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Where do narcotics act?
opium receptor cites in the CNS
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What is the prototype of narcotics?
Morphine
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What are contraindications of morphine (narcotics)?
- after biliary surgery or anastomoses
- diarrhea by poisons
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What are some cautions with narcotics?
- GI/GU surgery
- acute abdomen or ulcerative colitis
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What are drug interactions with narcotics
MAOIS, barbiturates, phenothiazines
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What narcotic us used for cough/resp irritation?
Codeine
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What is the narcotic used transdermally?
Fentanyl
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What other med is used for cough?
hydrocodone
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What narcotic is used for detoxing
methodone
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What narcotics are used for obstetrics?
meperidine (Demerol), oxymorphone
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What is the narcotic antagonist prototype?
- Naloxone (Narcan)
- reverses overdose
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What is the action of narcotic antagonists?
binds to opium receptors but does not activate the receptors
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What is a side effect of Narcan?
NAS (n/v, sweating, tachy, hypotension)
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What are adverse rxns to NA?
tachycardia, HTN or hypo, dysrrhythmias, pulmonary edema (if pushed too quickly)
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What are drug interaction with NA?
more narcan needed for Nubain, Talwin, Stadol
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What are the narcotic antagonists?
Naloxone, Nalmefene, Naltrexone
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What is the prototype for migraines?
Ergotamine
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What is the action of ergot meds?
- Block alpha-adrenergic/serotonin sites=
- constrict and decrease pulsation of cranial nerves
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How is ergotism syndrome caused?
By drug dependency and withdrawal from them
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What is the drug interaction with ergot meds?
- Beta blockers
- can cause gangrene and peripheral ischemia
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What is the prototype for triptans?
Sumatriptan
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What is the action of triptans?
binds to SSR sites and causes vasoconstriction of cranial vessels
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What is important to note about triptan indications?
- Does NOT prevent migraines
- Has less vascular and GI effects
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What are drug interactions with triptans?
ergot meds, MAOIS
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What is the only triptans used for cluster headaches?
Sumatriptan
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