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5. opioid analgesics

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Pharmacology
Third Year

Published in: Health & Medicine
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5. opioid analgesics

  1. 1. Opioid analgesics
  2. 2. Analgesics • Drugs that relieve pain without loss of consciousness ►Opioid or narcotic analgesics (morphine type) ►Non-opioid or NSAIDs (aspirin type)
  3. 3. Opioids Opium: – white latex (exudate) obtained by incision of seed pod of Papaver somniferum Classification • Naturally occurring: Morphine, Codeine • Synthetic: Pethidine, Fentanyl, Methadone, Loperamide, Opioid antagonists: Naloxone, Naltrexone. Mixed agonist-antagonist: Pentazocine Opioid Receptors: μ, Ќ, & δ • μ: Supraspinal analgesia, Euphoria/Sedation, Respiratory depression, Pupillary constriction,  GI motility. • Ќ : Spinal analgesia/sedation • δ: Spinal analgesia, opioid reinforcement & reward
  4. 4. Pharmacological actions of Morphine Opioids act by stimulating the μ, Ќ, & δ receptors • Miosis, decrease in pupil size • Analgesia • Respiratory depression • Physical & psychological dependence • Hypotension, • Nausea and vomiting • Cough suppression & constipation • Sedation
  5. 5. Uses of Opioids MORPHINE Analgesic (Severe, sharp, visceral pain) Myocardial Infarction, Burns, Fracture of long bones, Cancer pain, Acute pulmonary oedema PETHIDINE Analgesic similar to Morphine Epidural analgesia for Obstetric labour METHADONE De-addiction of Heroin /Morphine
  6. 6. Uses of Opioids Other opioids: • Codeine : Cough Suppression (Antitussive ) • Loperamide: Non infective diarrhoea • Fentanyl + Droperidol: Neuroleptanalgesia • Fentanyl + Droperidol + N2O: Neuroleptanesthesia • Transdermal Fentanyl: Chronic neuropathic pain
  7. 7. Adverse effects of Morphine 1. Vomiting 2. Respiratory depression 3. Constipation 4. Itching and skin rash (histamine release) 5. Tolerance develops to most of the effects of morphine except miosis & constipation. 6. Drug dependence ( physical & psychological ) Morphine poisoning: • Known addict with needle marks, coma, pinpoint pupils, depressed respiration, & constipation. • Antidote- Intra venous Naloxone • General supportive measures •
  8. 8. Contraindications of Morphine • Head injury • Pregnancy • Neonates & Elderly • Dysentery in children • Biliary colic • Chronic obstructive pulmonary disease • Hepatic & renal diseases. • Hypothyroidism

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