The narcotic agonists are drugs that react with the opioid receptors throughout the body to cause analgesia, sedation, or euphoria. Anticipated effects other than analgesia are mediated by the types of opioid receptors affected by each drug. Because of the potential for the development of physical dependence while taking these drugs the narcotic agonists are classified as controlled substances. The degree of control is determined by the relative ability of each drug to cause physical dependence. Hydrocodone and oxycodone have moved to C-II, providing more restrictions on their use and sale.
The narcotic agonists act at specific opioid receptor sites in the CNS to produce analgesia, sedation, and a sense of well-being. They also are used as antitussives and as adjuncts to general anesthesia to produce rapid analgesia, sedation, and respiratory depression. Indications for narcotic agonists include relief of severe acute or chronic pain, preoperative medication, analgesia during anesthesia, and specific individual indications, depending on their receptor affinity. Accurate calculation of a dose is crucial to prevent overdosing patients.
In deciding which narcotic to use in any particular situation, it is important to consider all of these aspects of the patient’s condition and to select the drug that will be most effective in each situation with the fewest adverse effects for the patient. Each patient is different, and his or her response to a drug also is different. For instance, if an analgesic that is long acting but not too sedating is desired for an outpatient, hydrocodone might fit those objectives. Fentanyl, which is available for injection, is also available as a lozenge for treating breakthrough pain, as a buccal tablet, as a transdermal patch, and as a sublingual tablet or nasal spray to be used as needed for treating breakthrough pain in cancer patients.
agonist – n. 激动剂/药
Actiq – n. 芬太尼粘膜制剂
Duragesic – n. 芬太尼透皮贴
Hysingla ER -- 酒石酸氢可酮缓释片
Zohydro ER -- 重酒石酸氢可酮缓释胶囊
Dilaudid – n. 地芝迪德
Demerol – n. 德美罗
Dolophine – n. 多罗芬
Roxanol – n.
Astramorph – n.
Paregoric —n. 鸦片樟脑酊
OxyContin – n. 奥斯康定
Ultiva -- n. 盐酸瑞芬太尼粉针剂
Sufental – n. 舒芬塔尔
Nucynta – n. 纽金塔
tramadol – n. 曲马朵
Ultram – n. 曲马多商标名
affinity – n. 亲和性，亲和力
breakthrough pain – 穿透性疼痛，突破性疼痛
1. All narcotics, regardless of their origin, reduce pain by:
A. Stimulating opiate receptors
B. Promoting the release of excitatory transmitters
C. Releasing large quantities of endorphin
D. Blocking the mu receptors
2. In addition to analgesia, narcotic effects include:
A. Euphoria, diarrhea, increased respirations
B. Euphoria, miosis, nausea and vomiting
C. Respiratory depression, increased blood pressure
D. Dependence, seizures, muscle spasms
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答案 Answers
1. A. Stimulating opiate receptors. Rationale: It is the stimulation of cerebral opiate receptors that reduces pain. Excitatory transmitters are not released during administration of morphine. Endorphin release is not associated with narcotic pain relief. The mu receptors mediate analgesia and are not blocked during narcotic administration. 2. B. Euphoria, miosis, nausea and vomiting. Rationale: These are the effects that often occur with administration of narcotics. Constipation (not diarrhea) and decreased respirations (not increased) are noted during administration of narcotics. Decreased blood pressure results from narcotic administration. Narcotics do not cause the effects in choice D at all.
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