Topical Agents
(1) Department of Anaesthesia, Royal Free Hospital, London, UK 22.1 Capsaicin Capsaicin (8-methyl-N-vanillyl-6-nonenamide) is an active component of chilli peppers. It binds to TRPV1 (transient receptor potential channel) receptors…
Anticonvulsants
(1) Department of Anaesthesia, Royal Free Hospital, London, UK These are mainly used for neuropathic pain. Broadly, they are divided into those whose mechanism of action is via alteration…
Antidepressants
(1) Department of Anaesthesia, Royal Free Hospital, London, UK 20.1 Tricyclic Antidepressants These are the most effective medications for the neuropathic pain (NNT 3.1). They also help with depression…
Nonsteroidal Anti-inflammatory Drugs
(1) Department of Anaesthesia, Royal Free Hospital, London, UK NSAIDs act through inhibition of cyclooxygenase enzyme (COX-1 and COX-2), thus inhibiting prostaglandin synthesis. Arachidonic acid is a polyunsaturated fatty…
Opioids-Clinical Use
(1) Department of Anaesthesia, Royal Free Hospital, London, UK 17.1 Morphine Morphine is a phenanthrene derivative. The effects are mediated by μ receptors. It is more effective for visceral…
Glutamate and GABA Receptors
(1) Department of Anaesthesia, Royal Free Hospital, London, UK Glutamate and GABA receptors are amino acid neurotransmitters present in the central nervous system. They are involved with nociception at…
Serotonergic Receptors
(1) Department of Anaesthesia, Royal Free Hospital, London, UK Serotonin is a transmitter found in the central nervous system. It is involved with nociception at the peripheral and spinal…
Sodium Channels
(1) Department of Anaesthesia, Royal Free Hospital, London, UK Action potential is initiated by voltage-gated sodium channels. Alterations in channel properties can contribute to inflammatory and neuropathic pain. Voltage-gated…
