This Slide is gives an overall general idea about narcotic analgesics,action of opiates on pain and the pharmacology.

1. Presented by:-
Abhisek Ghosh.
B.Pharma
NSHM Knowledge Campus.
Kolkata

2.  Narcotics agents are potent analgesics which are
effective for the relief of severe pain.
Two phrases:-
 Narcotic:-The term narcotic ( from ancient Greek "to make
numb") originally referred medically to any psychoactive
compound with any sleep-inducing properties .
 Commonly morphine and heroin and their derivatives, such
as hydrocodone.
 Analgesics:-These are selective CNS depressants which
are used for the relief of pain

3.  Narcotic agents are classified into four major
groups:-
 1.Morphine and Codeine:-natural alkaloids (mainly
resins of poppy Plant, fam. (papaver somniferum)
 2.Synthetic derivatives of morphine such as heroin
 3.Synthetic agents which resembles the morphine
structure. e.g. Pethidine,Methadone,Tramadol.
 4.Narcotics antagonists which are used for overdose of
narcotic analgesics.
 E.g.Naloxone,Dapsone

4.  Fentanyl
(Duragesic)
 Heroin (street drug)
 Hydrocodone with
 acetaminophen (Lorcet, Lortab)
 Hydrocodone (Zohydro ER)
 Hydromorphone (Dilaudid)
 Methadone
 Oxycodone (OxyContin)
 Oxycodone with aspirin (Percodan)
 Meperidine (Demerol)

5. Works by two process
1.By opening Na+channel causing Hyperpolarization
Mainly three different types of receptors (mew,delta,kappa)
G-protein linked
Works by binding to opoid receptors present in
Central Nervous System Peripheral Nervous System

6. Overall
Reduces neuronal activity in pain carrying pathways
In turn
Inhibits release of all excitatory neurotransmitters
OR
By inhibiting Ca++ channel opening

7.  Mu, delta and kappa receptors.
 Mu agonists:- produce analgesia
affect numerous body systems
influence mood & behavior.
 Delta agonists:- produce analgesia. Its not
frequently used
 Kappa agonists:- produce analgesia
may cause less respiratory
depression and miosis.
psych effects, can produce dysphoria

9.  Pharmacokinetic properties of an opioid can dictate
the circumstance which they are appropriate in:
E. g- Lipid-soluble drug such as fentanyl, which diffuse
rapidly across the BBB, are preferable if analgesia is
required immediately before a short, painful procedure.
 Elimination half life very short:
 So, steady state reached in a day or less!
◦ Thus, you can adjust the dose daily knowing we are
seeing it’s effect.

10.  Morphine sold under many trade names, is a pain
medication of the opiate type.
 It acts directly on the central nervous system (CNS)
to decrease the feeling of pain.
 It can be used for both acute pain and chronic pain.
 Morphine is also frequently used for pain
from myocardial infarction and during labour.

11.  1.CNS:- Morphine has site specific depressant and
stimulant actions in the CNS by interacting primarily with
the mew opoid receptors as full agonist.
 Analgesia, sedation, mood and subjective effects,
respiratory center depresses, cough center depresses,
temperature control center depresses.
 2.CVS:-Morphine causes vasodilatation due to
 A) Histamine release
 B)Depression of the vasomotor center.
 C)Direct action by decreasing the tone of blood vessel.

12.  3)SMOOTH MUSCLES GIT:-Constipation is the
common effect feature by morphine.
 Reduce all gastrointestinal secretions
 Tone of duodenum and colon may be increase.
 Actions directly on intestine and in CNS increases
tone but decreases propulsive movement.
 4)ANS:-Morphine causes mild hyperglycemia due
to central sympathetic stimulation.

13.  Respiratory depression
 Hallucination(Day Dreaming)
 Sedation
 Constipation
 Urinary retention
 Itching/Hypersensitivity.

14.  When people use narcotics only to control pain, they are
unlikely to become addicted to the drugs. However,
opioids provide an intoxicating high when injected or
taken orally in high doses. Opioids are also
powerful anxiety relievers.
 Narcotic rehab centers are widely available to individuals
who have become dependent on the drug
 Reduce abuse of Drugs.
 Proper prescribing and administration

15. REFERENCES
1.Sakchainanont, B, Ruangkanchanasetr, S, Chantarojanasiri, T, et al (1990)
Effectiveness of narcotic analgesics in siesure. J Med Assoc Thai 73, 96-101
2.Principle of Experimental Pharmacology . Rage and Dale
3.Pathophysioloy of Disease. Robins. H

16. THANK YOU