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D3 Analgesics . By Cameron Precord and Quin Peek And edited by Ms. Smith. Pain. Pain-described as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage
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D3 Analgesics By Cameron Precord and Quin Peek And edited by Ms. Smith
Pain Pain-described as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage Pain receptors-free nerve endings located in various tissues that respond to thermal, mechanical or chemical stimuli When stimulated, these pain receptors generate an impulse Pain results from interaction between more than one impulse arriving at the spinal cord and brain
When tissue is damaged, it releases chemicals known as prostaglandins and leukotrienes These sensitized receptors react to even slight stimuli, causing pain ( an injury being tender) Different people feel pain differently Analgesics are drugs that relive pain without causing a loss of consciousness.
Two Types of Analgesics • MILD ANALGESICS • relieve “mild” pain and often fever • non-addictive • Examples include • Aspirin • Acetaminophen • Phenacetin • Ibuprofen • NSAIDS (Nonsteroidalanti-inflammatory drugs) • STRONG ANALGESICS (OPIATES) • relieve severe pain • controlled substances • addictive • Examples include • Morphine • Heroin • Codeine
Aspirin – MILD ANALGESIC – a derivative of Salicylic Acid • Used in four different ways: • Mild analgesic for minor aches and pains, to relieve headaches, sunburn and arthritic pain • anti-pyretic to mitigate fever • anti-inflammatory agent (reducing swelling) • anti-platelet agent (decrease/prevent blood clotting)
Disadvantages of Using Aspirin • acidic; cause upset stomach, internal bleeding, ulcers • When taken with alcohol may produce gastrointestinal bleeding • .5% of people are allergic to aspirin • develop skin rashes, respiratory issues, and may go into shock • frequent causes of poisoning among infants • May lead to REYES Syndrome a potentially fatal liver and brain disorder which may result in brain damage, coma, death
Alternatives to Aspirin • Phenacetin • Acetaminophen • Metabolic byproduct of phenacetic • AKA • Tylenol • Known as paracetamol in some countries • Properties - Advantages • Anti-pyretic • Mild analgesic • Does NOT upset stomach • does NOT cause internal bleeding • Properties - Disdvantages • Not anti-inflammatory • Side effects include blood disorders… damage to kidnes… • Not safe to take with alcohol • Overdose can cause liver damage, brain damage, coma, death
Strong Analgesics • aka Opiates or Narcotics • Opiate = any natural or synthetic drugs that produces morphine-like characteristics • Narcotic = drug that has both sedative and analgesic action • Examples include • Morphine – natural – opium poppy plant • Heroin - semi-sythetic • Codeine – natural – opium poppy plant • Structures are similar… but… • Heroin has the two OH groups in morphine replaced with ester groups. • Codeine replaces one OH group of Morphine with a OCH3 group.
Strong Analgesics Heroin is most potent, then morphine, then codeine
Opiates impact Central nervous system Pain relief due to injury, surgery, chronic disease (cancer) Relieves coughing by relaxing the ‘cough center’ in the brain stem. Digestive system Produces a Constipating Effect – used for diarrhoea Impact Psychological state Relief from physical, emotional, and psychological pain. Advantages of Strong Analgesics
Disadvantages of Strong Analgesics Impact physical state Constipation Nausea Vomiting Sedation Can lead to tolerance and physical dependence Psychological state Mood changes metal clouding Anxiety Fear lethargy sedation, ackof concern inability to concentrate Can lead to psychological dependence
Short sedation / stupor pain relief euphoria impaired coordination reduced tension and fear suppressed coughing reflex occasional deaths from overdose LONG loss of appetite constipation risk of infections through shared needles withdrawal loss of job / income crime sterility loss of energy Common Short and Long Term Effects
Tolerance and Dependence • Tolerance – body needs more of the drug to have the desired impact • Cross tolerance - Users who develop tolerance for one opiate will begin to tolerate all other opiates. • Physical Dependence – inability to function normally without the drug • users experience withdrawal • Restlessness, sweating, fever, chills, vomiting, increased respiration, cramping, diarrhoea, aches, pains
Synthetic Opiates • demerol • methadone • bocks euphoric high of heroin • used to break addiction to heroin • dextromethorphan • can replace codeine • non-narcotic • used in cough syrups
Two Types of Anesthetics • LOCAL ANESTHETICS • Reversible loss of sensation (and pain) in a localized area • Maintain consciousness • Examples include • Lidocaine • Procaine used in dentistry • GENERALIZED ANESTHETICS • act on the brain • produce reversible unconsciousness and insensitivity to pain • Examples include • Inhalants: Isoflurane, Desflurane; sevoflurane; Nitrous oxide • IV : barbituates, benxodiazepines, ketamine
Practice Problems Can Be Found on Page 434 of your Green and Damji Book