body that leads to inflammation. With less inflammation, there is less pain. Another class of medications addresses Neuropathic or nerve pain. Neuropathic pain is pain that happens when a nerve gets damaged or confused, and then becomes over sensitive. For example, people who have diabetes for a long time will have damage to nerves. They start having pain and numbness in their hands and then their feet, they look at their foot and nothing seems wrong within. They see nothing there to cause the pain, but they are feeling pain because the diabetes over years has been damaging the nerve. Medicines that help calm down the oversensitive, damaged and confused nerve, will help with nerve pain. Neurontin, also called Gabapentin and Depakote, are examples of medications that can help some people with nerve pain. While these medications work somewhat differently from each other, they are all in the same class. As a group, they tend to calm down oversensitive nerves before they send messages to the brain saying, "I'm in pain." Wow, that was a fast lesson on classes of Non-Opioid pain medicines. It is important to go into more detail about when to use them, but you'll have to go to the next video to learn more about that.
