| Table of Contents
Analgesics and the treatment of acute pain
Aims and objectives
Analgesics: What is pain?
Analgesics
History of Pain : Milestones
History of Pain : Milestones
History of Pain : Milestones
The opium poppy: papaver somniferum
History of Pain: Use of Opium
History of Pain: Opium
History of Pain : Use of Opium
Pain pathways
The dorsal horn and A and C fibre input
First and Second Pain: The differences (after Bowsher)
The ‘spinal gate’
Opioids and ionisation : Theory
Calculating the diffusible percentage of buprenorphine
From free base to receptor site: Fraught with difficulties!
Update on opioid receptors
Opioid receptor mechanisms
Opioid receptor mechanisms
Pathophysiology of acute clinical (surgical) pain
Mechanisms of peripheral and central sensitisation
Mechanisms of peripheral and central sensitisation
Result of peripheral and central sensitisation
Clinical implications of peripheral and central sensitisation
The alkaloid content of opium
The structure and synthesis of Morphine
The structure of Morphine
Problems with prescribing opioids
Opioids for postoperative pain: is there a problem?
Opioid mu agonists and high efficacy partial agonists : Problems
Administration of opioids for postoperative pain
Pethidine Pharmacokinetics (1)
Pethidine Pharmacokinetics (2)
PCA versus 4 hourly i.m. analgesic regime
The PCA apparatus
Pethidine: concentration effect relationship (Mather 1982)
Buprenorphine versus morphine:
The difference between ‘potency’ (affinity) and ‘efficacy’ (activity)
Buprenorphine pharmacology
Buprenorphine profile
Endogenous opioid peptides: Discovery of enkephalins
Spinal opioids: History
Spinal opioids: Toxicity
Spinal opioids: Toxicity and side effects
Monitoring patients with spinal opioids postoperatively
Postoperative instructions must be very CLEAR!
The structure of Morphine: a template for the antagonists
Opioid antagonists
Non-steroidal anti-inflammatory drugs
Site of action of NSAIDs showing inhibition of cyclo-oxygenase and the effects on prostaglandin, prostacyclin and thromboxane
NSAIDs and postoperative pain: The advantages
Non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs
Use of NSAIDs for postoperative pain control
Strategies for effective postoperative analgesia
Recording postoperative pain
Analgesic technique used for major abdominal surgery
Finding a solution to the control of postoperative pain
Putting theory into practise: A few examples …...
Multiple choice questions on the treatment of acute pain
Multiple choice questions on the treatment of acute pain
Multiple choice questions on the treatment of acute pain
Multiple choice questions on the treatment of acute pain
Multiple choice questions on the treatment of acute pain
Analgesics and the treatment of acute pain THE END
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