The document discusses narcotic analgesics and antagonists. It describes how narcotic analgesics like morphine bind to opioid receptors in the central and peripheral nervous system to relieve moderate to severe pain. It classifies opioids into natural alkaloids, semisynthetic derivatives, and synthetic compounds. The document outlines the mechanisms of action of opioids like morphine at the mu, kappa, and delta receptors. It also discusses the pharmacological actions, clinical uses, adverse effects, contraindications, and management of acute opioid poisoning of morphine.
Sympatholytic drugs (Adrenergic blockers) bind to the adrenergic receptors and prevent the action of adrenergic drugs.
These are drugs which block the actions of sympathetic division or catecholamines (adrenaline and noradrenaline).
They are competitive antagonists at both α and β adrenergic receptors.
Med chem lecture on Anticholinergic drugs for B.Pharm level in Nepal
Content from Foye's Principle of medicinal chemistry, my own thoughts and some articles
Sympatholytic drugs (Adrenergic blockers) bind to the adrenergic receptors and prevent the action of adrenergic drugs.
These are drugs which block the actions of sympathetic division or catecholamines (adrenaline and noradrenaline).
They are competitive antagonists at both α and β adrenergic receptors.
Med chem lecture on Anticholinergic drugs for B.Pharm level in Nepal
Content from Foye's Principle of medicinal chemistry, my own thoughts and some articles
depression ,symptoms, mechanism of depression ,classification of antidepressants , tri cyclic anti depressants and its pharmacological actions ,acute poisoning and treatment
General Anaesthesia (Medicinal Chemistry)Yogesh Tiwari
General anaesthetics are group of drugs that produces loss of consciousness, and therefore, loss of all sensations.
The absolute loss of sensation is termed as anaesthesia.
Neurohumoral transmission in CNS-
The term neurohumoral transmission designates the transfer of a nerve impulse from a presynaptic to a postsynaptic neuron by means of a humoral agent e.g. a biogenic amine, an amino acid or a peptide.
Parasympatholytics are the drugs that block or inhibit the actions of acetylcholine at postganglionic nerve endings and cholinergic receptors. They are also referred to as anticholinergics or cholinergic blocking agents or antispasmodics.
Anticholinergic drugs include atropine and related drugs- atropine is the prototype. Atropine is obtained from the plant Atropa belladonna. Atropine and scopolamine (hyoscine) are the belladonna alkaloids. They compete with acetylcholine for muscarinic receptors and block this receptors-they are muscarinic antagonists.
depression ,symptoms, mechanism of depression ,classification of antidepressants , tri cyclic anti depressants and its pharmacological actions ,acute poisoning and treatment
General Anaesthesia (Medicinal Chemistry)Yogesh Tiwari
General anaesthetics are group of drugs that produces loss of consciousness, and therefore, loss of all sensations.
The absolute loss of sensation is termed as anaesthesia.
Neurohumoral transmission in CNS-
The term neurohumoral transmission designates the transfer of a nerve impulse from a presynaptic to a postsynaptic neuron by means of a humoral agent e.g. a biogenic amine, an amino acid or a peptide.
Parasympatholytics are the drugs that block or inhibit the actions of acetylcholine at postganglionic nerve endings and cholinergic receptors. They are also referred to as anticholinergics or cholinergic blocking agents or antispasmodics.
Anticholinergic drugs include atropine and related drugs- atropine is the prototype. Atropine is obtained from the plant Atropa belladonna. Atropine and scopolamine (hyoscine) are the belladonna alkaloids. They compete with acetylcholine for muscarinic receptors and block this receptors-they are muscarinic antagonists.
These are the pharmacological agent which when administered externally relieves mild or moderate pains without degree of consciousness called as Analgesics are worked against the pain so firstly introduced the Pain sensation.
opioid analgesics with detailed description of introduction, mechanism of action, adverse effect, uses and contraindication along with examples for under graduates.
this is an important topic in palliative care. a form of care each of us may need when we suffer terminal illness and severe trauma at one point in our life time.
Pharmacology Experiment based Questions With Answer KeysA M O L D E O R E
MSBTE Pharmacology Practical Exam for Diploma in pharmacy students in Maharashtra.
Experimental pharmacology for D. Pharmacy Students
Pharmacology Experiment based Questions
PCI New Syllabus ER2020
Course Code: 20056
Antidepressants are a class of medication used to treat major depressive disorder, anxiety disorders, chronic pain conditions and to help manage addictions. Common side-effects of antidepressants include dry mouth, weight gain, dizziness, headaches, sexual dysfunction, and emotional blunting
Anatomy and physiology are two of the most basic terms and areas of study in the life sciences. Anatomy refers to the internal and external structures of the body and their physical relationships, whereas physiology refers to the study of the functions of those structures.
Animal cells are typical of the eukaryotic cell, enclosed by a plasma membrane and containing a membrane-bound nucleus and organelles. Unlike the eukaryotic cells of plants and fungi, animal cells do not have a cell wall. This feature was lost in the distant past by the single-celled organisms that gave rise to the kingdom Animalia. Most cells, both animal and plant, range in size between 1 and 100 micrometers and are thus visible only with the aid of a microscope.
All living organisms are made of cells and cellular products. The cell is the smallest structural, functional, and biological unit of all living organisms. It can capable of biosynthesis, replication and energy transformation. All cellular organelles carry out specific functions that are necessary for the normal functioning of the cell. Animal cells work together and function interdependently. Human cells vary in size, shape, and function. Most animal cells are so small they can only be seen with the aid of a microscope. Based on function, there are more than 200 different kinds of animal cells that help each system contribute to the homeostasis of the entire body. Despite their many differences, human cells have several similar structural features: a cell membrane, a nucleus, and cytoplasm and cell organelles.
Your sympathetic nervous system is best known for its role in responding to dangerous or stressful situations.
In these situations, your sympathetic nervous system activates to speed up your heart rate, deliver more blood to areas of your body that need more oxygen or other responses to help your get out of danger.
Its nerve fibers arise from the thoracic and lumbar regions of the spinal cord.
The autonomic ganglia are the synapses between preganglionic and postganglionic neurons. The postganglionic axons then go to the visceral effectors.
Acetylcholine is a neurotransmitter releases in the preganglionic nerve endings and Noradrenaline at postganglionic nerve endings.
The drugs which mimic the action sympathetic division are called sympathomimetics.
They show similar actions as that of catecholamines.
Sympathomimetic
They act by either by directly interacting with adrenergic receptors (alpha or beta) or stimulation of the adrenergic nerve endings.
The digestive system is made up of the gastrointestinal tract—also called the GI tract or digestive tract—and the liver, pancreas, and gallbladder. ... The hollow organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestine, and anus.
Hemostasis or haemostasis is a process to prevent and stop bleeding, meaning to keep blood within a damaged blood vessel (the opposite of hemostasis is hemorrhage). It is the first stage of wound healing. This involves coagulation, blood changing from a liquid to a gel.
Aminocaproates.
Antifibrinolytic Agents.
Estrogens, Conjugated (USP)
Hemostatics.
Tranexamic Acid.
Aprotinin.
Deamino Arginine Vasopressin
Sulfonamides (sulphonamides) are a group of man-made (synthetic) medicines that contain the sulfonamide chemical group. They may also be called sulfa drugs. Many people use the term sulfonamide imprecisely to refer only to antibiotics that have a sulfonamide functional group in their chemical structure.
The endocrine system is a messenger system comprising feedback loops of the hormones released by internal glands of an organism directly into the circulatory system, regulating distant target organs. In vertebrates, the hypothalamus is the neural control center for all endocrine systems.
Anticoagulants are used to treat and prevent blood clots that may occur in your blood vessels. Blood clots can block blood vessels (an artery or a vein). A blocked artery stops blood and oxygen from getting to a part of your body (for example, to a part of the heart, brain or lungs).
A tissue is a group of similar cells that are specialized for a particular function.
The four basic fundamental types of body tissues are
1. Epithelial tissue
2. Connective tissue
3. Muscular tissue
4. Nervous tissue
Each type of tissue is characterized by specific functions. These tissues contribute to the overall health and maintenance of the body. These tissues combine to form organs. The various organs make up the systems of the body that allow us to function and survive in our complex world. Histology is the science that deals with the study of tissues.
In biology, the tissue is a cellular organizational level between cells and a complete organ. A tissue is an ensemble of similar cells and their extracellular matrix from the same origin that together carry out a specific function. Organs are then formed by the functional grouping together of multiple tissues.
The English word "tissue" derives from the French word "tissue", meaning that something that is "woven", from the verb tisse, "to weave".
Career scope and opportunities
Pharmacy is the health profession that links the health sciences with the chemical sciences, and it is charged with ensuring the safe and effective use of medication. The scope of pharmacy practice includes compounding and dispensing medications, and it also related to more modern services like patient care, including clinical services, reviewing medications for safety and efficacy, and providing drug information.
The demand for pharma graduates is high in sectors like - healthcare, research, manufacturing, medical marketing, pharmacovigilance etc. As a pharma graduate, you can take up job roles like - drugs inspector, drugs controller, hospital pharmacist etc.
Ever hear the term "bronchial asthma" and wonder what it means? When people talk about bronchial asthma, they are really talking about asthma, a chronic inflammatory disease of the airways that causes periodic "attacks" of coughing, wheezing, shortness of breath, and chest tightness.
According to the CDC, more than 25 million Americans, including 6.8 million children under age 18, suffer with asthma today.
Allergies are strongly linked to asthma and to other respiratory diseases such as chronic sinusitis, middle ear infections, and nasal polyps. Most interestingly, a recent analysis of people with asthma showed that those who had both allergies and asthma were much more likely to have nighttime awakening due to asthma, miss work because of asthma, and require more powerful medications to control their symptoms.
Asthma is associated with mast cells, eosinophils, and T lymphocytes. Mast cells are the allergy-causing cells that release chemicals like histamine. Histamine is the substance that causes nasal stuffiness and dripping in a cold or hay fever, constriction of airways in asthma, and itchy areas in a skin allergy. Eosinophils are a type of white blood cell associated with allergic disease. T lymphocytes are also white blood cells associated with allergy and inflammation.
These cells, along with other inflammatory cells, are involved in the development of airway inflammation in asthma that contributes to the airway hyperresponsiveness, airflow limitation, respiratory symptoms, and chronic disease. In certain individuals, the inflammation results in the feelings of chest tightness and breathlessness that's felt often at night (nocturnal asthma) or in the early morning hours. Others only feel symptoms when they exercise (called exercise-induced asthma). Because of the inflammation, the airway hyperresponsiveness occurs as a result of specific triggers.
These are substances produced by a wide variety of cells in the body, having strong biological activity. Autacoids generally act locally at the site of synthesis and release. So they have also been called ‘local hormones’. They have short duration of action. They usually exert their action at the site of inflammation, lesion and injury.
The autacoids also differ from circulating hormones in that they are produced by many tissues rather than in specific endocrine glands.
The classical autacoids are— Ex.
Histamine, Serotonin
Prostaglandins, Leukotriene, Heparin, Endothelins
Bradykinin, Angiotensin, Eicosanoids
Interleukins, TNFα (tissue necrosis factor),
Platelet activating factor
The cell is the smallest structural, functional, and biological unit of all living organisms. It can capable of biosynthesis, replication and energy transformation.
ANATOMY
Anatomy is the study of the structure or morphology of the body and the physical relationship between body parts.
PHYSIOLOGY
Physiology is the study of the functions of body parts, what they do, and how they do it.
Within the body, there are different levels of structural organization and complexity.
The parasympathetic division typically acts in opposition to the sympathetic autonomic nervous system through negative feedback control.
This action is a complementary response, causing a balance of sympathetic and parasympathetic responses.
Overall, the parasympathetic outflow results in the conservation and restoration of energy, reduction in heart rate and blood pressure, facilitation of digestion and absorption of nutrients, and excretion of waste products.
These are drugs that produce actions similar to that of Acetylcholine hence known as parasympathomimetics.
They act either by directly interacting with cholinergic receptors or by increasing the availability of Acetylcholine at these sites.
Drug dependence
It is a physical or psychological condition resulting from repeated administration of mood-altering drugs.
It is a state characterized by a compulsion to take the drug on a continuous or periodic basis in order to experience its euphoriogenic effects.
If a mood-altering drug is unavailable, then the individual develops certain withdrawal symptoms.
Physical dependence + Psychological dependence
Drug addiction
Drug habituation
Drug abuse
Habit-forming drug
General anesthesia is a medically induced reversible loss of consciousness and loss of protective reflexes over the entire body, resulting from the administration of general anesthetic agents. The optimal combination of these agents for any given patient and procedure is typically selected by an anesthesiologist.
General anesthesia has many purposes including:
Pain relief (analgesia)
Blocking memory of the procedure (amnesia)
Producing unconsciousness
Inhibiting normal body reflexes to make surgery safe and easier to perform
Relaxing the muscles of the body
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
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1. Prof. Amol B. Deore
Department of Pharmacology
MVP’s Institute of Pharmaceutical Sciences, Nashik
Narcotic Analgesics and Antagonist
2. Narcotic Analgesic
• Narcotics analgesics are drugs used to relieve moderate
to severe pain by binding to opioid receptors, which are
present in the central and peripheral nervous system.
• Narcotic refers to opium derivatives, and their semi-
synthetic or synthetic substitutes as well as cocaine and
coca leaves.
• They are only used for pain that is severe and is not
helped by other types of painkillers. When used
carefully and under a health care provider's direct care.
3. Opioids
• Any naturally occurring, semi-synthetic or synthetic compounds that bind
specifically to opioid receptors and share the properties of one or more of the
naturally occurring endogenous opioids.
• Opium is a mixture of alkaloids from the poppy plant- Papaver Somniferum.
5. Mechanism of action
• As morphine binds to opioid receptors and activates
the receptors to exert certain actions.
• There are three major types of opioid receptors and
these are:
• μ receptor (Mu) – These receptors are present in the
brainstem and the thalamus, activation of these
receptors can result in pain relief, sedation and
euphoria as well as respiratory depression,
constipation and physical dependence.
6.
7. κ receptor (kappa) - This receptor is present in the limbic
system, the brain stem and spinal cord. Activation of this
receptor causes pain relief, sedation, loss of breath and
dependence.
δ receptor (delta) - This receptor is widely distributed in the
brain and also present in the spinal cord and digestive tract.
Stimulation of this receptor leads to analgesic as well as
antidepressant effects but may also cause respiratory
depression.
9. Central Nervous System
•Analgesia: Most effective in relieving severe and
continuous pain arising from deeper structures and
less effective against superficial and sharp pain.
10. Sedation: Drowsiness, feeling of heaviness
and difficulty in concentrating are
common. Sleep may occur with relief of
pain, but they are not true hypnotics.
Euphoria and dysphoria: Morphine and
other opioids cause a sense of fulfillment,
satisfaction and euphoria. Euphoria is the
experience of pleasure or excitement and
intense feelings of well-being and
happiness.
11. Hallucination: Morphine and other opioids may cause
hallucinations. The hallucinations are where someone
sees, hears, smells, tastes or feels things that do not
exist outside their mind.
Hallucinations are sensations that appear real but are
created by your mind.
Tolerance and Dependence: Dependence exists when
the sudden withdrawn of an opioid, after repeated
use over a prolonged period, results in various
physical and psychological signs and symptoms. These
include; restlessness, irritability, increased salivation,
anorexia, lacrimation and sweating, muscle cramps,
vomiting and diarrhea.
12. Cardiovascular System
• Mild bradycardia is common because of decreased
sympathetic activity and a direct effect on the SA node.
Peripheral vasodilatation caused by histamine release and
reduced sympathetic activity may result in fall in blood
pressure.
Respiratory System
• It depresses the respiratory center in medulla oblongata and
decreases rate of respiration and tidal volume. In large doses,
it produces respiratory failure and hypoxia condition.
13. Suppression of cough
• Opioids depress the cough reflects
by depressant action on the cough
center in medulla oblongata.
14. Gastrointestinal System
• It decreases the gastrointestinal tract secretions and peristaltic
movements. It also decreases the gastric motility thus decreasing the
gastric emptying.
• It inhibits the defecation reflex and spasm of the anal sphincters all
these effects result in the complete absorption of the water causing
drying of the stools and inability to defecate thus producing the
constipation.
• Therefore, in diarrhea opium tincture (1 to 2 ml) can be given to
produce constipation.
15. • Preparation and doses-
• Morphine Hcl – 10 to 20 mg SC or IM
• Morphine sulfate – 10 to 20 mg SC or IM
16. Clinical uses of morphine
• For relief of severe pain- morphine is one of the most
powerful analgesic.it is use to relieve severe pain such as
myocardial infarction, accidental pain, post-operative
pain, fracture of the long bones, severe burns, acute
pericarditis and terminal stage of the cancer that is cancer
pain
• As preanesthetic medication- morphine is used before
operation or surgery To produce sedation and anxiolytic
effect. it also reduces dose of the general Anesthetic
required.
17. • Antitussive action– morphine can be used to suppress severe cough
but codeine is preferred.
• Antidiarrheal action: In diarrhea, morphine (tincture of opium 1 to 2
ml) can be used to produce constipation in severe diarrhea but
loperamide is preferred as the potent antidiarrheal drug.
18. Adverse drug reactions-
• Vomiting, nausea, constipation, vertigo
• Respiratory depression
• dizziness, drowsiness
• Pin-point pupil of eye and miosis
• Urinary retention
• Euphoria, and hallucinations
• Drug tolerance
• Drug dependence
• Increased intracranial pressure
• biliary spasm
19. Contraindications
• Head injury
• The diagnostic features of head injury are
mydriasis, vomiting and respiratory depression.
Morphine produces miosis, pin point pupil, nausea,
vomiting, respiratory depression and increases
intracranial pressure of Cerebrospinal fluid in brain.
• This may complicate the patient condition in head
injury. By producing miosis, respiratory depression
and mental clouding it may interfere with diagnosis
and assessment of head injury.
20. Bronchial asthma
• Morphine can precipitate an acute attack of
bronchial asthma by causing bronchospasm due to
direct action on bronchial smooth muscles and
depression of respiratory centre in medulla
oblongata in CNS.
21. Prostate enlargement
• Morphine can produce urinary retention, difficulty in urine
micturition by causing spasm of urinary sphincter of bladder.
• Morphine is strictly contraindicated in– Children, Old
patients, Pregnancy
22. Acute Opioid Poisoning
•Causes of opioid intoxication
•Opioid intoxication occurs when someone takes
too many opioids. Opioid intoxication can occur if
someone:
•overdoses
•mixes opioids together
•takes opioids without a prescription or for longer
than prescribed
23. Symptoms
• A cold or clammy feel to the skin,
• Bluish hue in the fingertips and lips,
• Pinpoint pupil (miosis),
• Blurry vision,
• Nausea and Vomiting,
• Severe constipation,
• Respiratory depression: irregular breathing,
• hypothermia and hypoglycaemia,
• Slow heartbeat, hypotension,
• CNS depression: Severe sleepiness,
• Loss of consciousness,
• Coma.
24. Management
• Gastric lavage by potassium permanganate solution to
oxidise the morphine to oxymorphine (less toxic) and to
wash out unabsorbed morphine from the stomach.
• Artificial ventilator is given for breathing
• Administration of specific opioid antidote- Naloxone or
nalorphine given by intravenously.
• Administration of intravenous fluids.
25. Morphine is good analgesic but worst drug for
addiction OR Morphine causes addiction.
• Morphine is an Opioid analgesic used to relieve very severe pain such
as cancer pain, myocardial infarction pain, accidental pain, post-
operative pain and for cough and diarrhoea.
• Morphine interacts with opioid receptors (mu, kappa, delta and
sigma) in the brain and CNS thereby producing sedation, euphoria,
mental state of well-being, pleasure, hallucinations.
• Hence, to experience positive state of mind and satisfaction,
individual continue the drug on its own therapeutic indication
(without prescription or consult). This develops tolerance and strong
degree of psychological drug dependence, which cause addiction.
26. Morphine should be contraindicated in children, old people and
pregnant women.
• Morphine is an Opioids analgesic shows adverse drug reactions–respiratory
depression, circulatory depression, pin point pupil, difficulty in urine micturition
and prostate enlargement which cannot be tolerated by children and old people.
• The drug metabolism capacity is not completely developed in children and
become weaker in old age.
• In pregnancy, morphine crosses placental barrier and depress fetal respiration.
Therefore, Morphine is strictly contraindicated in children, old people and
pregnant women.
27. Morphine should not be given in abdominal
pain before diagnosis.
• Abdominal pain may be due to peptic ulcer, gallbladder
stone, appendix swelling, pancreatitis and amoebiasis.
These conditions show different symptoms. Hence, their
diagnosis should be done.
• If narcotic analgesic like morphine is given, it relives
pain that interferes in the detection of the symptoms of
above mentioned diseases. This results into the faulty
diagnosis. Therefore
28. In treatment of biliary colic, morphine is always
combined with atropine. Why?
•Biliary Colic is the condition in which there is severe
pain due to spasm (sustained contraction) in biliary
tract.
•Morphine, an opioid analgesic relieves pain while
atropine is antispasmodic which reduces spasm.
•Combination of atropine and morphine gives
synergistic effect. Therefore….