Pain, should be accessed and monitored in all patients.
an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.
Associated with surgery, other medical procedures or trauma
Last only hours or a few days
Treated primarily with analgesics, often narcotic analgesics
Chronic Malignant pain
Associated with cancer or other progressive diseases
May last months or years
May be complicated by depression
Treated with analgesics, often narcotic analgesics
Chronic Nonmalignant pain
caused by ongoing disease that is not life-threatening, pain that has continued after the underlying cause is resolved or pain that has no identifiable cause
Includes arthritis pain, headache pain, neuropathic pain and fibromyalgia
May be complicated by depression, anxiety and other psychological disorders
Treatment is complex involving use of analgesics as well as other therapies
the immediate defensive action of tissue to any injury, which may be caused by infection, chemicals or physical agents.
involves pain, heat, redness, swelling, and loss of function of the affected part.
What is opium? Where does it come from?
the poppy, papaver somniferum
How do narcotic analgesics work?
produce most of their effects on the central nervous system (CNS) and the bowel.
an agonist-receptor (lock and key) interaction.
The relative potency of the different narcotic analgesics correlates well with their affinity for these receptors
What actions do narcotic analgesics have on various body functions?
Pupil: cause constriction of the pupil, pinpoint pupils in a patient are said to be an indicator of narcotic use. Note: meperidine (Demerol�) can cause dilation of the pupils, good for shavering after surgery.
Respiration system: all cause depression of respiration
GI: Inhibit GI motility, and stimulate the CTZ. Mepergin can antagonist the vomiting after surgery , Opium was used for relief of diarrhea. Opiates decrease propulsive movements in the GI tract and increase muscle tone of the sphincters.
Propoxyphene (Darvon�) low in pain relive ability, high in
that fits the lock of the narcotic receptor but doesn't turn the key.
also blocks the receptor from getting stimulation from any narcotic agonist.
Treat narcotic Addiction, reverse response of narcotic
Why are narcotic analgesics abused?
Psychological Dependence: euphoria is responsible for a large part of the problem with drug abuse.
Physical Dependence: When narcotic analgesics are used on a regular (usually daily) basis, the body tends to revolt if a scheduled dose is missed. This missing of a dose is very uncomfortable and is responsible for much of the "drug seeking behavior".
Patients who regularly take narcotic analgesics will develop tolerance to the euphoria, analgesia, sedation and respiratory depression caused by these agents.
However, they do not develop tolerance to the GI effects.
the "drying out" or "detox" period.
Symptoms of withdrawal from narcotic analgesics begin shortly before the next scheduled dose (usually about 8 to 12 hours after the last dose).
These symptoms will usually continue for 7 to 10 days.
What are some of the symptoms of narcotic withdrawal?