Adjuvant analgesics definition

Oxford Textbook of Palliative Medicine

September 6, 2013 – 11:05

Lecture Notes: Comfort

The term ‘adjuvant analgesic’ has been defined as any drug that has a primary indication other than pain, but is analgesic in some painful conditions. As drugs in this category have begun to be used in the treatment of diverse chronic pain disorders, the term itself, and its definition, have become outmoded. There are now drugs in this category that are approved in many countries as primary analgesics for selected pain disorders. The evolution of this group of non-traditional drugs has been rapid and a strongly positive development in the search for a more effective pharmacological...

The term ‘adjuvant analgesic’ has been defined as any drug that has a primary indication other than pain, but is analgesic in some painful conditions. As drugs in this category have begun to be used in the treatment of diverse chronic pain disorders, the term itself, and its definition, have become outmoded. There are now drugs in this category that are approved in many countries as primary analgesics for selected pain disorders. The evolution of this group of non-traditional drugs has been rapid and a strongly positive development in the search for a more effective pharmacological armentarium for chronic pain.

In the palliative care literature, the term ‘adjuvant analgesic’ also is often used synonymously with ‘co-analgesic’. These labels refer to drugs that may be administered with a primary analgesic, usually an opioid, to enhance pain relief, treat pain that is refractory to the analgesic, or allow reduction of the analgesic dose for the purpose of limiting side effects. In this context, adjuvant analgesics should be distinguished from other adjuvant drugs that are co-administered with analgesics for the specific purposes of treating side effects produced by the analgesic or managing symptoms other than pain. In the latter sense, laxatives and antiemetics are adjuvant drugs.

Given this imprecise terminology and the expanding use of adjuvant analgesics as non-traditional primary analgesics, it is important to understand the pharmacology of these drugs and their therapeutic role in varied patient populations. In this way, the use of the adjuvant analgesics can be optimized, both as ‘add-on’ therapy to an opioid regimen and as distinct, primary therapy in those painful disorders that are likely to demonstrate a good response.

Source: oxfordindex.oup.com

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