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Drugs for Pain Opiods and Headaches-pharm

Back pain is the leading cause of disability in

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Unformatted text preview: % of adults experience muscle pain each year. • 70% of people with cancer report moderate to severe pain. • Back pain is the leading cause of disability in Americans under the age of 45 years. • Pain costs approximately 50 million per year. Pain • Subjective experience/difficult to define. (there is no scale) • Objective signs may or may not accompany pain. (what we actually see) • Complex physiologic/psychogenic phenomenon. • Mediated through the CNS by nociceptors and perceived by the opiate receptors. • When opiate receptors are stimulated the perception of pain decreases. • To treat appropriately the pain must be assessed. • Doses should be titrated to obtain maximum efficacy with minimal side effects. Pain • Nonpharmacologic methods of pain management may be used to supplement drug therapy (massage, laying down, hot bath) • Pain is best controlled when analgesics taken before the pain becomes severe. (ask about pain before it gets to severity level) • Patients need education about the importance of pain control. • Nurses should reassess patients for pain following drug therapy. • There are many types or classifications of pain. Factors affecting the pain threshold. Pain • Pain is whatever the person say it is. • Pain has both sensory and affective components. • Pain Assessment---intensity, location, duration, quality, description, and what seems to intensify or relieve it***. • Pain pathways. Opioid (Narcotic) Analgesics, Opioid Antagonists, and Nonopioid Centrally Acting Analgesics Introduction to the opioids Introduction Basic pharmacology of the opioids Basic Clinical use of opioids Opioid antagonists Opioid Nonopioid centrally acting analgesics Nonopioid Analgesics and Opioids Analgesics • Analgesics---are drugs that relieve pain ---are without causing loss of consciousness. without – Ex: ibuprofen, tylenol Ex: • Opioids---are the most effective pain ---are relievers available. relievers • Opioid---a general term defined as any drug ---a that has actions similar to those of morphine • Opiate---applies only to compounds present ---applies in opium in Basic Pharmacology of the Opioids Basic • Strong opioid agonists – Morphine – Other strong opioid agonists • Moderate to strong opioid agonists • Agonist-antagonist opioids Opioid Agonists (Narcotics) • • • • • Morphine Codeine Hydrocodone Levorphanol Oxycodone • • • • • Oxymorphone Fentanyl Meperidine Methadone Propoxyphene • • Morphine (prototype of strong opioid (prototype analgesic) analgesic) Source---seedpod of the poppy plant Overview of pharmacologic actions – – – – – – Receptors involved Pain relief Drowsiness Mental clouding Anxiety reduction Sense of well-being – Ask if it took their pain away. Its hard to get a Ask patient to a 0 or 1 for pain. Morphine • Pharmacokinetics – Administered by several routes: oral, IM, IV, Administered subcutaneous, epidural, and intrathecal subcutaneous, – Not very lipid soluble (it may cross into the Not BBB) it is excreted very well. It wont last a long time, so we dose frequently long – Does not cross blood-brain barrier easily – Only small fraction of each dose reaches site of Only analgesic action higher dosing Morphine • Therapeutic use: relief of pain, sedation, Therapeutic euphoria, respiratory depression, cough suppression, suppression of bowel motility suppression, • Moderate to severe pain • Pre-op treatment of anxiety...
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