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D3 Analgesics By Cameron Precord and Quin Peek And edited by Ms. Smith By Cameron Precord and Quin Peek And edited by Ms. Smith
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FPain-described as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage FPain receptors-free nerve endings located in various tissues that respond to thermal, mechanical or chemical stimuli FWhen stimulated, these pain receptors generate an impulse FPain results from interaction between more than one impulse arriving at the spinal cord and brain Pain
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FWhen tissue is damaged, it releases chemicals known as prostaglandins and leukotrienes FThese sensitized receptors react to even slight stimuli, causing pain ( an injury being tender) FDifferent people feel pain differently FAnalgesics are drugs that relive pain without causing a loss of consciousness.
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FMILD ANALGESICS relieve “mild” pain and often fever non-addictive Examples include Aspirin Acetaminophen Phenacetin Ibuprofen NSAIDS (Nonsteroidal anti-inflammatory drugs) F STRONG ANALGESICS (OPIATES) relieve severe pain controlled substances addictive Examples include Morphine Heroin Codeine Two Types of Analgesics
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FUsed in four different ways: Mild analgesic for minor aches and pains, to relieve headaches, sunburn and arthritic pain anti-pyretic to mitigate fever anti-inflammatory agent (reducing swelling) anti-platelet agent (decrease/prevent blood clotting) Aspirin – MILD ANALGESIC – a derivative of Salicylic Acid
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Disadvantages of Using Aspirin acidic; cause upset stomach, internal bleeding, ulcers When taken with alcohol may produce gastrointestinal bleeding .5% of people are allergic to aspirin develop skin rashes, respiratory issues, and may go into shock frequent causes of poisoning among infants May lead to REYES Syndrome a potentially fatal liver and brain disorder which may result in brain damage, coma, death
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Alternatives to Aspirin FPhenacetin FAcetaminophen Metabolic byproduct of phenacetic AKA Tylenol Known as paracetamol in some countries Properties - Advantages Anti-pyretic Mild analgesic Does NOT upset stomach does NOT cause internal bleeding Properties - Disdvantages Not anti-inflammatory Side effects include blood disorders… damage to kidnes… Not safe to take with alcohol Overdose can cause liver damage, brain damage, coma, death
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Strong Analgesics Faka Opiates or Narcotics FOpiate = any natural or synthetic drugs that produces morphine-like characteristics FNarcotic = drug that has both sedative and analgesic action FExamples include Morphine – natural – opium poppy plant Heroin - semi-sythetic Codeine – natural – opium poppy plant FStructures are similar… but… Heroin has the two OH groups in morphine replaced with ester groups. Codeine replaces one OH group of Morphine with a OCH3 group. Faka Opiates or Narcotics FOpiate = any natural or synthetic drugs that produces morphine-like characteristics FNarcotic = drug that has both sedative and analgesic action FExamples include Morphine – natural – opium poppy plant Heroin - semi-sythetic Codeine – natural – opium poppy plant FStructures are similar… but… Heroin has the two OH groups in morphine replaced with ester groups. Codeine replaces one OH group of Morphine with a OCH3 group.
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Strong Analgesics Heroin is most potent, then morphine, then codeine
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Advantages of Strong Analgesics FOpiates impact Central nervous system Pain relief due to injury, surgery, chronic disease (cancer) Relieves coughing by relaxing the ‘cough center’ in the brain stem. Digestive system Produces a Constipating Effect – used for diarrhoea Impact Psychological state Relief from physical, emotional, and psychological pain. FOpiates impact Central nervous system Pain relief due to injury, surgery, chronic disease (cancer) Relieves coughing by relaxing the ‘cough center’ in the brain stem. Digestive system Produces a Constipating Effect – used for diarrhoea Impact Psychological state Relief from physical, emotional, and psychological pain.
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Impact physical state Constipation Nausea Vomiting Sedation Can lead to tolerance and physical dependence Psychological state Mood changes metal clouding Anxiety Fear lethargy sedation, ack of concern inability to concentrate Can lead to psychological dependence Impact physical state Constipation Nausea Vomiting Sedation Can lead to tolerance and physical dependence Psychological state Mood changes metal clouding Anxiety Fear lethargy sedation, ack of concern inability to concentrate Can lead to psychological dependence Disadvantages of Strong Analgesics
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Common Short and Long Term Effects Short sedation / stupor pain relief euphoria impaired coordination reduced tension and fear suppressed coughing reflex occasional deaths from overdose Short sedation / stupor pain relief euphoria impaired coordination reduced tension and fear suppressed coughing reflex occasional deaths from overdose LONG loss of appetite constipation risk of infections through shared needles withdrawal loss of job / income crime sterility loss of energy LONG loss of appetite constipation risk of infections through shared needles withdrawal loss of job / income crime sterility loss of energy
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Tolerance and Dependence FTolerance – body needs more of the drug to have the desired impact Cross tolerance - Users who develop tolerance for one opiate will begin to tolerate all other opiates. FPhysical Dependence – inability to function normally without the drug users experience withdrawal Restlessness, sweating, fever, chills, vomiting, increased respiration, cramping, diarrhoea, aches, pains FTolerance – body needs more of the drug to have the desired impact Cross tolerance - Users who develop tolerance for one opiate will begin to tolerate all other opiates. FPhysical Dependence – inability to function normally without the drug users experience withdrawal Restlessness, sweating, fever, chills, vomiting, increased respiration, cramping, diarrhoea, aches, pains
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Synthetic Opiates Fdemerol Fmethadone bocks euphoric high of heroin used to break addiction to heroin F dextromethorphan can replace codeine non-narcotic used in cough syrups Fdemerol Fmethadone bocks euphoric high of heroin used to break addiction to heroin F dextromethorphan can replace codeine non-narcotic used in cough syrups
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FLOCAL ANESTHETICS Reversible loss of sensation (and pain) in a localized area Maintain consciousness Examples include Lidocaine Procaine used in dentistry FGENERALIZED ANESTHETICS act on the brain produce reversible unconsciousness and insensitivity to pain Examples include Inhalants: Isoflurane, Desflurane; sevoflurane; Nitrous oxide IV : barbituates, benxodiazepines, ketamine Two Types of Anesthetics
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Practice Problems Can Be Found on Page 434 of your Green and Damji Book
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