Analgesics 

Analgesics are a class of drugs used to relieve pain. The pain relief induced by analgesics occurs either by blocking pain signals going to the brain or by interfering with the brain's interpretation of the singals, without producing anesthesia or loss of consciousness.

 

There are basically 2 types of analgesics:

*Non-Narcotics

*Narcotics

 

NOTE: Some references include aspirin and other non-steriodal anti-inflammatory drugs(NSAIDS), because they have some analgesic properties. Instead of being completely analgesic aspirin and NSAIDS primarily have an anti-inflammatory effect.

 

NON-NARCOTIC ANALGESICS

Acetaminophen is the most commonly used OTC, non-narcotic analgesic. This is a popular pain reliever because it is both effective for mild to moderate pain relief and relatively inexpensive. The safety, however, of this drug is completely based on the PROPER use of acetaminophen. If it is not used as directed on the label, serious side effects and possible fatal consequences can occur. For example, taking more than 4000 mg/day or using it longterm can increase the risk of liver damage. The risk of liver damage is increased when you use acetaminophen and alcohol together.

 

*DID YOU KNOW*

More than 600 OTC drugs have acetaminophen in them.

 

NARCOTIC ANALGESICS

There are 2 types of NARCOTIC ANALGESICS:

*Opiates

*Opioids(derivatives of opiates)

 

OPIATES are the alkaloids found in opium(a white liquid extract of unripe seeds of the poppy plant)

 

OPIOIDS are any medication which bind to opioid receptors in the central nervous system or gastointestinal tract. (GI tract)

 

4 BROAD classes of opioids:

*BODY PRODUCED (endorphines, dynorphins, enkephalins)

*Opium alkaloids(morphine, codeine, thebaine)

*Semi-synthetic opioids(heroin, oxycodone, hydrocodone, dihydrocodine, hydromorphone, oxymorphone, nicomorphine)

*Fully synthetic opioids(pethidine/Demerol, methadone, fentanyl, propoxyphene, pentazocine, buprenorphine, butorphanol, tramadol, and more)

 

Opioids are used in medicines as a relief for severe or chronic(long-lasting/reoccuring) pain.

 

~Side Effects/Adverse Reactions to Opioids~

-COMMON SIDE EFFECTS/ADVERSE REACTIONS-

*Nausea *Vomiting *Drowsiness *Miosis(contraction of the pupil) *Orthostatic Hypotension(blood pressure lowers upon sudden standing) *Urinary retention *Constipation

 

-LESS COMMON SIDE EFFECTS/ADVERSE REACTIONS-

*Confusion *Hallucinations *Delirium *Hives *Itch *Hypothermia *Bradycardia(slow heart rate) *Trahycardia(rapid heart rate) *Raised intracranial pressure *Uretetic/biliary spasm *Muscle rigidty *Flushing

 

--MOST SEVERE SIDE EFFECTS AND ADVERSE REACTIONS--

*respiratory depression

*fatal overdose

 

SPECIFIC ANALGESICS

*Acetaminophen *Codeine *Darvocet *Darvon *Duragesic *Hydromorphone *Morphine *Oxycodone *Percocet *Percodan *Talwin NX *Ultracet *Ultram *Vicodin

 

STATISTICS

  • In 2001, there were an estimated 90,232 emergency deparment visits related to narcotic analgesic abuse, a 117% increase since 1994.
  • Nationally, narcotic analgesics were invloved in 14% of all drug-abuse realted emergency department visits in 2001.
  • In 2001, apprx. 1/3 of the narcotic analgesics reported to DAWN were not specified by name(32,196 mentions).
  • Among the named narcotic analgesics, hydrocodone led with 21,567 mentions, followed by oxycodone(18,409 mentions).
  • Oxycodone mentions increased 70% from 2000 to 2001, compared to the 186% surge in mentions from 1999 to 2000. However, mentions of most narcotic analgesics did not increase from 2000 to 2001.
  • From 1994 to 1001, the only narcotic analgesic that decline was codeine. Mentions decreased 61%, from 9,639 to 3,720.
  • Dependence was the most frequently mentioned motive for narcotic analgesic abuse cases(38,941), followed by suicide(24,576), psychic effect(13,949), unkown motive(11,039), and other motives(1,727).
  • In 2001, the average age was 37 for patients who attended emergency department because of narcotic analgesic abuse.

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