This article focuses on pain management, pain is a sensation felt which is very unpleasant to a human. The main objectives while managing pain is to decrease the intensity of pain and improve the quality of life.Since pain is unavoidable in human life many methods have been introduced in order to prevent or decrease the intensity of pain. Treating pain has become easy with the introduction of various methods such as Pain Scale.Based on the scale marked by the patients, the particular drug and dose will be administered to the patients.Pharmacological and non – pharmacological treatment has been introduced in pain management.Treating pain mainly involve pain – killer medications which mainly has certain side effects and at times chronic pain are often prescribed with Opioid Analgesics which can cause drug dependence and overdose on the patients.Non –pharmacological treatment mainly focuses on treatment that does not require medication such as relaxation therapy.However, for pharmacological treatment it focuses on the various medications that are prescribed to patients based upon the type of pain they are suffering.For better patient care checking WHO guidelines such as WHO Analgesic ladder is of prime importance.

Toxic epidermal necrolysis (TEN) is a rare, and life-threatening condition that affects people of all ages, causing peeling and blistering of skin over the body. The main cause for Toxic epidermal necrolysis is drugs, which can also be triggered by infections and malignancy. Also, the genetic background of the patient, the coexistence of cancer, or concomitant radiotherapy can have an impact on the incidence of SJS(Steven Johnson syndrome ) and TEN. Fluconazole is an antifungal medication indicated and belongs to the azole class of drugs, which work by reducing ergosterol synthesis by inhibiting the fungal cytochrome P450 enzyme. After taking the tablet fluconazole 150mg for 5 days a 40-year-old male patient presented with complaints of discharge from eyes & redness for 5 days, Asymptomatic red lesions all over the body for 5 days, painful lesions in the oral cavity for 3 days, Pins and needle sensation over both feet increased while walking, and fever for 1 day. When the patient admitting to TEN, the most important thing is to analyze the patient's past medical history and medication history. The patch test confirmed that the patient has an allergic reaction to T. Fluconazole, hence it was discontinued. Through effective systemic and topical therapy, the patient's condition is improved, also the weekly checkup will be helpful for further monitoring.

Fixed drug eruption (FDE) is a form of drug-induced cutaneous adverse event caused by Type IV or delayed cell-mediated hypersensitivity that manifests as a recurrence of a comparable lesion at the same skin or mucosal site after systemic drug exposure. In all age groups of patients, paracetamol is the most usually given analgesic-antipyretic medication. A modest number of pruritic, well-circumscribed, erythematous macules are typical of a fixed drug eruption. These lesions usually reoccur at the same location and go away on their own once the causative substance is stopped. Fixed drug eruption is a well-known but rare side effect of paracetamol, most typically the classic, pigmenting variety encountered in children and teenagers. Paracetamol is a frequently prescribed analgesic and antipyretic with a well-established safety profile. We present a case of a 40-year-old male who had FDE as a result of paracetamol, resulting in generalised necrosis of the skin over his body. Patient presented with burning sensation of eyes along with watering of eyes. He had disturbed sleep secondary to burning sensation. The patient developed erosion in oral cavity since 2 days and also erosion in genitalia along with burning micturition since 1 day. The lesions resolved with a faint lingering hyperpigmentation after 15 days of treatment. Skin biopsy was performed from lesion on right arm. After starting the suggested course of treatment, the symptoms considerably improved.