Our Lady of Fatima University

College of Pharmacy
Clinical Pharmacy and Pharmacotherapeutics 1 (PHCP 311)

NEUROLOGIC
NERVOUS SYSTEM
DISORDER
OBJECTIVES

• To explain the pathophysiology of the neurologic

disorder
• To identify the factors that may induce and
potentiate the disorder
• To discuss the clinical presentation as well the
diagnosis and laboratory evaluation.
• To create a therapeutic outcome.

Our Lady of Fatima University

College of Pharmacy
PAIN MANAGMENT

• Pain
is an unpleasant, subjective, sensory
and emotional experience assocaiated
with actual or potential tissue damage or
described in terms of such damage.

Our Lady of Fatima University

College of Pharmacy
PATHOPHYSIOLOGY

• Nociceptors are pain sensing nerve cells. It

can be located in either somatic or visceral
• It will propagate the information to the
spinal cord nearby.
• The action potential will trigger the release
pain neuro transmitter (substance P).
• It will ascends to higher centers.

Our Lady of Fatima University

College of Pharmacy
• The thalmus acts as relay station and
passes the impulses to the central
structure.
• Body will modulate the pain.
• Endogenous opiate system will be activated.
• Neurotransmitter such as enkephalins,
dynorphins and B-endorphins will bind to the
receptors mu, delta and kappa

Our Lady of Fatima University

College of Pharmacy
NEUROPATHIC PAIN

• It is resulted from nerve damage.

E.g.
• Postherpetic neuralgia
• Diabetic neuropathy
• Acute pain is usually a nociceptive but can be
neuropathic
• Chronic pain can be both neuropathic and
functional pain, for example, a pain that
persist after the healing of acute injury.

Our Lady of Fatima University

College of Pharmacy
FUNCTIONAL PAIN

• It
refers to the abnormal operation of the
nervous system
E.g.
• Fibromyalgia
• Irritable bowel syndrome
• Tension-type headache

Our Lady of Fatima University

College of Pharmacy
CLINICAL
MANIFESTATION

• Patientcan have a distress from trauma or

appear to have no noticeable suffering
• Acute pain
• Sharp or dull, burning, shock-like tingling,
shooting radiating, fluctuating intensity, varying
location and occur in a timely relationship with
an obvious noxious stimulus

Our Lady of Fatima University

College of Pharmacy
• Acute pain can cause HTN, tachycardia,
diaphoresis, mydriasis and palor.
• Acute pain there is no relation with
comorbid conditions unlike chronic pain,
there is.
• Chronic pain occurs without a timely
relationship with a noxious stimulus.

Our Lady of Fatima University

College of Pharmacy
CLINICAL
ASSESSMENT

• Patientmedical history
• Pain Scale
• Blood Chemistry
• PQRST characteristic
• Medications

Our Lady of Fatima University

College of Pharmacy
 PAIN SCALE

Our Lady of Fatima University

College of Pharmacy
CLINICAL
INTERVENTION

• Non-opioid agents
• Given for mild to moderate pain
• Fewer side effects (GI problems)
•Opioid agents
• Given for severe pain at high dose
• Partial agonist and antagonist- selectivity with
the pain receptor site.
• Might exhibit allergic reaction.

Our Lady of Fatima University

College of Pharmacy
• Intrathecal
and epidural opioids are often
administered with patient controlled
analgesia.
• Safe and effective (lesser side effect)
• Morphine isthe first line agent for
moderate to severe pain.
• Cause respiratory depression that why it’s given
with naxolone

Our Lady of Fatima University

College of Pharmacy
DESIRED OUTCOMES

• Minimize the pain

• Provide reasonable comfort

Our Lady of Fatima University

College of Pharmacy
THANK YOU FOR
LISTENING