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Opioid Non-Opioid analgesics (analgesics-antipyretics) Are the most powerful analgesics that can relieve any type of pain Act mainly at the level of the cortex. Opioid Analgesics ? Opioids are drugs acting at opioid receptors, morphine is the prototype of opioid agonists. Opioids exert their major effect by interacting with opioids receptors in the CNS and ANS, such as GIT and urinary bladder. Opioid Receptors Several types of opioid receptors have been identified at various sites in the nervous system and other tissues.Several types of opioid receptors have been identified at various sites in the nervous system and other tissues.
Action Raising the pain threshold at the spinal cord level Altering the brain’s perception of pain.
Therapeutic uses Morphine is strong analgesic Opioids induce sleep Analgesia Morphine suppress the cough reflex Relief of cough Treatment of diarrhoea Morphine decreases the motility and increase the tone of intestinal circular smooth muscle. Cough receptors bronchi, diaphragm, external auditory canal, larynx, nose, paranasal sinuses, pericardium, pharynx, pleura, stomach, trachea and tympanic membrane. Narcotic Antitussives Codeine An opium alkaloid similar to morphine ? less potent than morphine as analgesic and respiratory depressant.
Advantages of Dextromethorphan No effect on ciliary activity No CNS depression No addiction potential No constipation Contraindicated in children below 6 yrs of age and also in patients taking Monoamine oxidase inhibitors.
Inhibition of pulmonary stretch receptor of alveoli: benzonanatete “tesselone” Chemically related to tetracaine. Pain Pathway and Narcotic Analgesics By Wael Hamdy Mansy, MD Assistant Professor of Pharmacology King Saud Univesity. OPIOID ANALGESICS Dr.Abdul latif Mahesar Department of Pharmacology King Saud University 1. 2 Todays Objectives Compare & contrast pathophysiology and clinical manifestations of asthma, emphysema, bronchitis & lung cancer. 26 Emphysema: Patho Loss of lung elasticity Loss of lung elasticity Alveolar destruction Alveolar destruction Excessive enlargement Excessive enlargement Loss of curves impairs gas exchange Loss of curves impairs gas exchange Compensation… Compensation… Hyperinflation of lung Hyperinflation of lung Secondary to air trapping Secondary to air trapping barrel chest appearance barrel chest appearance Pink puffer Pink puffer O2 diffused easier than CO2 O2 diffused easier than CO2 CO2 accumulates causing chronic resp. 27 Emphysema: Causes & Complications Cigarette smoking Cigarette smoking Pack years required Pack years required Smoke>enzyme elastase protease>destroys alveoli Smoke>enzyme elastase protease>destroys alveoli Destroys cilia Destroys cilia Chronic respiratory inflammation Chronic respiratory inflammation air pollution air pollution Complications Complications Hypoxemia & acidosis Hypoxemia & acidosis Resp.
Common cold (cold) is a mild viral infection of the upper respiratory tract which is usually self-limiting. There are more than 200 viruses that can cause a cold and most people recover from a cold within a week or two. Drinking plenty of fluid, taking more rest and taking drugs that alleviate symptoms could help you feel better. Oral cough and cold medicines are available in various dosage forms, such as tablets, capsules, powders, syrups, linctus or lozenges. Many cough and cold medicines are also compounded products in which different ingredients are contained to relieve various symptoms associated with a common cold. Although liver damage can also occur with the use of aspirin or ibuprofen, it is of rare occurrence.
Aspirin is not recommended in children under 16 years of age in Hong Kong unless otherwise prescribed by a doctor. Sympathomimetics are widely used as nasal decongestants to clear stuffy nose in patients with colds.
Cough is your body’s natural protective response to clear mucus or other irritants in your throat and airways. Most cough suppressants suppress the cough reflex by a direct effect on the cough centre in the central nervous system. Patients should not drive or operate machinery if they feel drowsy or that their mental alertness is impaired.
Expectorants are thought to work by increasing the volume of secretions in the respiratory tract which in turn, makes it easier to expel phlegm from the airways. Commonly used expectorants are ammonium salts, guaifenesin, ipecacuanha, senega and sodium citrate.
Mucolytics act by decreasing the viscosity of mucus and thus facilitating its removal from the respiratory tract. Non-sedating antihistamines, due to their lack of antimuscarinic effect, are relatively ineffective in relieving runny nose that are not of allergic nature. Patients should not drive or operate machinery if they feel drowsy after taking antihistamines.

Antihistamines should not be used in treating phlegmy coughs as they reduce bronchial secretions, leading to the production of more viscous mucus which becomes more difficult to remove.
The risk of side effects and their severity depend on the type, dosage and duration of medicine you take. In order to avoid the sedating effects of some antihistamines in daytime, you may take these medicines before going to bed. If your young child is suffering from symptoms of cough and cold, you should consult your doctor for the most appropriate treatment. Avoid taking drugs which contain same type of active ingredients to prevent overdose or duplication of medicinal effects.
Always seek your doctor or pharmacist’s advice if you need to drive or operate machinery whilst taking cough and cold medicines. Do not drink alcohol when taking cough and cold medicines as it will increase the risk and severity of side effects of your medicines. Some cough and cold medicines such as pseudoephedrine, phenylephrine or ibuprofen may cause increase in blood pressure. Take the drugs according to the labelled dosage instructions or as instructed by your doctor or pharmacist in order to reduce the risk of side effects. As some of these medicines contain caffeine, you should avoid drinking too many drinks that also contain caffeine, e.g.
Seek advice from a doctor if your symptoms worsen or you have any concerns about the medicines you are taking.
Cough and cold medicines, particularly when used in children, should preferably be used under the supervision of a pharmacist or a doctor.
It is always prudent to seek your doctor or pharmacist’s advice on the best treatment option. Inform your doctor or pharmacist if you are pregnant as some medicines may be best avoided during pregnancy, e.g.
Inform your doctor or pharmacist if you are breastfeeding as some types of cough and cold medicines are distributed into breast milk, e.g. Seek advice from your doctor or pharmacist as soon as possible if you experience any symptoms or side effects suspected to be related to your cough and cold medicines in order to review your medications. Furthermore, drugs should be kept properly in places unreachable by children to prevent accidental ingestion.
Amino Pep Forte Syrup, which we offer, is a combination of Essential Amino Acids, Multivitamin and Zinc. Hepto Pep Syrup is a tasty blend of Cyproheptadine, Lysine and Peptone, which is present in syrup form. Laclose Solution treats of constipation, chronic constipation; this solution can also be used after haemorrhoidectomy, in elderly after Barium meal examination, in bed ridden or institutionalized patients and others. Having mutually acting ingredients that effectively counteract productive cough, this Viscof Syrup contains Ambroxol, a powerful mucolytic and mucokinetic agent, used for excessive and tenacious sputum during productive cough. Capsitop Gel, which we offer, indicated the quick and comfortable relief from pain and inflammation associated with musculoskeletal disorders such as sprains, strains, tendinitis, bursitis, head, neck and shoulder pain, sciatica, muscle stiffness, joint pain, back-ache and lumbago.
We offer the Drez Medicines to the clients that are appreciated for their quality and efficacy. The injury will cause release of various pain chemical mediators like prostaglandin, histamine, serotonin, bradykinin and substance P.
Morphine inhibits release of many excitatory transmitters from nerve terminal carrying painful stimuli.
MOA :Reduces the cough reflex by anesthetizing the stretch receptors in the respiratory passages, Lungs and Pleura. Popy seeds Although it is almost certain that the analgesic effects of an extract of poppy seeds was known long before. Mechanism of pain and nociception Polymodal nociceptors are the main type of peripheral sensory neuron that responds. Identify the diagnostic tests, nursing priorities, and client education with asthma, emphysema, bronchitis, & lung cancer. Medical advice should be sought as soon as possible if symptoms persist for more than 14 days or other symptoms develop (e.g. In fact, Reye's syndrome occurs almost exclusively in young children and several studies have found an association between Reye’s syndrome and aspirin consumption.

Medical advice should be sought in patients with certain medical conditions including high blood pressure and glaucoma before using decongestants because special precautions may be needed. Pholcodine and dextromethorphan tend to cause fewer side effects than codeine but they still have the potential to cause drowsiness or dependence.
AntihistaminesSedating antihistamines may be used as cough suppressants, classic example being diphenhydramine or promethazine.
Compounded cough and cold preparations often contain antihistamines such as chlorpheniramine and brompheniramine. Driving or operating machinery should be avoided if you feel drowsy after taking antihistamines. If you miss a dose, take it as soon as possible or skip the missed dose and take the next dose as directed.
These Pharmaceutical Medicines are packed hygienically using the best quality packing material.
This is a known fact that EAAs are not synthesized by the body and have to be supplemented externally. This Hepto Pep Syrup is indicated for allergic conditions, vascular headaches and as an appetite stimulant.
Adverse effects of Codeine: In therapeutic doses minimum side effects Sedations, nausea, constipation At higher doses respiratory depression and drowsiness can occur.
Describe the mechanism of action, side effects and nursing responsibilities with pharmacologic management of asthma, emphysema & bronchitis. Sourced from the credible Vendors and Manufacturers, these Pharmaceutical Medicines are priced economically.
Also, we make sure to pack these Drez Medicines at the market leading rats to the customers.
Euphoria Morphine depresses respiration by reducing of the sensitivity of respiratory centre to carbon dioxide. Euphoric effect used for sever cough of bronchogenic carcinoma ? Less addictive ? Used limited due to SE.
Our range of Pharmaceutical Medicines consists of Amino Pep Forte Syrup, Hepto Pep Syrup, Laclose Solution, Nugel Medicines , Viscof Syrup, Capsitop Gel and Drez Medicines . Killing coughs with suppressants can prolong the causative disease such as tuberculosis, malignancy, pneumonia, lung abscess, congestive heart failure and so on, which can progress, even becoming fatal. Benzonatate begins to work within 15 to 20 minutes, and its effects last for approximately 3 hours. Moreover, these Pharmaceutical Medicines are acclaimed for their quality and quick results.
Most people are not aware that cough remedies are of two different types: for dry cough and productive cough.
Adverse effects: Headache, Dizziness Nasal Congestion, burning of eyes & tightness in chest. Top selling brands contain codeine that suppresses the cough and causes drowsiness, constipation and impaired reactions that can be dangerous while driving. Furthermore, these drugs must be avoided during pregnancy and lactation and should not be given to children under 6 years. Apart from lack of evidence of efficacy, such products can cause allergic reactions, sleep disturbances and hallucinations. Worse still, some brands contain a suppressant along with an expectorant resulting in countering each other's effects.
The intake of anti-hypertensive drugs enalapril, lisinopril, ramipril, perindopril or other 'prils', reflux of stomach contents in gastrooesophageal reflux disease (GORD) and eosinophilic bronchitis may induce coughing but are often missed.
Thumb rule: always consult your doctor if an uncomplicated cough does not resolve in a week or so.

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