Transcript Chapter 16 Cholinesterase Inhibitors

Chapter 27
Opioid (Narcotic) Analgesics,
Opioid Antagonists, and
Nonopioid Centrally Acting
Analgesics
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Opioid (Narcotic) Analgesics
• Analgesic
– Relieves pain without loss of consciousness
• Opioid
– Drug similar to morphine
– Derived from opium
• Narcotic
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Morphine
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Prototype of strong opioid analgesics
Used for relief of moderate and severe pain
Decreases sensation of pain
Decreases the emotional reaction to pain
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Morphine
• Adverse effects
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Respiratory depression
Constipation
Orthostatic hypotension
Urinary retention
Biliary colic
Cough suppression
Emesis
Increased IOP
Miosis
Euphoria/dysphoria
Sedation
Miosis
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Tolerance
• Tolerance
– Increasing doses to obtain same response
– Develops with analgesia, euphoria, sedation,
respiratory depression
– Cross-tolerance to other opioid agonists
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Physical Dependence
• Abstinence syndrome occurs if drug abruptly stopped
• Abstinence syndrome is dependent on
– Half-life of drug
– Degree of physical dependence
Copyright (c) 2004 Elsevier Inc. All rights reserved.
Opioid Overdose
• Classic triad
– Coma
– Respiratory depression
– Pinpoint pupils
• Treatment
– Ventilatory support
– Opioid antagonist
• Naloxone (Narcan)
Copyright (c) 2004 Elsevier Inc. All rights reserved.