镇痛药Analgesics——山东大学药理学英文课件.ppt

* (4) Artificial hibernation pethidine chlorpromazine promethazine lytic cocktailⅠ 4. Adverse effects CNS excitatory symptoms muscle tremors, twitches, convulsion should be combined with anticonvulsive drugs when treat overdose poisoning (2) some symptoms like atropine * Increased CNS depression, particularly respiratory depression Opioid analgesics MAOIs Tricyclic antidepressants chlorpromazine promethazine Sedative- hypnotics Absolute contraindication to pethidine , relative contraindication to other opioid analgesics , because of high incidence of hyperpyretic coma Drug – Drug interactions * Methadone Characteristics: 1. analgesia: equal to morphine 2. give reliable effects orally, longer duration of action 3. tolerance and physical dependence more slowly 4. withdrawal signs attenuated but protracted 5. detoxification of the morphine and heroin dependent addict * Fentanyl Characteristics: 1. more analgesic potentcy than morphine:100 times 2. has a rapid onset and short duration of action 3. high lipid- soluble, transdermal administration 4. + droperidol (氟哌利多） neuroleptanalgesia(神经阻滞镇痛术） or usually combined with anaesthetics 5. high dose cause truncal rigidity * Short acting fentanyl sufentanil alfentanil Agonists mixed Agonists /Antagonists Antagonists WEAK: codeine pentazocine STRONG: methadone morphine pethidine buprenorphine nalbuphine long acting naltrexone naloxone Classification of opioid analgesics * Section 2 Partial agonists of opioid receptor * Pentazocine Characteristic: κ, σ agonist , μ weak antagonist 1. CNS analgesia: 1/3 respiratory depression : 1/2 * psychomimetic action (60-90mg) dysphoric and hallucina