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MSc A-D Analgesic Medication

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by

Victoria Wheeldon

on 24 November 2016

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Transcript of MSc A-D Analgesic Medication

Analgesic Medication
Our patient with LBP
Paracetamol
NSAIDs
Actions: inhibits COX pathway, stopping formation of prostaglandins.
Particular affinity for synovial membrane of inflamed joints. ibuprofen reversible effects at binding sites; aspirin non-reversible for life of the platelet ie effective!
?contra-indicated with fracture

Side-effects: GI bleeding/ulceration; inc risk CV events
Maximum daily dose OTC: 1200mg
Maximum daily dose Rx: 2400mg

Opioids
Actions: Acts in spinal cord & limbic system: Spinal cord: bind to potassium channels to prevent opening of Ca2+ channels ie prevents voltage gates from opening at synapses to prevent pain signals from ascending. Limbic system: binds to receptors to increase dopamine release, to promote feelings of euphoria & counteract pain - addiction!

Side-effects: addictive due to the up-regulation of the dopamine receptors. Needs larger & larger doses to get same effect. Constipation & dry mouth common side effects.

Dose: as codeine: 8/500 OTC. 15/500 or 30/500 Rx.
as tramadol: Rx only <400mg daily.



Actions: affects COX pathway, to a lesser extent & differently to NSAIDs. Does not compete for protein binding sites, therefore less GI issues.

Side-effects: Hepatotoxicity at fairly low levels. Care in pts with liver & kidney disease.

Maximum daily dose paracetamol: 4g daily.
What do you do?

http://moodle.aecc.ac.uk/mod/folder/view.php?id=8342
https://uk.pinterest.com/vwheeldon9840/pharmacology-analgesia/
Pinterest Board
Stop taking either co-codamol or paracetamol; alternate NSAID & co-codamol for incrased therapeutic effect
Full transcript