Physical dependence narcotic analgesics

These dm may produce withdrawal symptoms in those physically dependent on the narcotics. The patient must not have taken any opiate for the last 7 to 10 days. Naloxone may prevent die action of opioid antidiarrheals, antitussives, and analgesics. This drug is used cautiously during lactation. 

Howes, J.F., A simple, reliable method for predicting the physical dependence liability of narcotic antagonist analgesics in the rat, Pharmacol. Biochem. Behav., 14, 689, 1981. 

Narcotics Demerol Morphine Heroin Others Natural and synthetic opioids analgesics Oral or injected (IM, IV) Relaxation euphoria feelings of tranquility prevent onset of opiate withdrawal Physical dependence respiratory depression high potential for death due to overdose See Chapter 14... 

Hydromorphone is highly addictive. Its use needs to be carefully monitored by the treating physician. Longterm use of the drug can lead to physical and psychological dependency. Mood can also be affected by hydromorphone and other narcotic analgesics. Infrequently, hallucinations and disorientation can develop. Insomnia develops in a minority of cases. 

Non-narcotic analgesics, unlike the NSAIDs, have little or no anti-inflammatory activity. They have a therapeutic advantage over narcotic analgesics in that they do not cause physical dependence or tolerance. 

Tolerance, Dependence, and Addiction Liability. Patients treated with long-term opioid therapy often develop tolerance and usually become physically dependent on narcotic analgesics as well. Tolerance results when exposure to a drug results in its decreased effectiveness with time and larger doses are required to achieve the same response (26). Physical dependence is also an adaptive state that is characterized by a specific constellation of withdrawal symptoms that occur upon abrupt cessation or significant reduction in the dose of the opioid or administration of an opioid antagonist (26). Addiction, however, is distinct from physical dependence, and "the term addiction should never be used when physical dependence is meant" (22). The... 

In a series of azabicycloalkanes, (17) and its dextro isomer exhibited analgesic activity comparable to meperidine and morphine, respectively.143 The two compounds also exhibited narcotic antagonist activity. (17) Produced slight physical dependence capacity in the Rhesus monkey. 

The nonnarcotic analgesics are a group of dni used to relieve pain witliout the possibility of causing physical dependency, which can occur witli the use of the narcotic analgesics. The nonnarcotic analgesics can be divided into the salicylates, nonsalicylates (acetaminophen), and tlie nonsteroidal anti-inflammatory dru (NSAIDs). There are a number of combination nonnarcotic analgesics tliat are available over the counter and by prescription. The NSAIDs have emerged as important dru in the treatment of the... 

Since morphine releases histamine from central stores [292] and chronic administration of histamine alters brain catecholamine levels [300], it has also been proposed that opiate-induced changes in central concentrations or tissue levels of other biogenic amines may be initiated by decreases in brain histamine [295], Whilst a role for brain histamine has yet to be determined in the antinociceptive effects of the narcotic analgesics, this amine may interact with one or more other amines to subserve the antinociceptive, tolerance and physical dependence effects of morphine-like agents. 

From the pharmacological and clinical side, little progress had been made, except that it was much easier to determine clinical activity and physical dependence liability. However, in 1954, Beecher and Lasagna made the remarkable discovery, confirmed by Keats and Telford in 1956, that nalorphine, a narcotic antagonist, was an analgesic in man comparable in potency to morphine. This observation took an added significance when it was recalled that nalorphine was ineffective in the hot-plate and tail flick tests. 

As is well known by now, we synthesized a large number of benzomorphans and evaluated several in the clinic. Only two have been subjected to the rigorous examination for physical dependence capacity in Lexington. Neither cycla-zoclne nor pentazocine substitute for morphine in dependent subjects nor do they Induce a morphine-like primary dependence in post-addicts. There is no reason to believe that the other narcotic antagonists would behave differently. Some of the narcotic antagonists which have been studied over the past several years are shown in Chart II. The clinical analgesic activity is recorded in the last column of Table I. 

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