Pharma W2 Part 1 Pain Drugs PDF

hypothalamic...

hypothalamic systems affected: thalamic manage moderate-severe pain limbidic mild agonist ej. codeine & hydrocodone receptors: GABA helps slow things down when other drugs are ej. morphine, dilaudid, fentanyl, methadone better than barbiturartes added to the opiod x additional pain relief sedative for the most part Morphine Schedule I, moderate-severe pain prolong half life (x compliance) ->unintentional OD inhibits stimulation of brain adjuvant analgesic 3 step ladder by WHO: NSAIDs Antidepressants Dilaudid 5-8x more potent than morphine Indications: anxiety, alcohol withdrawal.. Anticonvulsants opiods analgesics strong agonist no more tan 4 g/day, Tylenol NSAIDS Corticosteroids examples Methadone 5 - 10x more potent than morphine "hangover" effect or daytime sleepiness- sluggish next day Amitriptyline (antidepressant) Fentanyl 50-100x more potent than morphine 1st cause of OD in CA Gabapentin or pregabalin (anticonvulsants) ex for neuropathic pain tolerance Carfentanyl worst ~10 thousand x more than morphine Schedule meds based in 1. Benzodiazepines paradoxical excitement of nervousness Schedule I - highest potential Adverse effects: potential for harm Medications that relieve pain without 1. Respiratory depression causing loss of consciousness Opiod adverse effects 2. constipation habit forming and low therapeutic index (risk for toxicity d/t narrow take opioids with food, assess LOC 3. urinary incontinence more sensitive to pain therapeutic window Nurs Implications opioid induced hyperalgesia and watch out for RR