1 / 9

ANALGESICS

NARCOTIC & OPIOID. ANALGESICS. narke----any substance that relieved pain, dulled the senses, or induced sleep Opiate receptors are distributed widely in the brain , and are found in the spinal cord and digestive tract . narcotic=substance that binds to opiate receptors or

eleone
Download Presentation

ANALGESICS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. NARCOTIC & OPIOID ANALGESICS narke----any substance that relieved pain, dulled the senses, or induced sleep Opiate receptors are distributed widely in the brain, and are found in the spinal cord and digestive tract. narcotic=substance that binds to opiate receptors or illicit substance pain will give release of opiates (endorphins and enkephalins, dynorphin) Act like inhibitory transmitters… yields less pain.

  2. ANALGESICS opium poppy used by Egyptians,Greeks, Romans. morphine=purified constituent of opium---- Morpheus---Greek god of dreams….euphoria MOA----these drugs interact with specific receptor sites and have effect on CNS, acting on receptors located on neuronal cell membranes. The presynaptic action of opioids to inhibit neurotransmitter release is considered to be their major effect in the nervous system. also acts on gut wall and joints. Even in therapeutic doses, narcotic analgesics can cause respiratory depression, nausea, and drowsiness. Long term administration produces tolerance, psychic, and physical dependence called addiction. These drugs are commonly prescribed to manage pain, but can also be prescribed to treat diarrhea (Lomotil) or severe cough (codeine).

  3. ANALGESICS Narcotic agents may be classified into four categories: 1--Morphine and codeine-- natural alkaloids of opium. 2---Synthetic derivatives of morphine such as heroin. 3--- Synthetic agents which resemble the morphine structure. 4---Narcotic antagonists which are used as antidotes for overdoses of narcotic analgesics.

  4. ANALGESICS opioids --- bind to presynaptic nerve terminal calcium channels. this shortens action potential and yields inhibitied neurotransmitter release. The postsynaptic actions of opioids are usually inhibitory. opioids---bind to postsynaptic receptors in ascending pain pathway yields reduced action potential opioids---Nociceptive information is transmitted to the brain via the spinothalamic tracts. This ascending information can activate descending pathways which cause increased transmission of the descending inhibition of spinal nociceptive conduction. http://nba.uth.tmc.edu/neuroscience/s2/chapter08.html Usually Schedule II/III controlled drugs. adverse reaction----respiratory depression, constipation, confusion, naseau, euphoria consider----addiction and tolerance. federal and state laws for processing, dispensing, maintaining records.

  5. ANALGESICS examples—(moderate to severe pain) acet w codeine----tylenol w codeine codeine---Codeine fentanyl-----Duragesic patch hydrocodone----Hycodan acet w hydrocodone----Lortab hydromorphone----Dilaudid meperidine---Demerol methadone----Dolophine morphine----MS Contin oxycodone----Oxycontin acet w oxycodone----Percocet pentazocine---Talwin acet w propoxyphene----Darvocet

  6. NON-NARCOTIC ANALGESIC NSAIDs Nonsteroidal Antiinflammatory Drugs: prostaglandins have 20 carbon chain that includes 5 carbon ring. Make a prostaglandin-------cell injury releases arachidonic acid (fatty acid in cell membrane). cyclooxygenase(COX) will convert AA into PG. This irritates nerve endings, yields pain and inflammation. COX1 and COX2 hit different sites on AA. COX1 makes PG for kidney function,stomach protection mucous, blood clotting. COX2 makes PG for pain,heat, swelling. Most NSAID attack COX1 and COX2.

  7. NON-NARCOTIC ANALGESIC NSAID indications------fever, pain, antiinflammatory reactions----gastric upset, diarrhrea, kidney failure, hypertension NSAID examples--- ibuprofen----Motrin,Advil ketorolac---Toradol naproxen---Naprosyn celecoxib--Celebrex meloxicam---Mobic nabumetone---Relafen

  8. NON-NARCOTIC ANALGESIC COX2 inhibitor indications----rheumatoid arthritis, osteoarthritis, menstration cramps, acute pain reactions------GI issues, fluid retention example- only cox2 is celecoxib/Celebrex vioxx and bextra removed from production--MI,strokes Aspirin---from willow bark=acetylsalicyclic acid moa---reduced fever by increased skin blood flow and inhibit prostaglandin indications-- pain, inflammation, fever

  9. NON-NARCOTIC ANALGESIC aspirin reactions--- stomach ulcer, anemia, tinnitus, confusion, prolonged labor consider----not given to children exposed to chickenpox.(reyes syndrome) avoid with warfarin, 4g/day adult maximum Acetominophen---(APAP)tylenol max is 4g/day moa-----exact mechanism unknown, works on CNS not peripheral indications----fever, pain, inflammation reaction----avoid with warfarin, liver damage

More Related