Zusammenfassung
Die medikamentöse Therapie von Schmerzen ist mittelbar an die Ätiopathologie des zugrundeliegenden Krankheitsbildes gekoppelt. Die unterschiedlichen Auslöser der akuten und chronischen Schmerzen sowie die davon abweichenden Mechanismen des neuropathischen Schmerzes erfordern eine unterschiedliche Herangehensweise und Auswahl von analgetisch bzw. koanalgetisch wirksamen Substanzen. Grundsätzlich können akute Schmerzen durch Inhibition der Entstehung von Schmerzmediatoren, insbesondere Prostaglandin E2, durch direkte Inhibition nozizeptiver Schmerzfasern, z. B. Hemmung von Natriumkanälen, durch Inhibition der Schmerzweiterleitung und deren ganglionären Verschaltung sowie durch zentrale Dämpfung durch Stimulation von Opioidrezeptoren bekämpft werden. Die letzteren pharmakotherapeutischen Angriffspunkte erwiesen sich vor allem bei schweren akuten, aber auch bei chronischen Schmerzen als geeignet.
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Cascorbi, I. (2018). Analgetika. In: Medikamenten-Pocket Schmerztherapie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-57844-5_1
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