Analgesia

While sold under many different brand names, the three main nonaddictive analgesics are aspirin, acetaminophen, and ibuprofen.

Aspirin was first synthesized in 1853 from vinegar and salicylic acid (acetylsalicylic acid). It is a member of the salicin family, which is a bitter white chemical found in willow bark and leaves. The analgesic qualities of willow bark were known to the ancient Greeks and others throughout the ages. In 1898 a German company, Bayer, further developed and marketed acetylsalicylic acid from industrial dyes and one year later named it aspirin. It soon became enormously popular as a pain reliever and antifever medicine. Its use as an anti-inflammatory for the treatment of arthritis and rheumatism made it the "gold standard" for readily available pain relief.

One of the major drawbacks of aspirin, however, is its effect on the stomach. It acts as an irritant and can cause bleeding ulcers in persons who take it over a long period of time. Recent research shows that aspirin's effectiveness not only as an analgesic but also as an anticoagulant makes it useful in the treatment of heart attacks and stroke, as well as in preventive medicine for other diseases.

Acetaminophen, introduced in 1955, is an over-thecounter drug that has become a very popular alternative to aspirin, since it relieves moderate pain without irritating the stomach. For the treatment of arthritis and rheumatism, acetaminophen does not have aspirin's anti-inflammatory effect, but as a pain and fever reliever it is just as effective as aspirin.

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) first introduced as a prescription drug in 1974. The Food and Drug Administration allowed it to be marketed as an over-the-counter drug in 1984. As an analgesic for minor pain and fever, it has about the same performance as aspirin and acetaminophen. Unlike acetaminophen, however, it can be irritating to the stomach.