This interesting ppt is about the Pharmacology of morphine and acute morphine poisoning dealt with illustrative pictures, diagrams to facilitate learning for medical/paramedical students....
34. DR. V. SATHYANARAYANAN M.B.B.S.,M.D., ACME.,
PROFESSOR OF PHARMACOLOGY,
SRM MCH & RC
*OPIOID ANALGESICS - I
35. *
*Dark brown gummy exudate
*Obtained from poppy capsule ( papaver
somniferum )
*Opos – juice
*In use since 4000 BC
*Opium smoking popular by 18th century
*Used for medicinal and recreational purposes
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48. *
*Serturner --- isolated a pure opium alkaloid ( 1801)
*Named it as -------- MORPHINE
*By 19th century ----- pure alkaloids available for
therapeutic use
52. *
*Peptides released in the body in response to
pain
*These Act on the opioid receptors
*ENKEPHALINS - act on delta receptors
*ENDORPHINS – act on mu receptors
*DYNORPHINS - act on kappa receptors
53.
54.
55.
56. Actions at Opioid Receptors
Drugs Mu Kappa
Pure Agonists
-morphine, codeine, meperidine (Demerol®),
fentanyl (Sublimaze®), remifentanil (Ultiva®),
propoxyphene (Darvon®), hydrocodone (Vicodin®),
oxycodone (Percocet®)
Agonist Agonist
Agonist-Antagonist
-nalbuphine (Nubaine®), butorphanol (Stadol®)
Antagonist Agonist
Pure Antagonist
-naloxone (Narcan®)
Antagonist Antagonist
61. *
*Act on opioid receptors ------
*Mu – 1,2
*Kappa – 1, 2, 3
*Delta – 1,2
* all are G-protein coupled receptors
*Open K channels and close voltage gated Ca channels
reduces neuronal excitability, inhibit the release of pain
neurotransmitters
62.
63. Actions of Opioid Receptors
Response Mu Kappa
Analgesia
Respiratory
Depression
Sedation
Euphoria
Physical Dependence
GI motility
85. *GIT
*Decreased gastric motility increased gastric
emptying time decreases absorption of drugs
*Increased oesophageal reflux
*Decreased intestinal motility, secretions
*Increased tone of sphincters, spasm of intestine
*All actions result in MARKED CONSTIPATION
86.
87.
88. *
*Spasm of sphincter of Oddi - increased intrabiliary
pressure biliary colic
*Increases tone, amplitude of ureter may worsen ureteric
colic
*Increases tone of external sphincter of bladder, inhibits
urinary voiding reflex URINARY RETENTION
*BRONCHOCONSTRICTION
101. *
*Develops On repeated administration for
* sedation,
* analgesia,
* euphoria,
* respiratory depression
*Cross tolerance also seen
*NO TOLERANCE FOR constipation and miosis
102.
103. *
*Drug of addiction
*Produce both PSYCHOLOGICAL and PHYSICAL DEPENDENCE
*Sudden stoppage cause withdrawal symptoms known as
COLD TURKEY
*Babies born to addicted mothers also be DEPENDENT
153. *
AS AN ANALGESIC
*Excellent for severe pain in
Acute MI
Fractures
Burns
Pulmonary embolism
Terminal stages of cancer
Acute pericarditis
Postoperative pain
154.
155.
156.
157.
158.
159.
160. *
* AS AN ANALGESIC
morphine + atropine Biliary colic
Epidural analgesia
Patient Controlled Analgesia
161.
162.
163.
164. *
* As Pre-anaesthetic medication ( reduce
anxiety, pain, dose of anaesthetic, smoothen
induction )
*Acute left ventricular failure/ Acute
pulmonary edema
*Special anaesthesia
*Relieves anxiety in threatened abortion
165.
166.
167.
168.
169. *
*LETHAL DOSE – 250 MG ( in non-addicts )
*Pin point pupils
*Respiratory depression with shallow breathing
*Hypotension
*Shock
*Cyanosis
*Hypothermia, flaccidity
*Stupor, coma, death
175. *
*Morphine is the prototype of opioid analgesics
*It is Very useful in severe visceral pain, Though it has many
side effects
*It acts on opioid receptors
*Long term use cause tolerance and dependence
*Naloxone is the specific antidote for morphine poisoning
*Respiratory depression and hypotension has to be watched
for during morphine use