神经系统药理—魏尔清(镇痛药.pptVIP

2. Clinical uses (1) Analgesia the pain of high intensity and the pain of terminal illness Cautions: a) obscure the symptoms and the progress of the disease; b) dependence or addiction; c) biliary colic: combined with atropine d) not used for long-term if no clear indications A. Opioid Analgesics (2) Cardiac asthma (acute left ventricular failure) As an adjuvant treatment A. Vasodilatation: afterload ? B. Sedation: anxiety ? C. Respiratory depression: breathing slowly and deeply (3) Diarrhea Mixture containing opiate A. Opioid Analgesics 3. Adverse effects (1) Side effects (2) Tolerance and dependence psychological and physic dependence: addiction withdrawal syndromes or abstinance syndromes A. Opioid Analgesics (3) Acute intoxication coma, respiratory depression, hypotension, pinpoint pupils reversed by naloxone, an opioid receptor antagonist (4) Contraindications labor and lactation; bronchial asthma and cor pulmonal; increased intracranial pressures; severe hepatic damage A. Opioid Analgesics Part 12Analgesics Opioid analgesics Synthetic opioid analgesics Other analgesics General Considerations Pain (疼痛)： 躯体痛－快痛，慢痛 内脏痛 情绪反应 Analgesia (镇痛)： 选择性抑制疼痛感觉， 不影响意识和其他感觉 Pain Classification Headache (migraine) Acute Chronic Pain Nociceptive Mixed Neuropathic Visceral Diabetic neuropathy (DN) Post-herpetic neuralgia (PHN) Radiculopathy (RADIC) Cancer pain Low back pain Osteoarthritis Rheumatoid arthritis Fibromyalgia IBS Pancreatitis Bladder pain Noncardiac chest pain Abdominal pain syndrome Injury Postoperative Flare An adverse or unpleasant reaction plus the reactions evoked by it Stimulation and depolarization of sensory nerve endings Pain: peripheral sensory reflex Peripheral mechanisms of pain Peripheral mechanisms of pain Primary secondary hyperalges