Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Introduction to Clinical
Pharmacology
Chapter 15
Opioid Analgesics
Introduction to Clinical
Pharmacology
Chapter 15
Opioid Analgesics
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Three-Step Analgesic Pain Intensity
Treatment
Three-Step Analgesic Pain Intensity
Treatment
•
The World Health Organization (WHO) developed a three-
step analgesic protocol based on intensity as a guideline
for treating pain. The “pain ladder” directs the use of
both opioids and nonopioids in the treatment of mild to
severe pain.
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Introduction to Opioid Analgesics
Introduction to Opioid Analgesics
•
Controlled substances
•
Do not change tissues where pain originates
•
Change patient’s perception of pain
•
Treat pain centrally in the brain
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Opioid Analgesics
Opioid Analgesics
•
Opiates
•
Morphine
•
Heroin
•
Synthetic opioids
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Opioid Analgesics: Actions
Opioid Analgesics: Actions
•
Cells within central nervous system
•
Mu and kappa receptors
•
Agonist agents
•
Opioid analgesic
•
Agonist
•
Partial agonist
•
Agonist-antagonist
•
Nonintended responses
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Opioid Analgesics: Uses
Opioid Analgesics: Uses
•
Treat pain
•
Manage opiate dependence
•
Decrease anxiety
•
Support anesthesia adjunct
•
Promote obstetric analgesia
•
Administered intrathecally/epidurally
•
Treats severe diarrhea; intestinal cramping;
severe, persistent cough
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Opioid Analgesics: Adverse Reactions
Opioid Analgesics: Adverse Reactions
•
CNS: Sedation, increased intracranial pressure
•
Respiratory: Depressed breathing rate/depth
•
GI: Constipation, anorexia, biliary tract spasms
•
Cardiovascular: Tachycardia, bradycardia
•
Genitourinary: Urinary retention/hesitancy
•
Allergic reactions: Pruritus, rash, urticaria
•
Other reactions: Sweating, pain at injection site,
local tissue irritation
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins
Opioid Analgesics: Contraindications
Opioid Analgesics: Contraindications
•
Patients with hypersensitivity to drugs
•
Acute bronchial asthma, emphysema, or
upper airway obstruction
•
Patients with head injury or increased
intracranial pressure
•
Convulsive disorders; severe renal or hepatic
dysfunction; acute ulcerative colitis
•
Not recommended in pregnancy or labor
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