The document discusses opioids and their use for analgesia in children. It describes how opioids were originally derived from the opium poppy and outlines the types of opioid receptors in the body. It also summarizes different opioid drugs like morphine, codeine, fentanyl, and their effects. The document addresses misconceptions around opioid use in children and defines terms like addiction, tolerance, and withdrawal. It provides guidance on safely caring for children receiving opioids through monitoring and documentation.
Opioids are drugs that bind to opioid receptors in the brain and body to produce analgesic, sedative, and euphoric effects. They have been used for thousands of years to relieve pain and induce euphoria. Natural opioids are found in opium from the poppy plant, while semi-synthetic and synthetic opioids are derived from morphine or synthesized. The three main opioid receptor types are mu, kappa, and delta, with mu receptors primarily responsible for analgesia, respiratory depression, and euphoria. Common opioids include morphine, codeine, oxycodone, fentanyl, methadone, and heroin. Tolerance and dependence develop with prolonged use.
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
This document discusses opioids, including their classification, mechanisms of action, effects and side effects. It notes that opioids act on three receptor families in the central nervous system to produce analgesic and other effects. It describes the pharmacokinetics of opioids like morphine, including their metabolism and potential drug interactions. The document also discusses the use of opioid antagonists like naloxone to reverse overdose effects.
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.
Opioids act on three types of opioid receptors in the brain and body - mu, kappa, and delta. They produce effects like analgesia, sedation, euphoria, and respiratory depression. Common opioids include morphine, codeine, oxycodone, fentanyl, and heroin. Opioids are used medically to treat severe pain but carry risks of tolerance, dependence, and overdose. Naloxone and naltrexone are opioid antagonists that can reverse the effects of opioid overdose.
This document discusses opioid analgesics, including their classification, mechanisms of action, and effects. It begins by defining analgesics, opioids, opiates, and narcotics. It then discusses the opioid morphine in depth, including its pharmacological effects in the central nervous system and peripherally. Other opioids discussed include pethidine, methadone, tramadol, endogenous opioid peptides, and opioid receptor antagonists such as naloxone. The document provides an overview of the classification, properties, uses, and adverse effects of various opioid analgesics.
The document discusses opioid analgesics, including their uses, actions, adverse reactions, contraindications, and precautions. It explains that opioids are used to treat moderate to severe pain according to the WHO pain ladder. Their main action is binding to mu and kappa receptors in the central nervous system to reduce pain perception and cause side effects like respiratory depression. Common adverse reactions include nausea, constipation, sedation, and respiratory issues. Opioids are contraindicated in conditions like asthma, increased intracranial pressure, or pregnancy. Precautions must be taken with opioid-naive patients and older adults due to risk of respiratory depression.
This document provides an overview of opioids including their pharmacology, mechanisms of action, classifications, and clinical uses. It discusses how opioids bind to receptors in the central and peripheral nervous systems to produce analgesic and other effects. Opioids are classified based on their receptor activities and include pure agonists, partial agonists, mixed agonist-antagonists, and pure antagonists. The document reviews the central and peripheral effects of opioids as well as their indications, contraindications, and interactions. It also discusses opioid tolerance, dependence, overdose, and withdrawal.
Opioids are drugs that bind to opioid receptors in the brain and body to produce analgesic, sedative, and euphoric effects. They have been used for thousands of years to relieve pain and induce euphoria. Natural opioids are found in opium from the poppy plant, while semi-synthetic and synthetic opioids are derived from morphine or synthesized. The three main opioid receptor types are mu, kappa, and delta, with mu receptors primarily responsible for analgesia, respiratory depression, and euphoria. Common opioids include morphine, codeine, oxycodone, fentanyl, methadone, and heroin. Tolerance and dependence develop with prolonged use.
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
This document discusses opioids, including their classification, mechanisms of action, effects and side effects. It notes that opioids act on three receptor families in the central nervous system to produce analgesic and other effects. It describes the pharmacokinetics of opioids like morphine, including their metabolism and potential drug interactions. The document also discusses the use of opioid antagonists like naloxone to reverse overdose effects.
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.
Opioids act on three types of opioid receptors in the brain and body - mu, kappa, and delta. They produce effects like analgesia, sedation, euphoria, and respiratory depression. Common opioids include morphine, codeine, oxycodone, fentanyl, and heroin. Opioids are used medically to treat severe pain but carry risks of tolerance, dependence, and overdose. Naloxone and naltrexone are opioid antagonists that can reverse the effects of opioid overdose.
This document discusses opioid analgesics, including their classification, mechanisms of action, and effects. It begins by defining analgesics, opioids, opiates, and narcotics. It then discusses the opioid morphine in depth, including its pharmacological effects in the central nervous system and peripherally. Other opioids discussed include pethidine, methadone, tramadol, endogenous opioid peptides, and opioid receptor antagonists such as naloxone. The document provides an overview of the classification, properties, uses, and adverse effects of various opioid analgesics.
The document discusses opioid analgesics, including their uses, actions, adverse reactions, contraindications, and precautions. It explains that opioids are used to treat moderate to severe pain according to the WHO pain ladder. Their main action is binding to mu and kappa receptors in the central nervous system to reduce pain perception and cause side effects like respiratory depression. Common adverse reactions include nausea, constipation, sedation, and respiratory issues. Opioids are contraindicated in conditions like asthma, increased intracranial pressure, or pregnancy. Precautions must be taken with opioid-naive patients and older adults due to risk of respiratory depression.
This document provides an overview of opioids including their pharmacology, mechanisms of action, classifications, and clinical uses. It discusses how opioids bind to receptors in the central and peripheral nervous systems to produce analgesic and other effects. Opioids are classified based on their receptor activities and include pure agonists, partial agonists, mixed agonist-antagonists, and pure antagonists. The document reviews the central and peripheral effects of opioids as well as their indications, contraindications, and interactions. It also discusses opioid tolerance, dependence, overdose, and withdrawal.
This document discusses issues related to drug exposed infants. It provides information on an upcoming conference on drug exposed infants including accepted learning objectives, disclosure statements, and trends in drug use during pregnancy. Specific drugs discussed include nicotine, alcohol, benzodiazepines, marijuana, stimulants, cocaine, and opiates. Information is presented on trends in neonatal abstinence syndrome, mechanisms of action and effects of various opioids including methadone and buprenorphine. The document also discusses complications of chronic opiate use for both mother and fetus, and recommendations for screening, treatment and recognizing neonatal withdrawal.
This document summarizes opioids and their use as analgesics. It discusses the classification of opioids as natural, semi-synthetic, or synthetic and describes their mechanisms of action through mu, delta, and kappa receptors in the central nervous system. The document outlines the pharmacokinetics of opioid absorption, distribution, metabolism, and excretion. It also discusses the clinical uses of opioids like morphine, as well as their side effects, risks of overdose and addiction, and treatment options for opioid overuse.
This document discusses oxycodone, an opioid pain reliever. It lists the generic and brand names, describes how it works to relieve pain and its side effects. Potential signs of abuse are provided, such as doctor shopping or changing moods. Treatment options for addiction like buprenorphine, naltrexone and methadone are presented. Shocking statistics on overdose deaths and over-prescribing of opioids are shared, as well as a quote on the need to curb the epidemic.
This document discusses opioids and their medical uses and effects. It begins by defining opioids as substances that act on opioid receptors to produce morphine-like effects. It then discusses the classification of opioids, including natural, semi-synthetic, fully synthetic, and endogenous opioids. The document outlines several major opioids - morphine, codeine, heroin, and methadone - and describes their histories, mechanisms of action, medical uses, and side effects. It also discusses opioid antagonists that are used to treat overdose and the detection of various opioids. In conclusion, the document notes the regulated global supply of opioids to balance pain treatment with abuse and addiction.
This document discusses opioid use disorders and their management. It begins with an introduction to opioids, their physiology and routes of administration. It then covers the etiology of opioid use disorders, including genetic and psychosocial factors. The key opioid related disorders according to DSM and ICD criteria are outlined. Clinical features of opioid effects and withdrawal are described. Management includes treatment of dependence, intoxication and withdrawal. Pharmacological approaches discussed are antagonist therapy using naltrexone and agonist therapy using methadone, buprenorphine and other agents.
This document provides an overview of opioids including their history, mechanisms of action, classifications, and considerations for use. Opioids are a class of drugs that bind to opioid receptors in the brain and body to produce pain relief and other effects. They have been used for thousands of years to treat pain and their active components have been isolated over the past two centuries. Opioids are classified based on their origin as natural, semi-synthetic, or synthetic and produce analgesia through activation of mu opioid receptors in the central nervous system as well as other actions. Considerations for their use include side effects like respiratory depression and the potential for dependence and addiction with long-term use.
This document discusses opioids, which are drugs that bind to opioid receptors in the central nervous system to produce analgesic, calming, sedative, and euphoric effects. It describes endogenous opioids like endorphins and exogenous opioids extracted from opium or produced synthetically. The three main types of opioid receptors are mu, kappa, and delta. Representative opioid drugs are discussed, including morphine, heroin, methadone, fentanyl, buprenorphine, and antagonists like naloxone. The pharmacological effects, indications, and side effects of various opioids are outlined.
The document discusses opioid analgesics and their mechanisms of action. It notes that the body has an endogenous analgesic system centered in the brainstem that is stimulated by opioids. Opioids work by binding to mu, delta, and kappa receptors in the brain and spinal cord, inhibiting pain signal transmission. Several opioid analgesics are described, including morphine, codeine, heroin, fentanyl, and methadone. Tolerance, side effects, metabolism, and antagonists are also discussed. The future of opioid analgesics is seen to involve further study of the kappa receptor and endogenous opioid peptides to develop safer drugs.
This document discusses opioids, which are narcotic analgesics used to treat pain. It defines pain and describes how opioids work in the body by binding to opioid receptors in the central nervous system. It categorizes various opioids as strong agonists, mild-moderate agonists, mixed agonist-antagonists, and pure antagonists. It provides examples of opioids in each category and describes their clinical uses, mechanisms of action, adverse effects, risks of tolerance and dependence.
The document discusses various opioid analgesics including their mechanisms of action, effects, and therapeutic uses. It describes how opioids like morphine and pethidine work in the central nervous system to provide analgesia and other effects through binding to mu, kappa, and delta opioid receptors. It also covers the pharmacokinetics, indications, adverse effects and classifications of different opioid drugs.
Primer on pediatric sedation and analgesia resident lectureRobert Parker
The document provides an overview of pediatric sedation and analgesia in critical care settings. It discusses the role of sedation, including minimizing pain and anxiety during medical illness, procedures, and ventilation. Various scoring systems are described to assess sedation levels. A range of sedative and analgesic drugs are outlined, including opioids like fentanyl and morphine, benzodiazepines like midazolam, and others like dexmedetomidine and propofol. Factors in choosing an appropriate drug include the desired clinical effects, advantages, dosing, onset, and duration of action.
This document discusses the treatment of opioid use disorders. It begins by defining key opioid terminology and noting that while opioids are not directly toxic, they can cause lethal overdose. It then reviews the history of opioid use and regulation, including 19th century overprescription, the criminalization of addiction in the early 20th century, and the current opioid overdose epidemic in the US. The document outlines government responses like Risk Evaluation and Mitigation Strategies and CDC prescribing guidelines. It distinguishes physical dependence from addiction and notes medications used to treat opioid use disorders like antagonists, partial agonists, methadone, and buprenorphine.
Opioids work by binding to opioid receptors located throughout the body. There are several types of opioids that bind to receptors in different ways, producing varying effects. While opioids are effective analgesics, they can cause numerous side effects that must be carefully monitored and managed. Long term opioid therapy requires consideration of addiction risk, aberrant behaviors, and strategies to minimize dependency issues while providing pain relief.
1. Opioids are derived from the opium poppy and have been used for thousands of years to relieve pain, induce euphoria, and suppress coughing and diarrhea.
2. They work by binding to opioid receptors in the brain and spinal cord to reduce pain signaling and perception. This can produce strong analgesia but also side effects like sedation, respiratory depression, dependence, and tolerance with prolonged use.
3. Common natural and synthetic opioids include morphine, codeine, fentanyl, hydromorphone, and methadone. They are widely used to treat moderate to severe acute and chronic pain as well as for other purposes like cough suppression.
This document provides information on opioids and their use as analgesics. It begins by defining analgesics as any drug used to relieve pain and classifies them as opioids, NSAIDs, or paracetamol. Opioids act on opioid receptors in the brain and nervous system to produce morphine-like pain relief effects. Both natural and synthetic opioids are discussed. The document outlines the historical use of opium from the opium poppy and how semi-synthetic and synthetic opioids are derived from natural opiates. It also discusses how opioids work by binding to opioid receptors in the brain and nervous system to reduce pain transmission. Different classifications of opioids are presented including source, chemical structure, strength, and effects on opioid receptor subtypes. Common
Endorphin is a peptide hormone produced naturally in the brain and pituitary gland that functions as the body's natural analgesic. It binds to the same opioid receptors in the brain, spinal cord and nerve endings as exogenous opioids like morphine. High concentrations of endorphins produce feelings of euphoria and pain suppression, while low concentrations are associated with increased anxiety and pain awareness. Research into the endogenous opioid system and different types of endorphins like beta-endorphin may help develop non-addictive pain treatments that target opioid receptors without dangerous side effects.
Endorphin is a peptide hormone produced naturally in the brain and pituitary gland that functions as the body's natural analgesic. It binds to the same opioid receptors in the brain, spinal cord, and nerve endings as exogenous opioids like morphine. High concentrations of endorphins produce feelings of euphoria and pain suppression, while low concentrations are associated with increased anxiety and pain awareness. Research into the endogenous opioid system and different types of endorphins may help develop non-addictive pain treatments that target receptors like the kappa receptor without dangerous side effects.
Morphine and its analogues are called narcotic analgesics or opioid analgesics. They produce analgesia by binding to opioid receptors in the brain and spinal cord. Opioid receptors include mu, kappa, and delta receptors. Long term opioid treatment can cause tolerance, physical dependence, and addiction through changes in gene expression and neural plasticity in the brain. Recent research aims to develop new opioid drugs that prevent tolerance through combinations of agonists and antagonists or by targeting mechanisms of receptor desensitization and trafficking.
Narcotics are opioid drugs derived from opium poppy that are addictive and affect mood. They work by acting on receptors in the brain and nervous system to reduce pain and slow breathing. Common routes of administration include oral, intravenous, and inhalation. While narcotics have medical uses for pain relief, side effects include addiction, sedation, and trouble breathing. Treatment for narcotic addiction involves medication, counseling, and rehabilitation to support abstinence and prevent relapse.
The document discusses indications for ICU admission and management of critically ill COVID-19 patients. It provides criteria for ICU admission including need for mechanical ventilation, vasopressors, respiratory rate over 30, low oxygen saturation, confusion, and other organ dysfunction. It also outlines management strategies in the ICU including ventilation, vasopressors, steroids, blood products, glucose control, nutrition, and prevention of complications. Risk factors like comorbidities and laboratory values associated with worse prognosis are also mentioned.
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This document discusses issues related to drug exposed infants. It provides information on an upcoming conference on drug exposed infants including accepted learning objectives, disclosure statements, and trends in drug use during pregnancy. Specific drugs discussed include nicotine, alcohol, benzodiazepines, marijuana, stimulants, cocaine, and opiates. Information is presented on trends in neonatal abstinence syndrome, mechanisms of action and effects of various opioids including methadone and buprenorphine. The document also discusses complications of chronic opiate use for both mother and fetus, and recommendations for screening, treatment and recognizing neonatal withdrawal.
This document summarizes opioids and their use as analgesics. It discusses the classification of opioids as natural, semi-synthetic, or synthetic and describes their mechanisms of action through mu, delta, and kappa receptors in the central nervous system. The document outlines the pharmacokinetics of opioid absorption, distribution, metabolism, and excretion. It also discusses the clinical uses of opioids like morphine, as well as their side effects, risks of overdose and addiction, and treatment options for opioid overuse.
This document discusses oxycodone, an opioid pain reliever. It lists the generic and brand names, describes how it works to relieve pain and its side effects. Potential signs of abuse are provided, such as doctor shopping or changing moods. Treatment options for addiction like buprenorphine, naltrexone and methadone are presented. Shocking statistics on overdose deaths and over-prescribing of opioids are shared, as well as a quote on the need to curb the epidemic.
This document discusses opioids and their medical uses and effects. It begins by defining opioids as substances that act on opioid receptors to produce morphine-like effects. It then discusses the classification of opioids, including natural, semi-synthetic, fully synthetic, and endogenous opioids. The document outlines several major opioids - morphine, codeine, heroin, and methadone - and describes their histories, mechanisms of action, medical uses, and side effects. It also discusses opioid antagonists that are used to treat overdose and the detection of various opioids. In conclusion, the document notes the regulated global supply of opioids to balance pain treatment with abuse and addiction.
This document discusses opioid use disorders and their management. It begins with an introduction to opioids, their physiology and routes of administration. It then covers the etiology of opioid use disorders, including genetic and psychosocial factors. The key opioid related disorders according to DSM and ICD criteria are outlined. Clinical features of opioid effects and withdrawal are described. Management includes treatment of dependence, intoxication and withdrawal. Pharmacological approaches discussed are antagonist therapy using naltrexone and agonist therapy using methadone, buprenorphine and other agents.
This document provides an overview of opioids including their history, mechanisms of action, classifications, and considerations for use. Opioids are a class of drugs that bind to opioid receptors in the brain and body to produce pain relief and other effects. They have been used for thousands of years to treat pain and their active components have been isolated over the past two centuries. Opioids are classified based on their origin as natural, semi-synthetic, or synthetic and produce analgesia through activation of mu opioid receptors in the central nervous system as well as other actions. Considerations for their use include side effects like respiratory depression and the potential for dependence and addiction with long-term use.
This document discusses opioids, which are drugs that bind to opioid receptors in the central nervous system to produce analgesic, calming, sedative, and euphoric effects. It describes endogenous opioids like endorphins and exogenous opioids extracted from opium or produced synthetically. The three main types of opioid receptors are mu, kappa, and delta. Representative opioid drugs are discussed, including morphine, heroin, methadone, fentanyl, buprenorphine, and antagonists like naloxone. The pharmacological effects, indications, and side effects of various opioids are outlined.
The document discusses opioid analgesics and their mechanisms of action. It notes that the body has an endogenous analgesic system centered in the brainstem that is stimulated by opioids. Opioids work by binding to mu, delta, and kappa receptors in the brain and spinal cord, inhibiting pain signal transmission. Several opioid analgesics are described, including morphine, codeine, heroin, fentanyl, and methadone. Tolerance, side effects, metabolism, and antagonists are also discussed. The future of opioid analgesics is seen to involve further study of the kappa receptor and endogenous opioid peptides to develop safer drugs.
This document discusses opioids, which are narcotic analgesics used to treat pain. It defines pain and describes how opioids work in the body by binding to opioid receptors in the central nervous system. It categorizes various opioids as strong agonists, mild-moderate agonists, mixed agonist-antagonists, and pure antagonists. It provides examples of opioids in each category and describes their clinical uses, mechanisms of action, adverse effects, risks of tolerance and dependence.
The document discusses various opioid analgesics including their mechanisms of action, effects, and therapeutic uses. It describes how opioids like morphine and pethidine work in the central nervous system to provide analgesia and other effects through binding to mu, kappa, and delta opioid receptors. It also covers the pharmacokinetics, indications, adverse effects and classifications of different opioid drugs.
Primer on pediatric sedation and analgesia resident lectureRobert Parker
The document provides an overview of pediatric sedation and analgesia in critical care settings. It discusses the role of sedation, including minimizing pain and anxiety during medical illness, procedures, and ventilation. Various scoring systems are described to assess sedation levels. A range of sedative and analgesic drugs are outlined, including opioids like fentanyl and morphine, benzodiazepines like midazolam, and others like dexmedetomidine and propofol. Factors in choosing an appropriate drug include the desired clinical effects, advantages, dosing, onset, and duration of action.
This document discusses the treatment of opioid use disorders. It begins by defining key opioid terminology and noting that while opioids are not directly toxic, they can cause lethal overdose. It then reviews the history of opioid use and regulation, including 19th century overprescription, the criminalization of addiction in the early 20th century, and the current opioid overdose epidemic in the US. The document outlines government responses like Risk Evaluation and Mitigation Strategies and CDC prescribing guidelines. It distinguishes physical dependence from addiction and notes medications used to treat opioid use disorders like antagonists, partial agonists, methadone, and buprenorphine.
Opioids work by binding to opioid receptors located throughout the body. There are several types of opioids that bind to receptors in different ways, producing varying effects. While opioids are effective analgesics, they can cause numerous side effects that must be carefully monitored and managed. Long term opioid therapy requires consideration of addiction risk, aberrant behaviors, and strategies to minimize dependency issues while providing pain relief.
1. Opioids are derived from the opium poppy and have been used for thousands of years to relieve pain, induce euphoria, and suppress coughing and diarrhea.
2. They work by binding to opioid receptors in the brain and spinal cord to reduce pain signaling and perception. This can produce strong analgesia but also side effects like sedation, respiratory depression, dependence, and tolerance with prolonged use.
3. Common natural and synthetic opioids include morphine, codeine, fentanyl, hydromorphone, and methadone. They are widely used to treat moderate to severe acute and chronic pain as well as for other purposes like cough suppression.
This document provides information on opioids and their use as analgesics. It begins by defining analgesics as any drug used to relieve pain and classifies them as opioids, NSAIDs, or paracetamol. Opioids act on opioid receptors in the brain and nervous system to produce morphine-like pain relief effects. Both natural and synthetic opioids are discussed. The document outlines the historical use of opium from the opium poppy and how semi-synthetic and synthetic opioids are derived from natural opiates. It also discusses how opioids work by binding to opioid receptors in the brain and nervous system to reduce pain transmission. Different classifications of opioids are presented including source, chemical structure, strength, and effects on opioid receptor subtypes. Common
Endorphin is a peptide hormone produced naturally in the brain and pituitary gland that functions as the body's natural analgesic. It binds to the same opioid receptors in the brain, spinal cord and nerve endings as exogenous opioids like morphine. High concentrations of endorphins produce feelings of euphoria and pain suppression, while low concentrations are associated with increased anxiety and pain awareness. Research into the endogenous opioid system and different types of endorphins like beta-endorphin may help develop non-addictive pain treatments that target opioid receptors without dangerous side effects.
Endorphin is a peptide hormone produced naturally in the brain and pituitary gland that functions as the body's natural analgesic. It binds to the same opioid receptors in the brain, spinal cord, and nerve endings as exogenous opioids like morphine. High concentrations of endorphins produce feelings of euphoria and pain suppression, while low concentrations are associated with increased anxiety and pain awareness. Research into the endogenous opioid system and different types of endorphins may help develop non-addictive pain treatments that target receptors like the kappa receptor without dangerous side effects.
Morphine and its analogues are called narcotic analgesics or opioid analgesics. They produce analgesia by binding to opioid receptors in the brain and spinal cord. Opioid receptors include mu, kappa, and delta receptors. Long term opioid treatment can cause tolerance, physical dependence, and addiction through changes in gene expression and neural plasticity in the brain. Recent research aims to develop new opioid drugs that prevent tolerance through combinations of agonists and antagonists or by targeting mechanisms of receptor desensitization and trafficking.
Narcotics are opioid drugs derived from opium poppy that are addictive and affect mood. They work by acting on receptors in the brain and nervous system to reduce pain and slow breathing. Common routes of administration include oral, intravenous, and inhalation. While narcotics have medical uses for pain relief, side effects include addiction, sedation, and trouble breathing. Treatment for narcotic addiction involves medication, counseling, and rehabilitation to support abstinence and prevent relapse.
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Thiopentone sodium, propofol, ketamine and etomidate are commonly used intravenous induction agents in anaesthesia. Thiopentone sodium is an ultra-short acting barbiturate that must be given intravenously. Propofol provides fast induction and recovery. Ketamine is useful for its analgesic and cardiovascular stabilizing properties. Etomidate is cardiostable but can disturb the HPA axis. Anticholinergics like atropine and glycopyrrolate are used to reduce secretions and prevent bradycardia. Benzodiazepines like midazolam, diazepam and clonazepam are used for anxiolysis, seizures and sed
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1) This case discusses the challenges of managing acute pain in a hospitalized patient on chronic opioids who underwent foot amputation surgery.
2) The patient was prescribed escalating doses of opioids, including extended-release morphine up to 165mg 3 times daily as well as IV and oral hydromorphone. He developed somnolence and hypoxemia.
3) After holding the extended-release morphine, the patient's pain worsened and muscle spasms developed. He was prescribed diazepam which led to respiratory depression and an opioid/benzodiazepine overdose requiring naloxone and ICU admission.
Neuromuscular blockers (NMBs) are drugs that paralyze skeletal muscles by interfering with acetylcholine at the neuromuscular junction. The document discusses both depolarizing NMBs like succinylcholine and non-depolarizing NMBs. It provides details on the classification, mechanisms of action, pharmacokinetics, indications and contraindications of various NMBs. It also discusses factors that can alter the duration of action of non-depolarizing NMBs such as pH, temperature, age, electrolyte levels and interactions with other drugs.
Local anesthetics work by blocking sodium channels and include both ester and amide chemical structures. Ester local anesthetics like procaine are metabolized rapidly via plasma esterases while amides like lidocaine undergo hepatic metabolism. Factors like lipid solubility, pH, dose, and route of administration influence a local anesthetic's potency, onset, and duration of action as well as its systemic absorption and toxicity risk profile. The addition of vasoconstrictors can prolong a local anesthetic's effects by decreasing its rate of vascular uptake.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- 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
2. The use of opium
• Opium was first discovered in pre-
biblical times; derived from the opium
poppy
• Opium was widely used from the middle
ages in a medicine known as “tincture of
opium” or Laudanum
Children's Pain Management Service,
RCH, Melbourne
3. What are opioids?
• All drugs with morphine-like actions are
described as opioids
• Opioids were originally derived from the
opium poppy (papaver somniferum)
which has 25 alkaloids
• Only two of these alkaloids have any
analgesic action: morphine and codeine
Children's Pain Management Service,
RCH, Melbourne
4. GlaxoSmithKline supplies ~25% of the world's
medicinal opiate needs from opium poppies
grown by farmers in Tasmania
Children's Pain Management Service,
RCH, Melbourne
5. Opioid or Narcotic?
Opioid:
natural, semi-synthetic and synthetic drugs that
relieve pain by binding to opioid receptors in the
nervous system
Narcotic:
obsolete term for opioid, because governments
and media use the term loosely to refer to a
variety of substances of potential abuse including
opioids, cocaine and other substances
Children's Pain Management Service,
RCH, Melbourne
6. Opiate or Opioid?
Opiate:
term used to refer to drugs derived from
the opium poppy, for example, morphine
(thus excluding synthetic opioids such
as fentanyl)
Opioid:
refers to any substance with morphine-
like activity including natural, semi-
synthetic and synthetic opioids
Children's Pain Management Service,
RCH, Melbourne
7. How morphine was named
• In 1805, a German pharmacist
(Serturner) isolated an opium alkaloid
• He named it morphine (after Morpheus,
the Greek god of sleep)
Children's Pain Management Service,
RCH, Melbourne
8. How do opioids work?
• All opioids bind to opioid receptors
• Opioid receptors are located in the:
• peripheral nervous system
• spinal cord
• brain
• When opioids bind to these receptors
they affect the transmission of pain
signals to the brain
Children's Pain Management Service,
RCH, Melbourne
9. Opioid receptors
There are three main types of opioid
receptors:
• mu ()
• delta ()
• kappa ()
These receptors have multiple actions
Children's Pain Management Service,
RCH, Melbourne
10. Mu() opioid receptors
• The mu receptors are associated with:
• analgesia
• side effects
• Mu receptors are subtyped: mu-1 & mu-
2
Children's Pain Management Service,
RCH, Melbourne
11. Action at the mu() receptor
• Mu-1 receptor is responsible for
analgesia
• Mu-2 receptor is responsible for the
opioid side-effects:
• respiratory depression
• cardiovascular depression
• decreased gastrointestinal motility
• sedation
• euphoria
• urinary retention
Children's Pain Management Service,
RCH, Melbourne
12. Mu-1 specific opioids do not exist
• The opioid action of all known natural
and synthetic opioids at mu receptors is
non-specific
• No opioid has yet been found or
developed that acts only on the mu-1
receptor
Children's Pain Management Service,
RCH, Melbourne
13. Opioid receptor antagonist
• Naloxone (NarcanTM) is a pure opioid
receptor antagonist
• Naloxone displaces opioids bound to
opioid receptors
• The duration of action of naloxone is 30-
60 minutes
• Thus naloxone may wear off before a
longer acting opioid and symptoms of
opioid toxicity may reappear
Children's Pain Management Service,
RCH, Melbourne
15. Contraindications to opioids
The following are not absolute
contraindications,
as opioids may be used in small titrated
doses:
• depressed conscious state (relative)
• head injury (relative)
• respiratory insufficiency (relative)
Children's Pain Management Service,
RCH, Melbourne
16. Precautions
Neonates:
• lower doses may be required
• decreased clearance of opioids and
opioid metabolites
Children's Pain Management Service,
RCH, Melbourne
17. Side effects of opioids
• Opioid side effects occur regardless of
which opioid is used
• Side effects are usually dose-related
Children's Pain Management Service,
RCH, Melbourne
19. Respiratory depression
• Respiratory depression from opioids is
due to the combination of sedation,
decreased tidal volume, reduced
respiratory rate and a drop in oxygen
saturation
• This results in hypoxia and raised
carbon dioxide levels, which leads to
further sedation and further respiratory
depression
Children's Pain Management Service,
RCH, Melbourne
20. Different opioid drugs
Morphine:
• pure opioid
• powerful mu agonist
• varied formulations (oral, IV/IM/SC)
• oral immediate release eg Morphine mixture/tabs,
KapanolTM
• oral sustained release eg MS ContinTM
• the metabolites are M3G and M6G
• morphine 3 glucuronide & morphine 6 glucuronide
Children's Pain Management Service,
RCH, Melbourne
21. Different opioid drugs
Codeine:
• pure opioid
• mu agonist
• prodrug (converts to another form)
• converts to morphine
• 7-10% of some population groups are
unable to convert codeine to morphine, thus get no analgesia
effect while others are rapid converters and become sedated.
Children's Pain Management Service,
RCH, Melbourne
22. Different opioid drugs
Pethidine: (rarely used at RCH)
• synthetic opioid
• mu agonist
• metabolite is nor-pethidine
• pethidine infusions should be avoided
due to the concerns of nor-pethidine
toxicity
Children's Pain Management Service,
RCH, Melbourne
23. Different opioid drugs
Fentanyl:
• synthetic opioid
• mu agonist
• structurally similar to pethidine
• short acting, but a lipophilic (fat soluble)
drug which may result in accumulation
• no metabolites
Children's Pain Management Service,
RCH, Melbourne
24. Different opioid drugs
Hydromorphone (DilaudidTM):
• synthetic opioid
• related to oxycodone and hydrocodone
• varied formulations (oral, IV/IM/SC,
epidural)
• the metabolites are H3G and H6G
• hydromorphone 3 glucuronide & hydromorphone 6
glucuronide
Children's Pain Management Service,
RCH, Melbourne
25. Different opioid drugs
Oxycodone:
• synthetic opioid
• related to hydrocodone and
hydromorphone
• similar strength to oral morphine
• sustained release version available
• OxycontinTM
Children's Pain Management Service,
RCH, Melbourne
26. Different opioid drugs
Dextropropoxyphene:
• synthetic opioid
• weak mu agonist
• preparations often mixed with other
analgesics
• eg combined with paracetamol as DigesicTM
Children's Pain Management Service,
RCH, Melbourne
27. Different opioid drugs
Methadone:
• synthetic opioid
• strong mu agonist
• very long acting opioid
• useful for neuropathic pain
• no metabolites
Children's Pain Management Service,
RCH, Melbourne
28. Different opioid drugs
Tramadol:
• not a true opioid
• has opioid and non-opioid properties
• non-opioid effects are via nor-adrenaline
and serotonin pathways
• active metabolite (M1) has mu receptor
affinity
Children's Pain Management Service,
RCH, Melbourne
29. Misbeliefs about opioids and children
• ‘Children are more sensitive to opioids’
• ‘Infants and neonates do not feel pain’
• ‘Pain is character building’
• ‘Children have little requirements for
opioids’
• ‘Children can be easily overdosed’
• ‘The use of opioids leads to addiction’
Children's Pain Management Service,
RCH, Melbourne
30. Misunderstanding of definitions
• Confusion about the definitions of
addiction, tolerance, withdrawal and
the implications for patients are the
main reason that opioids are under
utilised
Children's Pain Management Service,
RCH, Melbourne
31. Definitions
• Addiction: psychological dependence
with compulsive drug use, and craving
for opioids for effects other than pain
relief
• Tolerance: when increased doses of a
drug is needed to produce the same
pharmacological effect
Children's Pain Management Service,
RCH, Melbourne
32. Definitions
• Withdrawal: a cluster of physiological
signs and symptoms, which occur after
sudden ceasing of some drugs
• Dependency: when sudden absence of
an opioid produces physical withdrawal
syndrome
Children's Pain Management Service,
RCH, Melbourne
33. Fear of addiction
• Fear of creating addiction in patients
contributes to the under use of opioid
analgesics (Ferrell BR et al, J Pain & Sympt Manage,
1992)
• The risk of addiction for patients having
opioids for medical reasons is
extremely low
• Tolerance to an opioid does not mean
the patient has an addiction
Children's Pain Management Service,
RCH, Melbourne
34. Caring for children receiving opioids
• Accurate documentation
• Correct dose of opioid
• Correct and safe delivery of opioid
• Observation of vital signs
• Minimal side effects
• Documented pain scores
• Adequate analgesia achieved
Children's Pain Management Service,
RCH, Melbourne
36. Combining opioids
• It is not good practice to administer more than
one opioid at a time, as this increases the risk of
side effects
• At RCH we do not administer morphine and
codeine together
• An exception is when long-acting and short-
acting formulations of the same opioid are
administered for optimal analgesia in patients
with severe pain
eg MS Contin & morphine mixture OR Oxycontin & oxycodone
Children's Pain Management Service,
RCH, Melbourne
37. Optimising opioid analgesia
• The child needs to be comfortable
• The child needs to be able to breathe
deeply/cough without pain
• The child needs to be able to mobilise
freely without being limited by pain
Children's Pain Management Service,
RCH, Melbourne
38. Optimising opioid analgesia
• Pre-emptive pain management is
important
• Treat side effects early and adequately
• Adjunctive analgesia may be required
• Children should not be sedated
• Believe the child’s pain assessment
• Act on assessment
Children's Pain Management Service,
RCH, Melbourne
39. Children's Pain Management Service
• The Children's Pain Management
Service supervises most patients with
opioid infusions at Royal Children's
Hospital
• CPMS can be contacted at all times on
pager 5773
Children's Pain Management Service,
RCH, Melbourne
40. Finally…
Optimal pain management
is the right of all patients
and the responsibility of
all health professionals
Children's Pain Management Service,
RCH, Melbourne