ANALGESICS

Question 1

What is an analgesic?

Answer 1

A drug which relieves pain of any origin.

Question 2

Classify analgesics.

Answer 2

1. Opoidal / Narcotic analgesic
2. Non opoidal / Non-narcotic analgesic

Question 3

Name examples of opoidal/narcotic analgesics.

Answer 3

• Morphine
• Pethidine
• Tramadol
• Fentanyl
• Pentazosine
• Methadone

Question 4

Name examples of non opoidal/non-narcotic analgesics.( These are NSAIDS)

Answer 4

• Paracetamol
• Diclofenac
• Ketorolac
• Aceclofenac
• Aspirin
• Indomethacin
• Ibuprofen
• Naproxen
• Tenoxicam

Question 5

Fill in the blank: An analgesic that relieves pain without the use of narcotics is called a _______.

Answer 5

Non opoidal / Non-narcotic analgesic

Question 6

True or False: Morphine is classified as a non opoidal analgesic.

Answer 6

False

Question 7

What type of analgesic is Fentanyl?

Answer 7

Opoidal / Narcotic analgesic

Question 8

Fill in the blank: _______ is a common non opoidal analgesic used to relieve pain and reduce fever.

Answer 8

Paracetamol

Question 9

What are the natural opoidal analgesics?

Answer 9

Morphine, Codeine, Endorphine, Dynorphine, Enkephaline

Question 10

What are the semi-synthetic opoidal analgesics?

Answer 10

Diamorphine (Heroin), Dihydrocodeine, Hydrocodeine, Oxycodeine, Oxymorphine

Question 11

What are the synthetic opoidal analgesics?

Answer 11

Pethidine, Fentanyl, Pentazosine, Loperamide, Nalbuphine

Question 12

Which opoidal analgesics have high efficacy?

Answer 12

Morphine, Pethidine, Fentanyl, Tramadol, Diamorphine

Question 13

Which opoidal analgesics have low efficacy?

Answer 13

Codeine, Dihydrocodeine, Pentazocine, Nalbuphine

Question 14

Properties of narcotic/opoidal analgesics

Answer 14

•act in CNS
•Cause CNS depression
•Active in visceral pain
•Highly potent analgesics
•no antiinflammatory and antipyretic action
•used in labour pain (pethidine)
•low TI
•Chance of addiction, dependence

Question 15

Pharmacological action of morphine

Answer 15

> CNS effects:
Analgesia
Sedation
Cough suppression
Respiratory distress
Nausea and vomiting
Miosis
Euphoria
Hyperthermia
Peripheral effects:
Bradycardia
Constipation
Increase billiary pressure
Urinary retention
Oliguria
Prolonged labour
Warming and itching of skin
Galactorhoea

Question 16

Clinical use of morphine

Answer 16

•diagnosed severe visceral pain
>Pancreatitis, pericarditis, pleurisy, cholecystitis, pyelonephritis
•Post operative pain
•cancer pain
•burn pain
•MI
•Acute ALVF
•cough suppression
•spinal anaesthesia

Question 17

Adverse effect of morphine

Answer 17

Nausea
Vomiting
Shivering
Warming
Itching
Sedation
Respiratory distress
Cough suppression
Miosis
Constipation
Urinary retention
Oliguria
Hypotension
Bradycardia
Euphoria
Dependence
Addiction liability

Question 18

Contraindications of morphine and why

Answer 18

Undiagnosed acute abdomen
Bronchial asthma
Pregnancy
Head injury
Convulsive disorder
Biliary colic
Acute renal failure

Question 19

Analgesic action of morphine

Answer 19

Morphine
Presynaptic nerve terminal
1.bind with opoidal reception
2.closing of Ca+² channel and release of glutamate, ach, noradrenaline, substance P
Post synaptic nerve terminal
1. Opening of potassium channel
2. increase Potassium channel
3. Hyperpolarization
4. Blocks pain pathway
Analgesic action

Question 20

Morphine vs pethidine

Answer 20

Morphine
Natural
More potent
Duration 4-6 hrs pethidine 2-3
Miosis
Not used in pregnancy
Atropine effects
Tolerance develops quickly
Addiction more likely