A rational approach to the management of acute pain states (part 1)

Several classes of drugs can be used in the management of acute pain: acetaminophen, salicylates, miscellaneous mild analgesics, nonsteroidal anti- inflammatory drugs (NSAIDs), and opioids. In part one of this two-part series, agents used to treat mild pain states will be explored. For this condition, acetaminophen and aspirin remain the standards of comparison. These agents are inexpensive and their adverse effect profiles are well described. For patients unable to take acetaminophen or aspirin, a variety of NSAIDs are available. This article reviews the advantages and disadvantages of the various agents and their role within the analgesic armamentarium for management of mild, acute pain states. Next month, in part two of this two- part series, the use of opioids will be explored.