l Relevant to the case
n Opioids for shingles
u Used when patient complained of severe pain (and antidepressent failed to work)
u Study conducted with 76 senior citizens
u Pain relief: 38% from opioids, 32% with antidepressants, 11% placebo
l Common forms
n Opium, codeine, Fentanyl, Heroin, Hydrocodone, Methadone, Morphine (strongest), Oxycodone, Paregoric, sufentanil
n Capsules, tablets, oral solution, injection…
l Mode of action
n Works at presynaptic region, inhibit release of neurotransmitters
n 3 types of opioid receptors (ultilises G proteins, opioids as ligands)
u Mu (μ)
u delta (δ)
u kappa (κ)
l Side-effects
n Allergy to the painkiller (rare)
n Addiction (rare if the course is monitored carefully)
n Common: drowsiness, sickness (goes away when body gets used to the drug)
n Others: constipation (take stool softener), dizziness, dry mouth, hallucinations
l Other Uses
n Pain relief in cancer patients
References:
http://www.australianprescriber.com/magazine/19/3/63/5/
http://www.cancerhelp.org.uk/help/default.asp?page=5976#opioids
The Essential Guide to Prescription Drugs 2006, James J. Rybacki, Pharm. D.
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