Pain and Analgesics

Analgesics

any substance that reduces pain

Opioids

treat moderate-severe pain

NSAIDS

treat mild-moderate pain

Morphine

prototype opioid (natural opiate in poppy plant)

How do opioids produce analgesia?

They inhibit ascending pain pathways and activate descending pain pathways

Epidural

inserted in spinal cord- limits where opioid goes to. activates spinal “itch” neurons

Codeine (therapeutic)

metabolized to morphine

Fentanyl (therapeutic)

fast acting and short duration. 100x more potent that morphine

Oxycodone (therapeutic)

more long term pain relief

Heroin (non-therapeutic)

highly lipid soluble- gets into brain quicker than morphine. metabolized into morphine

Cross tolerance between opioids

all opioids are chemically structured similarlly

Opioid side effects

Pupil construction, sedation, reward, itching, slowed HR, repiratory depression, constipation (#1 complaint)

Opioid epidemic

Opioid removes the breaks on DA reward pathway, just like THC

Methadone

opioid withdrawal treatment

Opioid withdrawal effects

insomnia, dilated pupils, anxiety, diarrhea