20 麻醉性镇痛药.ppt

Peripheral analgesics Causal -Treat the cause Example: Atropine (antispasmodic) Aspirin Section 3 Other analgesics Naloxone Naloxone is a drug used to counter the effects of opioid overdose, for example， heroin or morphine overdose. Naloxone is specifically used to counteract life-threatening depression of the central nervous system and respiratory system. 2.6 Side Effects 2.6.1. Morphine has many side effects. The most dangerous is respiratory depression. ------Naloxone 2.6.2. With higher doses or in frail patients, the patient becomes increasingly sedated, and the pupils become very small. 2.6.3. Common side effects are nausea and vomiting due to a central action of morphine stimulating one of the centres in the brain concerned with vomiting called the chemotactic trigger zone. Side Effects 2.6.4. Tolerance. With repeated administration of opioids, their CNS effects undergo habituation (adaptation). In the course of therapy, progressively larger doses are thus needed to achieve the same degree of pain relief. 2.6.5. Other central nervous system side effects of morphine is addiction (dependence). ---Methatone (opioid receptor agonist) ---Clonidine (?2-R agonist) Side Effects 2.6.6. Morphine can also cause histamine release, which causes itching of the skin and nose and a mild flushing of the skin. 2.6.7. Morphine also has an effect on the muscle of the bowel and urinary tract, causing the sphincter to contract and reduce the peristalsis (the wavelike movements of the bowel muscle that propel its contents forwards). This results in a delayed emptying of the stomach, constipation, and may also lead to urinary retention. * 2.6.8. Acute opioid toxicity may result from clinical overdosage, accidental overdosage in addicts, or attempts at suicide. Symtoms: Three Cardinal Symptoms: coma, pinpoint pupils, and depressed respiration strongly suggests opioid poisoning. Others: blood pressure will fall progressively; hypoxia is severe a