Analgesic and side effect, Abuse on body

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Analgesic and side effect, Abuse on body


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Analgesic (also known as a painkiller) is any
member of the group of drugs used to relieve pain
. The word analgesic derives from Greek an-
("without") and algos ("pain) Analgesic drugs
act in various ways on the peripheral and central
nervous systems . They are distinct from
anesthetics, which reversibly eliminate sensation.
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• Analgesics are those drugs that mainly provide
  pain relief.
• classes of analgesics
• - Narcotics chemically based on the morphine
  molecule such as morphine and opium
• nonsteroidal anti-inflammatory drugs such as the
• salicylates
• -acetaminophen. they include paracetamol
  (para-acetylaminophenol, also known in the US as
  acetaminophen (

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• Narcotic analgesics (opioids)
• derived from opium. The class includes
  morphine, codeine, and a number of
  semi-synthetics including meperidine (Demerol),
  propoxyphen (Darvon) and others. The narcotic
  analgesics vary in potency, but all are effective
  in treatment of visceral pain when used in
  adequate doses. A variety of dosage forms are
  available, including oral solids, liquids,
  intravenous and intrathecal injections, and
  transcutaneous patches.

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• Opioid Toxicity
• Symptoms include subtle agitation, shadows at the
  periphery of the visual field, vivid dreams,
  nightmares, myoclonic jerks, confusion, paranoia
  and visual hallucinations. Failing renal
  function/dehydration may precipitate these
  symptoms. The development of opioid toxicity is
  dependent on previous opioid exposure, and the
  rate of dose escalation. Management includes
  rehydration, and reducing the opioid dose.

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• NSAIDs
• are effective analgesics even at doses too low to
  have any anti-inflammatory effects. There are a
  number of chemical classes, but all have similar
  therapeutic effects and side effects. Most are
  appropriate only for oral administration however
  ketorolac (Toradol) is appropriate for injection
  and may be used in moderate to severe pain for
  short periods.
• Aspirin and the other non-steroidal
  anti-inflammatory drugs (NSAIDs) inhibit
  cyclooxygenases, leading to a decrease in
  prostaglandin production. This reduces pain and
  also inflammation (in contrast to paracetamol and
  the opioids).
• -

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• Acetaminophen
• is a non-narcotic analgesic with no
  anti-inflammatory properties. It is appropriate
  for mild to moderate pain. Although the drug is
  well tolerated in normal doses, it may have
  significant toxicity at high doses.
• The exact mechanism of action of
  paracetamol/acetaminophen is uncertain, but it
  appears to be acting centrally rather than
  peripherally (in the brain rather than in nerve
  endings).
• Because acetaminophen is largely free of side
  effects at therapeutic doses, it has been
  considered the first choice for mild pain,
  including that of osteoarthritis.

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Paracetamol Toxicity Overdose of paracetamol
leads to 'paracetamol toxicity,' which mainly
results into liver injury but is also one of the
most common causes of poisoning all over world.
Many people who develop paracetamol toxicity may
feel no symptoms at all in the first 24 hours
that follow overdose of paracetamol. As the
paracetamol toxicity increases, signs of liver
failure like low blood sugar, low blood pH, easy
bleeding, hepatic encephalopathymay may develop,
abdominal pain and nausea. The risk of
paracetamol toxicity increases with excessive
alcohol intake, fasting or anorexia nervosa, and
also with the use of certain drugs like
isoniazid.


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• The exact mechanism of action of
  paracetamol/acetaminophen is uncertain, but it
  appears to be acting centrally rather than
  peripherally (in the brain rather than in nerve
  endings). Aspirin and the other non-steroidal
  anti-inflammatory drugs (NSAIDs) inhibit
  cyclooxygenases, leading to a decrease in
  prostaglandin production. This reduces pain and
  also inflammation (in contrast to paracetamol and
  the opioids).citation needed
• Paracetamol has few side effects and is regarded
  as safe, although intake above the recommended
  dose can lead to liver damage, which can be
  severe and life-threatening, and occasionally
  kidney damage. NSAIDs predispose to peptic
  ulcers, renal failure, allergic reactions, and
  occasionally hearing loss, and they can increase
  the risk of hemorrhage by affecting platelet
  function. The use of aspirin in children under 16
  suffering from viral illness has been linked to
  Reye's syndrome, a rare but severe liver
  disorder.

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• Topical analgesics
• (topical being those that are applied on the
  skin) have become much more popular in recent
  years. Those applied for local effect include
  capsaicin, methylsalicylate, and transdermal
  lidocaine. Transdermal fentanyl may be applied
  for systemic (the entire body in general) effect.
  In some cases, these topical agents reduce the
  need for drug therapy.
• Sales of pain relief patches have increased
  substantially in recent years. They are
  particularly useful for elderly patients who may
  not want to take a lot of tablets.

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Recommended dosage Appropriate dosage varies by
drug, and should consider the type of pain, as
well as other risks associated with patient age
and condition. For example, narcotic analgesics
should usually be avoided in patients with a
history of substance abuse, but may be fully
appropriate in patients with cancer pain.
Similarly, because narcotics are more rapidly
metabolized in patients who have used these drugs
for a long period, higher than normal doses may
be needed to provide adequate pain management.
NSAIDs, although comparatively safe in adults,
represent an increased risk of gastrointestinal
bleeding in patients over the age of 60.
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Precautions Narcotic analgesics may be
contraindicated in patients with respiratory
depression. NSAIDS may be hazardous to patients
with ulcers or an ulcer history. They should be
used with care in patients with renal
insufficiency or coagulation disorders. NSAIDs
are contraindicated in patients allergic to
aspirin.
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Side effects The primary adverse effects of the
narcotic analgesics are addiction, constipation,
and respiratory depression. Because narcotic
analgesics stimulate the production of enzymes
that cause the metabolism of these drugs,
patients on narcotics for a prolonged period may
require increasing doses. This is not the same
thing as addiction, and is not a reason for
withholding medication from patients in severe
pain. NSAIDs can lead to ulcers and may cause
kidney problems. Gastrointestinal discomfort is
common, although in some cases, these drugs may
cause ulcers without the prior warning of
gastrointestinal distress. Platelet aggregation
problems may occur, although not to the same
extent as is seen with aspirin.

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• Adjuvant analgesics
• Tricyclic Antidepressants eg amitriptyline or
  nortriptyline are first line treatment for
  neuropathic pain, which may be only partially
  controlled by morphine. Often effective in
  sub-antidepressant doses, eg 10mg-25mg at night.
• Anticonvulsants eg gabapentin and sodium
  valproate are useful as second line treatment
  for neuropathic pain.
• NSAIDs eg diclofenac is useful in controlling
  bone and soft tissue pain.
• Corticosteroids eg dexamethasone, are effective
  in nerve damage pain by reducing peri-neural
  oedema. Reduces headache and confusion in
  cerebral metastases.

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• Anxiolytics eg diazepam, lorazepam and
  midazolam, can improve pain control in
  conjunction with opioids. Useful in agitated
  states and for dyspnoea. Lorazepam is an
  effective anxiolytic when used sublingually.
  Midazolam is a very effective anxiolytic when
  added to diamorphine in a continuous subcutaneous
  infusion.
• Muscle Relaxants eg baclofen, benzodiazepines and
  quinine are useful in treating pain associated
  with muscle spasm. Use with care as they may
  cause depression and weakness.
• Antimuscarinics eg hyoscine butylbromide, are
  useful in relieving colic pain.

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Prescription Drug Abuse- Prescription Drug
Addiction The types of prescription drugs most
commonly abused are Central Nervous System (CNS)
Depressants Barbiturates, Tranquilizers,  Xanax,
Valium,  Rohypnol, Placidil, Ativan, Klonopine,
Librium, Quaalude Prescription Painkillers
Opioids, narcotics, hydrocodone, morphine,
fentanyl, codeine, Oxycontin, Percocet, Percodan,
Darvon, Dilaudid, Demerol Prescription
Stimulants Adderall, Ritalin, Concerta,
Dexedrine

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Addiction Users need larger and larger doses to
get the same effect, which brings them,
continually closer to the fatal dose. Overdose is
more likely to occur when users mix depressants
with alcohol. Users become disoriented, confused,
and cant remember how much they took. The list
of people who have died from depressants and
alcohol is long.


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How are Prescription Painkillers
Abused? Prescription painkillers can be taken
orally, or the pills may be crushed and the
powder snorted or injected. A number of overdose
deaths have resulted from the latter routes of
administration, particularly with the drug
OxyContin, which was designed to be a
slow-release formulation. Snorting or injecting
opioids results in a rapid release of the drug
into the bloodstream, exposing the person to high
doses and causing many of the reported overdose
reactions.

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• What Adverse Effects Can be Associated with
  Prescription Painkillers?
• Prescription pain medications can produce
  drowsiness, cause constipation, and, depending
  upon the amount taken, depress breathing. Taking
  a large single dose could cause severe
  respiratory depression or death.
• These medications are only safe to use with other
  substances under a physicians supervision.
  Typically, they should not be used with alcohol,
  antihistamines, barbiturates, or benzodiazepines.
  Because these substances slow breathing, their
  combined effects could lead to life-threatening
  respiratory depression.

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Tranquilizers Tranquilizers are drugs used to
treat anxiety or problems with sleep. They have a
calming effect by depressing the nervous system
in a way similar to alcohol. Tranquilizers are
among the most commonly prescribed psychiatric
medications. In some ways, the term
"tranquilizer" is inaccurate. Although they may
produce specific anxiety-reducing effects, the
members of the tranquilizer group of drugs have
the same clinical effects as sedatives such as
the barbiturates (downers). The much-sought
relaxing and anxiety-reducing effects of the
tranquilizers are simply the early stages of the
biochemical process of sedation. The effects of
sedation are a continuum from relaxation to
significant sedation to coma to death.



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Central nervous system depressants, including
minor tranquilizers, sedatives, and alcohol,
place the user on the sedation continuum. The
specific dosage and drug used determines how far
the user goes on that pathway. Tranquilizers are
frequently abused because of their ability to
reduce anxiety. They are addictive because
tolerance develops rapidly, and more and more are
needed to be effective.



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Thank you very much for your kind and help