Opiod Analgesics

Question 1

Define Analgesics

Answer 1

The drug which relives pain of any origin

Question 2

Classification of analgesics

Answer 2

1.Opoidal /Narcotic analgesic.
2 .Non opiodal/ Non narcotic analgesics

Question 3

1. Opoidal/Narcotic analgesics are:

Answer 3

•Morphine
• Pethidine → Safer than morphine.
• Tramadol → Pain in surgery.
• Fentanyl → A n e s t h e s í a
• Pentazosine
• Methadone

Question 4

Non opoidal/ Non-narcotic analgesic are

Answer 4

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

Question 5

Classification of opoidal analgesics

Answer 5

According to sources

According to efficacy

Question 6

Opoidal analgesics acc to source are

Answer 6

Natural:
• Morphine
• C o d e i n e
• Endorphine
• Dynorphine
• Enkephaline

• Semi-Synthetic:
• Diamorphine(Heroine)
• Dihydrocodeine
• Hydrocodeine
• Oxycodeine
• Oxymorphine

• Synthetic:
• Pethidine
• Fentanyl
• Pentazosine
• Loperamide
•Nalbuphine

Question 7

According to efficacy

Answer 7

High efficacy:
• Morphine Pethidine
• Fentanyl
• Tramadol
• Diamorphine

• Low efficacy:
• Codeine
• Dihydrocodeine
• Pentazocine
• Nalbuphine

Question 8

Properties of opiodal analgesic

Answer 8

They act in CNS

Active in visceral pain

Causes CNS depression(narcosis)-Sedation

Highly potent analgesic

No anti-inflammatory and antipyretic action

Can be used in labour pain(Pethidine)

They h a v e low TI

• Chance of addiction,dependence

Question 9

Opoidal receptors are:

Answer 9

Meu
Delta
K

Question 10

Pharmacological action of morphine

Answer 10

CNS effects:
• Analgesia
• S e d a t i o n
• Respiratory depression
• Cough suppression
• Nausea and vomiting
• Miosis
• Euphoria
• Hyperthermia

Peripheral effects:
• Bradycardia
• Constipation
• 1 Biliary pressure
• Urinary retention
• Oliguria(TADH)
• Prolong labour
• Warming and itching of skin
• Galactorrhoea (prolactin)

Question 11

Clinical use of morphine

Answer 11

• Diagnosed severe visceral pain
→ Pancreatitis
→ Pericarditis
→ Pleurisy
→ Cholecystitis
→ Pyelonephritis

• Postoperative pain

• Cancer pain

• Burn pain

• MI

• Acute ALVF

• Cough suppression

• Spinal anaesthesia(IN)

Question 12

Adverse effects of morphine

Answer 12

N a u s e a
• Vomoting
• Shivering
• Warming
• Itching
• Sedation
• Respiratory depression
• Cough suppression
• Miosis
• Constipation
• Urinary retention
• Oliguria
• Orthostetis hypotention
• Hypotension
• Bradycardia
• Euphoria
• Dependence
• Addiction liability

Question 13

Contraindication of morphine

Answer 13

•Undiagnosed acute abdomen
• Bronchial asthma
• P r e g n a n c y
• Head injury
• Convulsive disorder
• Biliary colic
• Acute renal failure

Question 14

Why morphine is contraindicated in undiagnosed visceral pain

Answer 14

Morphine relieve visceral pain but proper diagnosis is not possible so complication may be developed (rupture of viscera may occur).
For this morphine is contraindicated.

Question 15

Why morphine is contraindicated in Pregnancy?

Answer 15

Morphine crosses blood placental barrier and may cause foetal respiratory depression and intrauterine foetal death may occurred.

Question 16

Analgesic action of morphine

Answer 16

Morphine/Pethidine
|
|
1. Acts in presynaptic nerveterminal
by bind with opoidal receptors (M, 8, K)
|
|
Closing of ca++ channel and
NT release(Glutamate, Ach.NA,substance p)
|
|
Analgesic action

2. acts in post synaptic terminal
   by bind with opoidal receptors
   |
   Opening of k+ channel
   |
   Increase K+ conductance
   |
   Hyperpolarization
   |
   blocking of pain pathway
   |
   Analgesic action