Opioids general anesthetics

Inhibition of pain perception (opioids, general anesthetics)... 

Hydromorphone should be used with caution if other central nervous system depressants are given concomitantly. These drugs are other opioids, general anesthetics, phenothiazine, tricyclic antidepressants, sedative-hypnotics, and other central nervous system depressants (including ethanol). 

Behaviorai effects Opioids produce sedation, but not as profoundly as CNS depressants like barbiturates or general anesthetics. A person administered an opioid is generally lethargic but arousable. 

The interactions of benzodiazepines with other nervous system depressants, especially alcohol and other GABA-ergic drugs, have been reviewed (152). Other drugs with nervous system depressant effects (opioids, anticonvulsants, general anesthetics) also can add to, and complicate, the depressant action of benzodiazepines. 

Keywords Acetylcholine Autonomic nervous system Cyclosporine Epinephrine General anesthetics Immunostimu-lating agents Immunosuppressive agents Mycophenolate mofetil Opioid drugs Sedative-hypnotic agents... 

Current research makes it clear that the opioids, sedative-hypnotic agents, and general anesthetics, as used clinically, have a major impact on iimnune system function... 

Mama K R, Pascoe P J, Steffey E P 1993 Evaluation of the interaction of mu and kappa opioid agonists on locomotor behavior in the horse. Canadian Journal of Veterinary Research 57 106-109 Mama K R, Steffey E P, Peiscoe P J 1995 Evaluation of propofol as a general anesthetic for horses. Veterinary Surgery 24 188-194... 

General consideration oxymorphone should be started at 1/3 to 1/2 of the usual dose in patients who are concurrently receiving other CNS depressants including sedatives or hypnotics, general anesthetics, phenothiazines, tranquilizers, and alcohol, because respiratory depression, hypotension, and profound sedation or coma may result. No specific interaction between oxymorphone and monoamine oxidase inhibitors has been observed, but caution in the use of any opioid in patients taking this class of drugs is appropriate. 

Major CNS depression may be observed in elderly, debilitated patients, with co-administration of opioid analgesics, general anesthetics, phenothiazines or other tranquilizers, sedatives, hypnotics, or other CNS depressants (including alcohol) and mild hepatic dysfunction. 

Preservative-free morphine, like all opioid analgesics, may cause severe hypotension in an individual whose ability to maintain blood pressure has already been compromised by a depleted blood volume or a concurrent administration of drugs, such as pheno-thiazines or general anesthetics. 

CNS depressant drugs, including barbiturates, benzodiazepines, opioids, and general anesthetics, can increase or potentiate the sedative effect of droperidol. 

Administration Nalbuphine should be given as a supplement to general anesthesia only by persons specifically trained in the use of IV anesthetics and management of the respiratory effects of potent opioids. 

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