Analgesics

Mechanism-based analgesia

Analgesia is mechanism-based, not ladder-based - the drug follows the pain type

Pain type	Mechanism	Responds to
Nociceptive	Tissue injury -> peripheral nociceptors	Paracetamol, NSAIDs, opioids
Inflammatory	Prostaglandin sensitisation	NSAIDs, corticosteroids
Neuropathic	Nerve injury, ectopic firing, central sensitisation	TCA, SNRI, gabapentinoid (opioid-poor response)
Nociplastic	Altered central processing (fibromyalgia, IBS)	Non-drug therapy, SNRI/TCA; opioids are harmful

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