Eschalier A, Jourdan D, Courteix C
Laboratoire de pharmacologie médicale, faculté de médecine, Clemont-Ferrand.
Rev Prat. 1994 Sep 15;44(14):1903-9.
Currently, the pharmacology of analgesics can be sum up to three main compounds: morphine, paracetamol and aspirin. The use of antidepressants and anticonvulsants will also be mentioned. Morphine remains the reference compound among centrally acting analgesics both for acute and chronic pain. Its mechanism of action is relatively well known as well as the role of opiate receptors. Paracetamol is largely used as analgesic for relief of slight to moderate pain. Its mechanism of action still remains unclear. Usually the tolerability of this compound is considered as being excellent. However overdosage can induce severe and possible lethal liver necrosis. Aspirin is also a very old and a largely used compound. Its inhibiting effect on cyclooxygenase acts mainly peripherally but it could also act centrally. According to the current knowledge of its mechanism of action, it seems that the main pharmacological properties as well as adverse events of aspirin are all related to its enzyme inhibiting effect. Slight to moderate pain, related or not to inflammatory disease responds well to aspirin and other NSAIDs.
目前,镇痛药的药理学可归纳为三种主要化合物:吗啡、对乙酰氨基酚和阿司匹林。还将提及抗抑郁药和抗惊厥药的使用。吗啡仍然是中枢性镇痛药中治疗急性和慢性疼痛的参考化合物。其作用机制以及阿片受体的作用相对较为人所知。对乙酰氨基酚大量用作缓解轻至中度疼痛的镇痛药。其作用机制仍不清楚。通常认为该化合物的耐受性极佳。然而,过量服用可导致严重且可能致命的肝坏死。阿司匹林也是一种使用历史悠久且应用广泛的化合物。其对环氧化酶的抑制作用主要在周围发挥,但也可能在中枢起作用。根据目前对其作用机制的了解,阿司匹林的主要药理特性以及不良事件似乎都与其酶抑制作用有关。与炎症性疾病相关或无关的轻至中度疼痛对阿司匹林和其他非甾体抗炎药反应良好。