Episode Summary
Explore the key medications used in chronic pain care, from opioids and NSAIDs to anticonvulsants, antidepressants, and ketamine, with a clear look at benefits, risks, and real-world limitations. Learners will gain practical insight into spotting drug interactions, inappropriate prescribing, and safer opportunities for review and referral.
Chronic pain pharmacology is presented as a broad clinical overview, with emphasis on helping community practitioners recognize drug interactions, inappropriate long-term use, self-prescribing risks, and possible gaps in treatment. The main drug groups covered are opioids, tramadol and tapentadol, NSAIDs, paracetamol/acetaminophen, anticonvulsants, antidepressants, and ketamine.
A major focus is the limited role of opioids in chronic non-cancer pain despite their usefulness in acute pain, along with common adverse effects, tolerance, overdose risk, and opioid-induced hyperalgesia. Codeine variability, tramadol’s risk of serotonin syndrome, and tapentadol’s lower side-effect profile are also explained. NSAIDs and paracetamol are reviewed in terms of benefits, safety, and limited evidence in chronic pain. Anticonvulsants and antidepressants are outlined mainly for neuropathic pain, including their variable effectiveness and frequent side effects. Ketamine is described as a specialist option for selected neuropathic or widespread pain conditions.
Learners can expect practical guidance on when medication review may be needed, how evidence supports or challenges common prescribing habits, and why function and patient outcomes matter more than pain relief alone.
