This document provides an introduction to opioids. It discusses the history of opioid use dating back to ancient Egypt and Greece. It describes the isolation of morphine from opium in 1806 and the subsequent development of other semi-synthetic and synthetic opioids. The document outlines the four main opioid receptor types and their locations in the body. It examines the pharmacological effects of opioids including analgesia, respiratory depression, miosis, gastrointestinal effects, and others. It also covers tolerance development and cross-tolerance between opioids.
opioid analgesics with detailed description of introduction, mechanism of action, adverse effect, uses and contraindication along with examples for under graduates.
opioid analgesics with detailed description of introduction, mechanism of action, adverse effect, uses and contraindication along with examples for under graduates.
Opiod analgesics used in Dentistry by Dr. Amit T. Suryawanshi
(MDS) Facial Cosmetic Surgeon
Oral & Maxillofacial Surgeon
Dental Surgeon & Implantologist
Hair Transplant Surgeon (Germany)
Consulting Surgeon in Kolhapur, Sangli, Pune & Mumbai (India)
&
founder of
Face Art International Super speciality
at Kolhapur (India)
General Anesthetics
Its help in the B pharma students and all science students.
Here give the full notes about General Anesthetics so read nd learn here also share with your friends,
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morphine- an analgesic drug which is obtained from opium has several other analogues also. The presentation gives a brief and important information regarding morphine- cultivation, collection, presentation, it's chemical structure and therapeutic uses.
Alongwith it, the slides also gives a brief account of the structure and uses of its analogues such as heroine, codeine etc.
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.
Opiod analgesics used in Dentistry by Dr. Amit T. Suryawanshi
(MDS) Facial Cosmetic Surgeon
Oral & Maxillofacial Surgeon
Dental Surgeon & Implantologist
Hair Transplant Surgeon (Germany)
Consulting Surgeon in Kolhapur, Sangli, Pune & Mumbai (India)
&
founder of
Face Art International Super speciality
at Kolhapur (India)
General Anesthetics
Its help in the B pharma students and all science students.
Here give the full notes about General Anesthetics so read nd learn here also share with your friends,
Share and like the my slides
Thank you...
morphine- an analgesic drug which is obtained from opium has several other analogues also. The presentation gives a brief and important information regarding morphine- cultivation, collection, presentation, it's chemical structure and therapeutic uses.
Alongwith it, the slides also gives a brief account of the structure and uses of its analogues such as heroine, codeine etc.
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 --> are important drugs used in the pain management.
Employ appropriate pharmacological choice by knowing the pharmacology of the drugs --> both pharmaco dynamic and pharmaco kinetics.
Provide optimal effect and minimize side effects
The term “opiate” refers only to substances with morphine-like activity that are structurally related to morphine. Opioids are sometimes referred to as “narcotic analgesics” and opioid receptor antagonists as “narcotic antagonists”
The all the content in this profile is completed by the teachers, students as well as other health care peoples.
thank you, all the respected peoples, for giving the information to complete this presentation.
this information is free to use by anyone.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Adv. biopharm. APPLICATION OF PHARMACOKINETICS : TARGETED DRUG DELIVERY SYSTEMSAkankshaAshtankar
MIP 201T & MPH 202T
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Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
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
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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!
Title: Sense of Smell
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 primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
1. Opioids - an introduction
Dr. S. Parthasarathy
MD., DA., DNB, MD (Acu), Dip. Diab.
DCA, Dip. Software statistics-
PhD ( physiology), IDRA
2. History
• Opium was first mentioned in Eber’s papyrus
(1500 BC) and in the writing of Theophrastus (300
BC)
• It was used throughout the middle ages in Europe
as the preparation, named ‘laudanum’.
• Tincture !!
• Crude opium is a dark brown and resinous
material which is obtained from poppy (papaver
somniferum) capsule.
• Opos – juice of poppy
4. In 1806, Sertürner reported the isolation of a
pure substance in opium that he named
morphine after Morpheus, the Greek god of
dreams.
It contains two types of alkaloids:
(i) alkaloid of phenanthrene derivatives–
morphine (10%), codeine (5%), thebaine (0.2%),
(ii) alkaloid of benzoisoquinoline derivatives –
papaverine (1%), noscapine (6%).
5.
6. • 1840 – oral morphine – went on
• 1860 – 70 – hypodermic- morphine – used
• 1900 – more side effects
• 1914 – thio
• Concept of balanced analgesia
• More uses
• 1939 – pethidine
• 1960-70 – fentanyl
7. Some terms- opioid , opiate , narcotic
• Opioid
• opioid is defined as a natural, semisynthetic or
synthetic compound that acts at opioid receptors.
• May be antagonist!
• Opiate
• is a specific term to describe drugs derived from
the opium poppy (Papaver somniferum).
• Narcotic Greek word for stupor.
• At one time the term ‘narcotic’ was referred to
any drug that induced sleep and then it became
associated with opioids. But now it is often used
in legal context
8. Receptors
• Four broad classes of opioid receptors are
currently accepted.
• Mu (MOP) – morphine
• Kappa (KOP) - ketocyclazocine
• Delta (DOP) – vas deferens
• Nociceptin receptor (NOP)
9. MOP DOP KOP NOP
analgesia,
sedation,
respiratory
depression,
bradycardia,
nausea
vomiting
reduction in
gastric
motility
spinal and
supraspinal
analgesia
and reduce
gastric
motility
spinal
analgesia,
diuresis and
dysphoria.
Analgesia
Hyperalgesia
Allodynia
10. Where are mu receptors
• cerebral cortex
• basal ganglia
• presynaptic primary afferent neurones in dorsal
horn
• periaquaductal grey
• µ2 receptor has lower affinity for morphine. It
mediates spinal analgesia, respiratory depression
and constipation
11. DOP
• Found in midbrain
• nucleus raphe magnus
• part of descending inhibitory control pathway
Limited clinical use as produces side effects at doses
lower than those required for analgesia
• Side effects include diuresis, sedation, dizziness,
confusion and dysphoria
12. KOP
• Nucleus raphe magnus (midbrain),
hypothalamus, spinal cord
• Analgesia
• Dysphoria
• Sedation
• Dependence
• Miosis
13. NOP
• . Spinally, has been shown to produce analgesia and
hyperalgesia, dependent upon the administered
concentration, and allodynia.
• Supraspinally, when administered intra
cerebrovascularly it is thought to produce a pro-
nociceptive anti-analgesic effect, owing to an
inhibition of endogenous opioid tone
14.
15.
16. • A μ3 receptor is found in vascular tissue and in
leukocytes, and it may have roles in vascular
control and immunomodulation
• The κ1 receptor mediates spinal analgesia,
whereas activation of the κ3 receptor results
in supraspinal analgesia, sedation, and
ventilatory depression
• The majority of opioid receptors in
myocardium appear to be δ, and this receptor
may play a role in the phenomenon of
ischemic preconditioning
17. In short what ?
• Mu 1 and 2
• Delta
• Kappa
• Nociceptin
18.
19. Mechanism of action ??
• Inhibition of calcium entry into the cell
• closes voltage sensitive calcium channels Potassium
efflux resulting in hyperpolarisation
• Inhibition of adenylyl cyclase reduces cAMP levels
• Overall result is reduced neuronal cell excitability with
a reduction in nerve impulse transmission and
inhibition of neurotransmitter release
20.
21. Classification of opioids
• According to chemistry
– Natural
– Semisynthetic
– Synthetic
According to Pharmacodynamics
Agonists
Partial agonists
Agonists antagonists
Antagonists
30. Analgesia
• Relief of almost any pain
• Acute burning severe pain – more effective
• Neuropathic pain less
• First pain ? √ Second pain !!
• Blunt reflexes
• Perception of pain- it acts
• Descending pathways and spinal cord
• Don’t put to sleep always and don’t numb
• Euphoria - yes
32. CNS effects – euphoria
• Dysphoria and agitation rare with analgesic
doses
• Hypnosis and sedation will occur with high
doses
• No amnesia
• Elevate ICP with PaCO2 only
• Seizures with norpethidine
33. Ventilation
• Opioids produce a dose-related depression of
the ventilatory response to CO2 by a direct
effect on ventilatory centers in the medulla.
• Morphine also blunts the response to hypoxia
• Sleep will increase blunting
• Difficult to reverse without reversing analgesia
• Extremes of age , other potent depressants-
danger
35. Skeletal muscle rigidity
• Generalized hypertonus of skeletal muscle can be
produced by large IV doses of most opioid agonists.
• Common with fentanyl, alfentanil, sufentanil, severe
form, “lead pipe” muscle rigidity
• very little loss of compliance when opioids are given
to patients with tracheotomies, suggesting that the
primary etiology is supraglottic obstruction from
constriction of laryngeal and pharyngeal muscles.
36. Antitussive
• Suppression of cough centres in medulla
• Codeine
• Dextromethorphan ( dextro isomers - better
antitussive )
• Heroin
• Antitussive activity – in fibreoptic intubation -
• Less analgesia with codeine – different
mechanism
37. Miosis
• Opioids stimulate the Edinger-Westphal
nucleus of the oculomotor nerve to produce
miosis
• Hypoxia – mydriasis – beware
• Small doses – maximal effect
• Qualitative but not quantitative
38. CVS effects
• Bradycardia and peripheral vasodilatation are
seen at higher doses and when opioids are
combined with other anesthetic drugs.
• No myocardial depression, no autonomic activity
–
• Ideal for cardiac anesthesia
• Fentanyl – brady , pethidine and pentazocine –
tachycardia and hypertension
• Reduces the size of infarct
39. Histamine release
• Some opioids, particularly morphine and meperidine,
produce a nonimmunologic release of histamine from
circulating basophils and tissue mast cells.
• most often seen as local itching, redness, or urticaria near
the site of intravenous injection,
• often mistake for true allergy.
• Anti H1 and anti H2 drugs as prevention
• Perioral itch by fentanyl – no histamine – naloxone ok but
antihistaminics ?
41. GI and smooth muscle
• Opioids decrease the passage of fluids and solids at
every level of the GI tract—so-called opioid bowel
dysfunction (OBD). They delay gastric emptying and
increase antral tone.
• Opioids cause contraction of smooth muscle in the
gall bladder and spasm of the sphincter of Oddi.
biliary colic -? Intra op cholangiogram - ?
42. • Opioid receptors are found throughout the enteric
plexus of the bowel;
• their activation or stimulation causes tonic
contraction of gastrointestinal smooth muscle,
thereby decreasing coordinated, peristaltic
contractions.
43. Smooth Muscle Effects
• increase the contractions of the ureter although they
relieve the pain caused by ureteral stones.
• They also decrease detrusor contraction in response
to bladder distension (the voiding reflex) and
increase the tone of the urinary sphincter by both
central and peripheral mechanisms.
44. Pregnancy and fetus
• Opioids have no specific teratogenic effects,
but chronic opioid use by the mother can lead
to physical dependence by the fetus.
• Neonatal withdrawal may occur shortly after
delivery and in some instances may be life-
threatening.
45. • When tolerance to an opioid occurs, there is
simultaneous development of cross-tolerance
to all other opioid agonists.
• In general, tolerance develops to depressant
effects (analgesia, ventilatory depression,
euphoria),
• less tolerance to some of the stimulant effects,
like constipation or pupillary constriction.
46. • Hormonal effects = ? Use in the perioperative
scenario
• OPIOIDS MODULATE ANGIOGENESIS
• OPIOIDS ARE IMMUNOSUPPRESSIVE
• Cardiac protective
• Neuro protective
• Meperidine and shivering why ??