Analgesics, CNS Depressants, and Antiepileptics

Definitions & Terms to Know Pain (acute vs chronic vs somatic vs phantom vs special) Analgesia Addiction Adjuvent Prostaglandin Agonist Agonist-Antagonist Antagonist Hypnotic GABA Sedative Autoinduction Seizure Convulsion Epilepsy

Non-Pharmalogical Interventions for Pain Relief H_______ or C_________ M________________ D________________ I______________ M________, A____, or P____Therapy R______________ Therapeutic C__________________

Gate Theory of Pain Transmission and Relief Pain causes chemo-receptors to be released. Message sent along sensory nerves to the spinal cord “gates.” Gate is controlled by the brain, not the peripheral nerves. When impulses are stopped at the gate, no pain is “felt” by the brain. Cells that control the Gate have a threshold, some impulses overcome the threshold to travel to the brain.

Acetaminophen Inhibits prostaglandin synthesis Analgesic Antipyretic Hepatic necrosis c overdose (>4000mg/d) antidote is Mucomyst(acetylsisteine) Nephropathy with long term use Numerous combos

Opioids Agonist action- binds to pain receptors. Antagonist action- reverses the action of agonist on pain receptors. Chemo-receptors: P________________ E____________, S________, H_______, B________________

Opioids (cont.) Uses: pain, cough, diarrhea, anesthesia Side Effects: Constipation, sedation, dependence, hypotension, respiratory depression, itching, urinary retention, N&V Adverse effects: paralitic ileus, hypoventilation, respiratory arrest, addiction, hallucination Interactions: Potentiates other CNS deprsnts.

Barbiturates Uses: Insomnia, seizures/epilepsy, Many side effects, narrow therapeutic index, addictive, deprived of REM sleep = rebound nightmares on cessation

Benzodiazepines Uses: Insomnia (sedative-hypnotic), anxiety (anxiolytic), alcohol withdrawal (competes with CNS receptors) muscle spasms (skeletal muscle relaxant) Side Effects: Headache drowsiness, dizziness

Skeletal Muscle Relaxants Uses: muscle spasticity from acute injury or chronic disease Side effects: lightheaded, dizziness, drowsiness, muscle weakness, constipation

Antiepileptic Agents Uses: various seizures and convulsions (suppress transmission of nerve impulses) Side Effects: drowsiness, agranulocytosis, gingival hyperplasia, “Dilantin Facies,” dysrhythmias, drug interactions, numerous others

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