Opioids

1,502 views

Published on

long presentation

0 Comments
6 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
1,502
On SlideShare
0
From Embeds
0
Number of Embeds
4
Actions
Shares
0
Downloads
151
Comments
0
Likes
6
Embeds 0
No embeds

No notes for slide

Opioids

  1. 1. Opium poppies are white flowers that thrive in the dry, warm   climate of southern Asia.   This field was grown for   pharmaceutical purposes.     <br />OPIOIDS<br />DR CHANDRA SEKHAR BEHERA<br />PG 2ND YEAR ANAESTHESIOLOGY<br />The Magic within The Flower of Joy<br />Monday, November 16, 2009<br />1<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  2. 2. OPIUM<br />Monday, November 16, 2009<br />2<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  3. 3. HISTORY<br />Monday, November 16, 2009<br />3<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  4. 4. HISTORY<br />Monday, November 16, 2009<br />4<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  5. 5. HISTORY<br />Monday, November 16, 2009<br />5<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  6. 6. HISTORY<br />Monday, November 16, 2009<br />6<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  7. 7. INTRODUCTION<br />Monday, November 16, 2009<br />7<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  8. 8. CLASSIFICATIONS<br />Monday, November 16, 2009<br />8<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  9. 9. ENDOGENOUS OPIOIDS<br />Monday, November 16, 2009<br />9<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  10. 10. ENDORPHINS<br />
  11. 11. ENKEPHALLINS<br />Monday, November 16, 2009<br />11<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  12. 12. STRUCTURE ACTIVITY<br />Monday, November 16, 2009<br />12<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  13. 13. Structure - T<br />Monday, November 16, 2009<br />13<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  14. 14. MORPHINE<br />Monday, November 16, 2009<br />14<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  15. 15. Schematic of Presynaptic Opiate action<br />Monday, November 16, 2009<br />15<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  16. 16. RECEPTORS<br />Monday, November 16, 2009<br />16<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  17. 17. RECEPTORS<br />Monday, November 16, 2009<br />17<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  18. 18. OPIOID RECEPTORS<br />Monday, November 16, 2009<br />18<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  19. 19. RECEPTOR ACTIVITY<br />Monday, November 16, 2009<br />19<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  20. 20. TERMINOLOGY<br />Monday, November 16, 2009<br />20<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  21. 21. CLASSIFICATION<br />Monday, November 16, 2009<br />21<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  22. 22. PARTIAL AGONISTS<br />Monday, November 16, 2009<br />22<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  23. 23. PARTIAL AGONISTS<br />Monday, November 16, 2009<br />23<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  24. 24. AGONISTS<br />Monday, November 16, 2009<br />24<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  25. 25. ANTAGONISTS<br />Monday, November 16, 2009<br />25<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  26. 26. AGONISTS - ANTAGONISTS<br />Monday, November 16, 2009<br />26<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  27. 27. ANALGESIA<br />Monday, November 16, 2009<br />27<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  28. 28. ANALGESIA<br />Monday, November 16, 2009<br />28<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  29. 29. AGE EFFECTS<br />Monday, November 16, 2009<br />29<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  30. 30. PHARMACODYNAMICS<br />Monday, November 16, 2009<br />30<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  31. 31. CNS<br />Monday, November 16, 2009<br />31<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  32. 32. CNS<br />Monday, November 16, 2009<br />32<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  33. 33. CNS<br />Monday, November 16, 2009<br />33<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  34. 34. CNS<br />Monday, November 16, 2009<br />34<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  35. 35. OTHER CNS EFFECTS<br />Monday, November 16, 2009<br />35<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  36. 36. MUSCLE RIGIDITY<br />Monday, November 16, 2009<br />36<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  37. 37. CEREBRAL BLOOD FLOW<br />Monday, November 16, 2009<br />37<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  38. 38. CEREBRAL BLOOD FLOW<br />Monday, November 16, 2009<br />38<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  39. 39. CVS<br />Monday, November 16, 2009<br />39<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  40. 40. CVS EFFECTS<br />Monday, November 16, 2009<br />40<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  41. 41. CVS EFFECTS<br />Monday, November 16, 2009<br />41<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  42. 42. CVS:BRADYCARDIA<br />Monday, November 16, 2009<br />42<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  43. 43. RESPIRATORY<br />Monday, November 16, 2009<br />43<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  44. 44. RESPIRATORY<br />Monday, November 16, 2009<br />44<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  45. 45. RESPIRATORY<br />Monday, November 16, 2009<br />45<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  46. 46. FACTORS INCREASING RESPIRATORY DEPRESSION<br />Monday, November 16, 2009<br />46<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  47. 47. GIT<br />Monday, November 16, 2009<br />47<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  48. 48. GUT<br />Monday, November 16, 2009<br />48<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  49. 49. NEUROENDOCRINE <br />Monday, November 16, 2009<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />49<br />
  50. 50. Monday, November 16, 2009<br />50<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  51. 51. TOLERANCE TO OPIOIDS<br />Monday, November 16, 2009<br />51<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  52. 52. PHARMACOKINETICS<br />Monday, November 16, 2009<br />52<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  53. 53. IMPORTENCE OF KINETICS IN OPIOIDS<br />Monday, November 16, 2009<br />53<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  54. 54. IDEAL KINETICS FOR OPIOID INFUSION<br />Monday, November 16, 2009<br />54<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  55. 55. PHARMACOKINETIC PROPERTIES OF OPIOIDS<br />Monday, November 16, 2009<br />55<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  56. 56. MORPHINE<br />Monday, November 16, 2009<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />56<br />
  57. 57. MORPHINE<br />Poor lipid solubility and vd-3-5l/kg<br />Conversion of phamacologicaly active metabolite m6g<br />Slow onset and prolong duration<br />Pka-8.0 ,<br />% unionised at pH-7.4-23<br />%plasma protein binding-35<br />Clearance-15-30ml/min/kg<br />Monday, November 16, 2009<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />57<br />
  58. 58. INDICATIONS<br />Morphine can be used as an analgesic in hospital settings to relieve:<br />pain in myocardial infarction<br />pain in sickle cell crisis<br />pain associated with surgical conditions, pre- and postoperatively <br />pain associated with trauma <br />severe chronic pain, e.g., cancer<br />pain from kidney stones (renal colic, ureterolithiasis) <br />severe back pain<br />Morphine can also be used:<br />as an adjunct to general anesthesia<br />in epidural anesthesia or intrathecal analgesia <br />for palliative care (i.e., to alleviate pain without curing the underlying reason for it, usually because the latter is found impossible) <br />as an antitussive for severe cough <br />as an antidiarrheal in chronic conditions (e.g., for diarrhea associated with AIDS, although loperamide (a non-absorbed opioid acting only on the gut) is the most commonly used opioid for diarrhea). <br />Monday, November 16, 2009<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />58<br />
  59. 59. CONTRADICTIONS<br />The following conditions are relative contraindications for morphine:<br />acute respiratory depression<br />renal failure (due to accumulation of the metabolites morphine-3-glucuronide and morphine-6-glucuronide) <br />chemical toxicity (potentially lethal in low tolerance subjects) <br />raised intracranial pressure, including head injury (risk of worsening respiratory depression) <br />Biliary colic.<br />Although it has previously been thought that morphine was contraindicated in acute pancreatitis, a review of the literature shows no evidence for this.<br />Monday, November 16, 2009<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />59<br />
  60. 60. CODEINE<br />Monday, November 16, 2009<br />60<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  61. 61. HEROIN<br />Monday, November 16, 2009<br />61<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  62. 62. HYDROMORPHONE<br />Monday, November 16, 2009<br />62<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  63. 63. OXYMORPHONE<br />Monday, November 16, 2009<br />63<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  64. 64. OXYCODEINE<br />Monday, November 16, 2009<br />64<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  65. 65. HYDROCODONE AND DIHYDROCODEINE<br />Monday, November 16, 2009<br />65<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  66. 66. PARTIAL AGONIST-BUPRENORPHINE<br />Monday, November 16, 2009<br />66<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  67. 67. SYNTHETIC COMPOUND<br />Monday, November 16, 2009<br />67<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  68. 68. MEPERIDINE<br />Monday, November 16, 2009<br />68<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  69. 69. FENTANYL<br />Monday, November 16, 2009<br />69<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  70. 70. USES<br />Extensivly used for anaesthesia and analgesia in both operating room and ICUsettings<br />Used with benzodiazepines and midazolam in endoscopic procedure,cardiac catheterisation, oral surgeries<br />Widely used as tansdermal patches to alleviate pain like in cancer<br />Fentanyl given in intrathecaly as spinal anaesthesia and epiduraly as epidural anaesthsia and anagesia<br />Monday, November 16, 2009<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />70<br />
  71. 71. SULFENTANIL<br />Monday, November 16, 2009<br />71<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  72. 72. ALFENTNIL<br />Monday, November 16, 2009<br />72<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  73. 73. REMIFENTANIL<br />Monday, November 16, 2009<br />73<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  74. 74. METHADONE<br />Monday, November 16, 2009<br />74<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  75. 75. LAAM<br />Monday, November 16, 2009<br />75<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  76. 76. TRAMADOL<br />Monday, November 16, 2009<br />76<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  77. 77. ANTAGONISTS<br />Monday, November 16, 2009<br />77<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  78. 78. SIGNS OF OVERDOSE<br />Monday, November 16, 2009<br />78<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  79. 79. NALOXONE<br />
  80. 80. NALTREXONE<br />Monday, November 16, 2009<br />80<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  81. 81. NALMEFENE<br />Monday, November 16, 2009<br />81<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  82. 82. MIXED AGONIST ANTAGONIST<br />Monday, November 16, 2009<br />82<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  83. 83. NALORPHIN AND CYCLOZOCINE<br />Monday, November 16, 2009<br />83<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  84. 84. PENTAZOCINE<br />Monday, November 16, 2009<br />84<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  85. 85. BUTORPHANOL<br />Monday, November 16, 2009<br />85<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  86. 86. NALBUPHINE<br />Monday, November 16, 2009<br />86<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  87. 87. DEPENDENCE AND ADDICTION<br />Monday, November 16, 2009<br />87<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  88. 88. WITHDRAWAL<br />Monday, November 16, 2009<br />88<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  89. 89. WITHDRAWAL<br />
  90. 90. OPIOID ANAESTHESIA<br />Monday, November 16, 2009<br />90<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  91. 91. OPIOID ANAESTHESIA<br />Monday, November 16, 2009<br />91<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  92. 92. ANAESTHESIA<br />
  93. 93. ANAESTHETIC TECNIQUES USING OPIOIDS<br />Monday, November 16, 2009<br />93<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  94. 94. PCA<br />Monday, November 16, 2009<br />94<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  95. 95. PCA<br />Monday, November 16, 2009<br />95<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  96. 96. PCA<br />Monday, November 16, 2009<br />96<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  97. 97. OPIOID PATHWAY<br />Monday, November 16, 2009<br />97<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />
  98. 98. Monday, November 16, 2009<br />98<br />DEPT OF ANAESTHESIA MKCG MEDICAL COLLEGE<br />

×