Analgesics Pentazocine, Pethidine

SSRIs OPIOIDS 1. Possible 1 analgesic effect of oxycodone and tramadol 2. T serotonin effects, including possible cases of serotonin syndrome, when opioids (oxycodone, pethidine, pentazocine, tramadol) are co-administered with SSRIs (fluoxetine and sertraline) 3. SSRIs may t codeine, fentanyl, methadone, pethidine and tramadol levels 1. Uncertain. Paroxetine inhibits CYP2D6, which is required to produce the active form of tramadol. 2. Uncertain 3. SSRIs inhibit CYP2D6-mediated metabolism of these opioids 1. Consider using an alternative opioid 2. Look for signs of T serotonin activity, particularly on initiating therapy 3. Watch for excessive narcotization... 

Rudra A. Comparison of buprenorphine, morphine, pethidine, and pentazocine as postoperative analgesic after upper abdominal surgery. Calcutta Med J 1989 86 1. 

Ketoprofen has been shown to be a potent analgesic with effects equivalent to pentazocine and meperidine (pethidine) in the treatment of postoperative pain in humans (Avouac Teule 1988). In horses, ketoprofen has also been shown to be an effective analgesic and anti-inflammatory agent. In one study, the pharmacodynamics of ketoprofen (2.2 mg/kg) were studied in a non-immune acute inflammatory model (Landoni Lees 1995a). In this study, ketoprofen inhibited... 

In addition to modifications of the morphine molecule, many purely synthetic analgesics have been produced, the first of these, pethidine (meperidine), having been synthesized in 1939 in an attempt to make a substitute for atropine (276). As in the case of heroin, pethidine was at first thought to be nonaddictive. It has been followed by a hundred or so other compounds of several different types, but, as with the morphine derivatives, none, with the possible exception of pentazocine, has been found to have analgesic without addictive properties. However, it seems that the two effects may not be entirely inseparable, as diphenoxylate, which has come into use as an antidiarrheal drug, has been found to possess the power to cause addiction but no analgesic action at all (277). 

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