Unformatted text preview: % of adults experience muscle pain each year.
• 70% of people with cancer report moderate to
• 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
• 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
• 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
• 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
Introduction to the opioids
Basic pharmacology of the opioids
Clinical use of opioids
Nonopioid centrally acting analgesics
Nonopioid Analgesics and Opioids
• Analgesics---are drugs that relieve pain
without causing loss of consciousness.
– Ex: ibuprofen, tylenol
Ex: • Opioids---are the most effective pain
• Opioid---a general term defined as any drug
that has actions similar to those of morphine
• Opiate---applies only to compounds present
in Basic Pharmacology of the Opioids
• Strong opioid agonists – Morphine
– Other strong opioid agonists • Moderate to strong opioid agonists
• Agonist-antagonist opioids Opioid Agonists
(prototype of strong opioid
analgesic) Source---seedpod of the poppy plant
Overview of pharmacologic actions –
– Receptors involved
Sense of well-being – Ask if it took their pain away. Its hard to get a
patient to a 0 or 1 for pain. Morphine
• Pharmacokinetics – Administered by several routes: oral, IM, IV,
subcutaneous, epidural, and intrathecal
– Not very lipid soluble (it may cross into the
BBB) it is excreted very well. It wont last a
long time, so we dose frequently
– Does not cross blood-brain barrier easily
– Only small fraction of each dose reaches site of
analgesic action higher dosing Morphine
• Therapeutic use: relief of pain, sedation,
euphoria, respiratory depression, cough
suppression, suppression of bowel motility
• Moderate to severe pain
• Pre-op treatment of anxiety...
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- Spring '14
- Pharmacology, Morphine