Not Used


It is a central nervous system (CNS) depressant. It changes the way the body or brain responds to pain.

Painkiller, cough suppressant and treats mild to severe pain.

Postoperative pain in children, paralytic Ileus, hypercapnia, acute or severe bronchial asthma and respiratory depression.


Specific CNS opioid receptors for endogenous compounds with opioid-like activity and play a role in the analgesic effects of this drug

Use in the management of severe pain that require the use of opioids.

Hypersensitivity to hydrocodone, acute or severe bronchial asthma, respiratory depression and suspected gastrointestinal obstruction


It is an agonist at the mu opioid peptide receptor/it has a weaker affinity at the kappa and delta opioid peptide receptors.

Same as above

Same as above


A semisynthetic opioid with agonistic properties on the different opioid receptors. It has the strongest affinity for mu-type receptors.

Used for all types of pain especially in cases where other medications showed failure

Same as above


It is a synthetic opioid, it induces other opioid receptors. Methadone activates the μ-receptors in the same pathway as the above mentioned opioids.

Manages pain that is non-responsive to non-narcotic drugs. Treatment of neonatal abstinence syndrome

CNS-related pathologies such as trauma, delirium, etc. Not to be used in conjunction with medications or substances with similar depressant effects


It binds to the mu-opioid receptor in the CNS and the PNS to reduce nociceptive transmission.

Moderate to severe pain that may be acute or chronic especially in the management of palliative care, in active cancer treatment, and vaso-occlusive pain during sickle cell crisis.

It should be avoided in severe respiratory depression, asthma exacerbation cases and in cases of previous hypersensitivity reaction and immediately discontinued in the presence of an active reaction.


It acts as an inhibitor for the cyclooxygenase (COX) pathways.

It is an antipyretic and a non-opioid analgesic agent.

Hypersensitivity to acetaminophen and severe hepatic impairment.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Inhibition cyclooxygenase thus leading to lack of eicosanoids such as prostaglandins which has an anti-nociception activity.

Used to treat pain, fever, and other inflammatory processes.

Hypersensitivity to NSAIDs, patients who have undergone coronary artery bypass graft and third trimester pregnancy


They increase neurotransmitters serotonin or norepinephrine or both in the synapse.

Depression, pain, insomnia and migraine

Hypersensitivity to antidepressants, cardiovascular disease

Tricyclic antidepressants

Work by inhibiting the reuptake of serotonin and norepinephrine.

Same as above

Patients with orthostatic hypotension, bundle-branch disease

Musculoskeletal agents

There are two types; antispasmodics and antispasticity. The latter works directly on the skeletal muscle and on the spinal cord. Antispasmodics alters conduction in the CNS hence decrease muscle spasms.

They are used as muscle relaxants and musculoskeletal spasmodic pain.

Severe hepatic and renal dysfunction and patients who have hypersensitivity to these agents.

Topical analgesics

Its mode of actions is the same as described above, but are applied transdermally.

Management of moderate to severe acute and chronic pain

Patients who have sympathetic systems blocks