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Analgesics

Analgesics

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Published by: Mohd Rohaimi Ab Halim on May 07, 2012
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01/26/2013

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ANALGESICSI.Pain
occurs when there is tissue damagerelease of kinins & prostaglandinsstimulate sensory nerves (A-delta & C fibers)pain is perceived
Gate-Control Theory
II.Non -Narcotic AnalgesicsA. Nonsteroidal Antiinflammatory Drugs (NSAIDs)
ibuprofen (Advil, Alaxan, Dolan, Muskelax, Midol)
mefenamic acid (Dolfenal, Gardan, Ponstan)
Naproxen (Flanax)
Ketorolac (Toradol)
ketoprofen (Orudis)
diclofenac (Cataflam, Neopyrazone )
indomethacin
piroxicam
Meloxicam (Mobic)Indic:
analgesic (arthritis, mild-moderate pain, dysmenorrhea)
antipyreticMOA: block prostaglandin (PG) synthesisSide Effects:1.gastric irritation & bleeding -MC2.blood dyscrasias3.dizziness4.hypotension5.pruritus6.Na & water retention7.tinnitus 
B. Salicylates
aspirin (ASA, Aspilet)Indic:
analgesic
antipyretic
 
anticoagulant (reduce risk of TIA, stroke, or MI)MOA: block PG synthesisSide Effects:1.gastric irritation
2.
8
th
CN damage3.salicylisma.tinnitus, dizzinessb.difficulty hearingc.N, V & diarrhea
d.
confusion4. salicylate toxicity
C.Cyclooxygenase (COX)- 2 inhibitors
celecoxib ( Celebrex )
valdecoxib ( Bextra )Indic:
analgesicMOA: block cyclooxygenase-2 ---> reduce inflammation & painSide Effect: less GI & CNS effects
D.Acetaminophen
acetaminophen (Tylenol)
Indic:
analgesic,
antiypyreticMOA: blocks PG synthesisSide Effects:1.V,A, N2.rash3.hepatotoxicity4.acetaminophen toxicity
III.
Narcotic (Opioid) Analgesics
morphine
meperidine (Demerol)
 
nalbuphine (Nubain)
codeine
oxycodone
 
methadone
Butorphanol (Stadol)Indic:
DOC for severe pain
cough suppressant
slows motility of GIT
induction of anesthesiaMOA: bind with opioid receptors -->regulate transmission of pain impulses,promote feelings of well-being & euphoriaSide Effects:1.constipation2.hypotension3.urinary retention4.miosis5.respiratory depression6.euphoria & sedation7.drug tolerance & drug dependence8.increase ICP
Opioid Antagonist
naloxone (Narcan)
NaltrexoneIndic:
reversal of opioid effects in narcotic overdose
Dx of narcotic overdoseMOA: reverses opioid effects ( resp. depression, sedation & hypotension)Side Effects:1.Acute narcotic abstinence syndrome
NV, sweating, tachycardia, hypotension2.BP changes3.pulmonary edema 

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