://module2 The WHO method page 5/9
The Pain Ladder: Drug Classes <<previous next>>
Here are some examples of drugs in each class. We will look at where each class fits in the WHO ladder and some typical drug dosages later on.
Non opioids
These include simple analgesics such as Paracetamol and Aspirin, as well as Non-Steroidal Anti Inflammatory Drugs (NSAIDS) such as Ibuprofen, Ketoprofen and Diclofenac.
Opioids
The opioids are a large group of drugs that include codeine, tramadol, morphine and methadone. They play an important role in the management of pain in a large proportion of cancer patients. They are looked at in depth in Module 3.
Adjuvants
These include analgesics for specific types of pain, drugs that enhance the effect of other analgesics, and drugs that help treat concurrent symptoms that exacerbate pain. They include Gabapentin (neuropathic pain), Midazolam (agitation, anxiety), Baclofen (muscle spasm), Zoledronic Acid (bone pain), and Dexamethasone (nerve root compression). Adjuvants can be added in at any step of the ladder as the need arises. Often more than one adjuvant may be needed. We will look at adjuvants in more depth in Module 3.