Downloaded 26 times
Uploaded byDiana Rangaves, PharmD, CEO
Anesthetics, Analgesics & Narcotics
This document discusses pain management and anesthetics. It covers topics like general anesthesia, local anesthetics, opioids, non-opioid pain relievers, and the treatment of migraines. It also examines non-drug pain management techniques and provides an overview of headache classification and therapeutic agents for treatment.
More Related Content
Similar to Anesthetics, Analgesics & Narcotics
More from Diana Rangaves, PharmD, CEO
Anesthetics, Analgesics & Narcotics
- 3. 3 Anesthetics, Analgesics & Narcotics PainManagement Opioids (Narcotics) Management of Migraine
- 4. 4 General Anesthesia Reversible unconsciousness Absenceof a response to painful stimuli Characteristics Unawareness Analgesia Skeletal & muscle relaxation Amnesia on recovery
- 6. 6 Types of GeneralAnesthesia Inhalant Anesthetics Nitrous Oxide Injectable Anesthetics Barbiturates, Benzodiazepines Ketamine – dissociative amnesia Antagonists Naloxone Neuromuscular Blockers
- 7.
- 8. 8 Local Anesthetics Transient, reversibleloss of sensation in a specific body area No change in alertness or mental functioning Indications Sunburn, bites, cuts, dental work, hemorrhoids Chemical Agents Benzocaine, lidocaine, cocaine
- 10. 10 What is Pain? Anunpleasant sensory or emotional experience which we primarily associate with tissue damage. Pathway damages the nerve pain impulse to brain
- 11. Opioid Receptor BrainDistribution
- 12.
- 13.
- 16. 16 Pain Syndromes Acute Pain recent onset, transient, identifiable cause Chronic Pain persistent or recurrent pain, beyond usual course of acute illness or injury Nonmalignant Diagnosed or undiagnosed cause such as a nonmalignant disease Malignant Disease present pain severity worsens as progresses Breakthrough Pain transient pain, severe or excruciating, over baseline of moderate pain
- 18. 18 ABC’s of PainManagement
- 19.
- 20. 20 Non-Drug Pain Management Techniques Distraction Ice/Heat TV/read/visiting Relaxation Breathing, yoga Tapes, music Massage Biofeedback Acupuncture Imagery Pleasant mental picture
- 21. 21 Pain Neuro Transmitters PainRelief Meds Substance P Glutamate GABA Norepinephrine Serotonin Histamine NSAIDS Antidepressants Anti seizure meds Muscle relaxants Local salves- capsaicin Narcotics
- 22. 22 Opioids (God Morpheusof Dreams) Narcotics (Narcosis—stupor) Produce analgesia by binding to opiate receptors in the CNS, brain and spinal cord involved with the transmission of pain impulses. Endogenous opioids are present at brain sites Released during stress, pain & anticipation of pain
- 23. 23 Common Opioid SideEffects
- 24.
- 25. 25 Toxicity Opioid Antagonists Tolerance Dependence Physical Psychological Overdose DrugInteractions Contraindications Agents Naloxone Naltrexone MOA Indications
- 26. 26 Analgesic Ladder NSAID (ASA) Adjuvantanalgesic (APAP, antihist) Non-narcotic analgesic (NSAID) Weak opioid (Codeine, propoxyphene) Strong opioid (Morphine) with adjuvant analgesic
- 27.
- 28.
- 29. 29 Oxycontin Abuse When tabletsare crushed, snorted or extracted & injected. Effective, less toxic, well-tolerated medication. Backlash ‘war on drugs’ challenges legitimate users
- 30. 30 Non-Opioid Agents Non-Steroidal Anti-InflammatoryDrugs (NSAIDS) Aspirin (prototype) Indications Anti-inflammatory Analgesic Anti-pyretic Anti-platelet Dosage Toxicity Reye’s Syndrome brain pressure COX-2 Inhibitors Celebrex Mobic MOA Toxicity
- 32. 32 Headache Classification Primary: noknown cause Tension type Episodic Chronic Migraine Secondary: known cause
- 33. 33 Headache Triggers Physical causes Hormonalfactors Menstrual migraines Sleep Oversleeping, fatigue Environmental causes Weather, seasons, light, odors, altitude... Medications Dietary factors
- 34. 34 Migraine Tension Headache Lasts4-72 hours Prodrome or aura Unilateral,pulsating Moderate-severe Aggravated by strain Nausea, vomiting photo/phono phobia Lasts 30min to 7days Bilateral No pulsation Mild to moderate Not aggravated by strain
- 35. 35 Migraine Headaches Pathogenesis Vasodilation 5-HT mediated ErgotPreparations Constrict blood vessels Rebound HA w/overuse Caution > 40yr Heart attack risk
- 36. 36 Therapeutic Management Selective 5-HTreceptor agonist Bind to serotonin receptors to cause vasoconstriction of the blood vessels Anti emetics Reduces nausea, vomiting and gastritis Opioid analgesics Blocks impulses to the brain
- 37. 37 Prophylaxis Management Anticonvulsants Beta blockers Preventsvasodilation Ca channel blocker NSAID Relieve inflammation & are non-sedating TCA Induces sleep, relaxation
- 38. 38 Herbal Remedies Feverfew Peppermint oil Valerianroot Ginkgo Lemon balm Caffeine
- 39.
- 40. 40 Summary Slide General Anesthesia ABC’sof Pain Management (drug & nondrug) Narcotics/Opiates Organ Effects Common Opioid Side Effects Analgesic Ladder Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
- 41. 41 Summary Slide (cont.) HeadacheClassification Therapeutic Agents