Opioid analgesics are the important group of medications used in pain management. The present seminar has been prepared by referring to standard textbooks of pharmacology and presented point wise for easy understanding.
opioid analgesics with detailed description of introduction, mechanism of action, adverse effect, uses and contraindication along with examples for under graduates.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
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Opioid analgesics are the important group of medications used in pain management. The present seminar has been prepared by referring to standard textbooks of pharmacology and presented point wise for easy understanding.
opioid analgesics with detailed description of introduction, mechanism of action, adverse effect, uses and contraindication along with examples for under graduates.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Methadone, a synthetic oipiod analgesicKiran Niure
Introduction of methadone along with pharmacological effects, pharmacokinetics, adverse effects, contraindications, drug interactions, clinical uses and dose
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This slide deck give detail presentation on Analgesic, Anti-inflammatory & Anti-pyretic drugs |Narcotic analgesics | Non-steroidal anti-inflammatory drugs (NSAID'S)
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http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
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This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
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The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
2. CLASSIFICATION
• A. Spectrum of Clinical Uses
• Opioid drugs can be subdivided on the basis of their major therapeutic uses (eg,
analgesics, antitussives, and antidiarrheal drugs).
3. • B. Strength of Analgesia
• On the basis of their relative abilities to relieve pain, the analgesic opioids may be
classified as strong, moderate, and weak agonists.
• Partial agonists are opioids that exert less analgesia than morphine, the prototype of a
strong analgesic, or full agonist.
4. • C. Ratio of Agonist to Antagonist Effects
• Opioid drugs may be classified as agonists (full or partial receptor activators), antagonists
(receptor blockers), or mixed agonist antagonists, which are capable of activating one
opioid receptor subtype and blocking another subtype.
5. PHARMACOKINETICS
• A. Absorption and Distribution
• well absorbed when taken orally
• Can be taken parenterally
• First-pass metabolism.
6. B. METABOLISM
• The opioids are metabolized by hepatic enzymes, usually to inactive glucuronide
conjugates, before their elimination by the kidney.
• However, morphine-6-glucuronide has analgesic activity equivalent to that of morphine,
and morphine-3-glucuronide (the primary metabolite) is neuroexcitatory.
• Codeine, oxycodone, and hydrocodone are metabolized by cytochrome CYP2D6, an
isozyme exhibiting genotypic variability
7. • Depending on the specific drug, the duration of their analgesic effects ranges from 1–2 h
(eg, fentanyl) to 6–8 h (eg, buprenorphine).
• However, long-acting formulations of some drugs may provide analgesia for 24 h or more.
• The elimination half-life of opioids increases in patients with liver disease
8. MECHANISMS OF ACTION
• A. Receptors
• Many of the effects of opioid analgesics have been interpreted in terms of their
interactions with specific receptors for endogenous peptides in the CNS and peripheral
tissues.
• Certain opioid receptors are located on primary afferents and spinal cord pain
transmission neurons (ascending pathways) and on neurons in the midbrain and medulla
(descending pathways) that function in pain modulation.
9. • Three major opioid receptor subtypes have been extensively characterized
pharmacologically: μ, δ, and κ receptors.
• The μ-receptor activation plays a major role in the respiratory depressant actions of
opioids and together with κ-receptor activation slows gastrointestinal transit; κ-receptor
activation also appears to be involved in sedative actions; δ-receptor activation may play
a role in the development of tolerance.
10. B. OPIOID PEPTIDES
• Opioid receptors are thought to be activated by endogenous peptides under physiologic
conditions.
• These peptides, which include endorphins such as a-endorphin, enkephalins, and
dynorphins, are synthesized in the cell body and are transported to the nerve endings
where they accumulate in synaptic vesicles.
11. • Endorphins have highest affinity for μ receptors, enkephalins for δ receptors, and
dynorphins for κ receptors.
12. C. IONIC MECHANISMS
• Opioid analgesics inhibit synaptic activity partly through direct activation of opioid
receptors and partly through release of the endogenous opioid peptides, which are
themselves inhibitory to neurons.
• All 3 major opioid receptors are coupled to their effectors by G proteins and activate
phospholipase C or inhibit adenylyl cyclase.
13. • At the postsynaptic level, activation of these receptors can open potassium ion channels
to cause membrane hyperpolarization (inhibitory postsynaptic potentials).
• At the presynaptic level, opioid receptor activation can close voltage-gated calcium ion
channels to inhibit neurotransmitter release.
16. CLINICAL USES
• Analgesia
• Cough suppression
• Treatment of diarrhea
• Treatment of acute pulmonary edema
• Anesthesia
17. TOXICITY
• A. Overdose
• A triad of pupillary constriction, comatose state, and respiratory depression is
characteristic; the latter is responsible for most fatalities.
18. AGONIST-ANTAGONIST DRUGS
• A. Analgesic Activity
• The analgesic activity of mixed agonist-antagonists varies with the individual drug but is
somewhat less than that of strong full agonists like morphine.
• Buprenorphine, butorphanol, and nalbuphine afford greater analgesia than
pentazocine, which is similar to codeine in analgesic efficacy.
19. B. RECEPTORS
• Butorphanol, nalbuphine, and pentazocine are κ agonists, with weak μ-receptor
antagonist activity. Butorphanol may act as a partial agonist or antagonist at the μ
receptor.
• Buprenorphine is a μ-receptor partial agonist with weak antagonist effects at κ and δ
receptors. These characteristics can lead to decreased analgesia, or even precipitate
withdrawal symptoms, when such drugs are used in patients taking conventional full μ-
receptor agonists.
21. OPIOID ANTAGONISTS
• Naloxone, nalmefene, and naltrexone are pure opioid receptor antagonists that have
few other effects at doses that produce marked antagonism of agonist effects.
• These drugs have greater affinity for μ receptors than for other opioid receptors.
• A major clinical use of the opioid antagonists is in the management of acute opioid
overdose.
22. • Naltrexone has a long elimination half-life, blocking the actions of strong agonists (eg,
heroin) for up to 48 h after oral use.
• These agents block adverse effects of strong opioids on peripheral μ receptors, including
those in the gastrointestinal tract responsible for constipation, with minimal effects on
analgesic actions and without precipitating an abstinence syndrome.