1 / 28

Chapter 13

Chapter 13. Opioids. General Classifications. A family of drugs which cause: Sleep Stuporous state Analgesic action Origins: Natural Synthetic. Narcotics Are….

yetta
Download Presentation

Chapter 13

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. Chapter 13 Opioids

  2. General Classifications • A family of drugs which cause: • Sleep • Stuporous state • Analgesic action • Origins: • Natural • Synthetic

  3. Narcotics Are… • The term narcotic currently refers to naturally occurring substances derived from the opium poppy and their synthetic substitutes. • These drugs are referred to as the opioid (or opiate) narcotics because of their association with opium.

  4. Narcotics Are… • For the most part, the opioid narcotics possess abuse potential, but they also have important clinical value (analgesic, antitussive). • The term narcotic has been used to label many substances, from opium to marijuana to cocaine.

  5. Natural Opiates • Opium, Morphine, Codeine, Thebaine OPIUM CODEINE MORPHINE THEBAINE

  6. Semisynthetic Narcotics • Heroin, Hydromorphone, Thebaine deriviatives, Etorphine • Produced by modifying the chemical compounds of natural substances • Morphine heroin and hydromorphone • Thebaine thebaine deriviatives and etorphine

  7. Synthetic Narcotics • Meperidine • Methadone • LAAM • Propoxyphene • Fentanyl

  8. Endogenous Opioids • Endorphins • Enkephalins • Dynorphins

  9. History • From an annual plant • Egyptian and Greek cultures • India and China • Opioids dependence • Writers and Opium • Opium Wars • Started by outside incidents • Britain given the island of Hong Kong for winning

  10. Narcotics & the Law • 1906 Federal Food & Drug Act • Prohibits interstate commerce of misbranded drugs • Must list ALL narcotic ingredients • Must list purity of the drug • 1914 Harrison Narcotics Act • Established governmental narcotics control • Outlawed nonmedical use of heroin • Permitted prescription of narcotics • Mistakenly classified cocaine as a narcotic • Eventually forbade dispensing of narcotics to known addicts

  11. Production of Narcotics • 1924 – importation of heroin outlawed • 1942 – cultivation of opium banned • 1935 & 1938 – hospital farms for drug treatment • 1970 – Comprehensive Drug Abuse Prevention and Control Act • Consolidated drug laws & became legal foundation for reducing illegal drug use • Created the Controlled Substances Act • Psychoactive drugs other than alcohol, nicotine, and caffeine were categorized into 5 Schedules • Presumed potential for abuse • Current acceptability in medical practice

  12. Side Effects • The principle side effects of the opioid narcotics, besides their abuse potential, include: • Drowsiness • Respiratory depression • Nausea, vomiting, and constipation • Inability to urinate • Drop in blood pressure

  13. Pharmacological Effects • The most common clinical use of the opioid narcotics is as analgesics to relieve pain. • The opioid narcotics relieve pain by activating the same group of receptors that are controlled by the endogenous substances called endorphins. • Activation of opioid receptors blocks the transmission of pain through the spinal cord or brain stem.

  14. Pharmacological Effects • Morphine is a particularly potent pain reliever and is often used as the analgesic standard by which other narcotics are compared. • With continual use, tolerance to the analgesic effects of morphine and other narcotics develops. • Physicians frequently under-prescribe narcotics, because of fear of causing narcotic addiction.

  15. What Are The Effects? • Pain Relief • Reduce fears & anxiety • Induce sleep if used alone • Heavy use will cause dependence, tolerance, addiction, withdrawal symptoms • CNS depression without loss of motor control, coordination, or speech • Adverse effects – irregular breathing, euphoria, pupil constriction, cloud mental function

  16. Abuse, Tolerance, Dependence, and Withdrawal • All the opioid narcotic agents that activate opioid receptors have abuse potential and are classified as schedule drugs. • Tolerance begins with the first dose of a narcotic, but does not become clinically evident until 2 to 3 weeks of frequent use.

  17. Abuse, Tolerance, Dependence, and Withdrawal • Tolerance occurs most rapidly with high doses given in short intervals • Doses can be increased as much as 35 times in order to regain the narcotic effect • Physical dependence invariably accompanies severe tolerance • Psychological dependence can also develop with continual narcotic use

  18. Morphine • 1806 morphine was discovered • 10 times as potent as opium • Hypodermic syringe and war time medicine • “Soldier’s disease”

  19. Heroin • Heroin is classified as a Schedule I drug • Heroin is the most widely abused illegal drug in European and Far Eastern countries • Until 15 years ago, Heroin was illicitly used more than any other drug of abuse in the U.S. (except for marijuana) • What was it replaced by? • Cocaine

  20. HEROIN • Most widely abused opioid – 90% • 300,000 occaisional/800,000 chronic • Over the past 5 yrs. – huge comeback WHY • Initially injected, now more commonly snorted • Media promotion

  21. Methods of Administration • Sniffing the powder • Injecting it into a muscle (intramuscular) • Smoked • Mainlining (intravenous injection)

  22. Facts on Heroin • Initially thought of having fewer side effects than morphine (medical use), but unaware of high dependencey rate • Illegal for possession – felony offense • Research is being done on effects on cancer tx patients – could move drug to Schedule II

  23. Characteristics • Duration of effects : 3 – 6 hours • High Physical dependence • Potency of the drug has increased from 40% to 80% • “China White” – 90% pure • Threat of HIV and AIDS reduced due to smoking or snorting of the drug • Often combined with • Cocaine • Marijuana

  24. Rush Quick binding to opioid receptors in the brain Effect on the limbic system CNS depressant can cause death Dependency Rapid development of: psychological and physical dependence Withdrawal symptoms occur about 8 hrs. after last dose taken – symptoms can last as long as 7 – 30 days Continued use due to fear of withdrawal Fetus effects Other Aspects

  25. Heroin Addicts And AIDS • Over 50% of IV heroin users have been exposed to the AIDS virus

  26. Withdrawal Symptoms • A single “shot” of heroin lasts 4 to 6 hours • After the effects of the heroin wear off, the addict has only a few hours in which to find the next dose before severe withdrawal symptoms begin • Withdrawal symptoms: • runny nose, tears, • minor stomach cramps, loss of appetite, vomiting, diarrhea, abdominal cramps, • chills, fever, aching bones, and muscle spasms

  27. Treatment • Methadone • frequently used to help narcotic addicts • Oral methadone relieves the withdrawal symptoms • Can cause psychological and physical dependence

  28. Morphine Methadone Fentanyl Hydromorphone Meperidine MPTP Codeine Pentazocine Propoxyphene Other Narcotics

More Related