Pain always occurs unexpectedly and most often indicates pathological processes that occur in the body. In some cases, when pain is caused by a mild injury, no medication is required. Unless the doctor prescribes light analgesics. And sometimes a person’s suffering is so strong that only powerful drugs can cope with them - painkillers. We will tell you more about them in this article.
Narcotic analgesic drugs
This group of painkillers includes drugs that are highly active in relation to the opioid receptors of the brain. When using painkillers, the patient’s suffering gradually recedes, the feeling of waiting for another exhausting attack disappears. However, the patient continues to be conscious and does not lose the sensitivity of tissues to external influences. The peculiarity of painkillers in comparison with other means designed to eliminate human suffering is the occurrence of euphoria and the formation of dependence as a result of prolonged use.
Narcotic analgesic drugs for the following types:
- agonists;
- antagonists;
- antagonist agonists.
Let’s explain. Opioid receptor agonists and antagonist agonists are distinguished by a targeted effect on the focus of pain, while antagonists contribute to overcoming the state of overdose from the effects of opiates.
Drug classification
All known painkillers are divided into three main groups:
- Natural origin. They include opioid drugs produced from sleeping pills poppy (morphine, codeine).
- Semi-synthetic substances - "Ethylmorphine", "Omnopon". This group of drugs is obtained by changing the substances of natural origin at the molecular level.
- Synthetic preparations. This group includes all analgesic drugs produced by humans that have nothing to do with opiates created by nature. Among them are Promedol, Sufentanil, Fentanyl and others.
Narcotic painkillers are classified not only by the source of occurrence, but also by the chemical formula:
- Morphine derivatives. Morphine and codeine, as well as their synthetic derivatives: “Nalorfin”, “Nalbufin”, “Butorphanol”, “Pentazocine” are included in this group as the widely known, most powerful pain relievers of natural origin.
- Acyclic substances. Currently, only Estocin is used from this category of drugs.
- Derivatives of piperidine. This group includes Promedol, Fentanyl, Dipidolor, Sufentanil, Imodium.
- Derivatives of cyclohexane. This is a group of agonist antagonists, which indicates less addiction to them in comparison with previous categories of drugs. These drugs include Tramadol, Valoron, Tilidin.
The mechanism of action on the body
The process of pain is quite complicated. The human body is full of many nerve endings. Each of them reacts to internal or external stimuli. Signals of pain, passing through the nerve endings, enter the spinal cord. Here the sensitivity increases. The intensified impulse of pain moves further to the brain. That, in turn, processes the information received and develops a response.
It is important to note that a person reacts differently to pain that is dragging, sharp, or lasting for a long time. We explain in more detail. Acute pain occurs unexpectedly, it is accompanied by an instant reaction. For example, a person abruptly pulls his hand from a burning fire. Dull pain is accompanied by painful sensations and various kinds of reactions, such as nausea, increased sweating, dizziness, tachycardia. The human body is designed in such a way that it is capable of stopping an unpleasant syndrome on its own with the assistance of opiate receptors. Their activation stimulates a powerful injection of substances that reduce sensitivity into the blood. Thus, the constant aching pain is calmed.
Narcotic substances, interacting with opiate receptors, awaken them and cause reactions that directly depend on the accepted analgesic:
- give the body the ability to endure acute pain;
- dull fear and emotional stress before arising attacks;
- reduce the body's response to pain.
It is worth noting that the receptors are located not only in the spinal cord and brain, but also in the nerve endings throughout the body. Opiates are able to penetrate even through complex barriers, which explains one more effect - euphoria. Having taken painkillers-drugs, the patient is pacified, can see hallucinations, ceases to feel the experiences and fears generated by pain.
Addiction development
Having once felt a sense of euphoria and absolute relaxation, a person with all his might wants to experience it again. As a result, begins to take drugs again. Thus, psychological dependence is formed.
With regular use of strong painkillers for the opium group, the body gets used to the dosage that has recently helped, it becomes insufficient. To again fall into a state of rest, a person has to take an increased dose. As a result, over time, the body stops the production of endogenous substances that alleviate pain, which leads to withdrawal. Thus, physical drug addiction develops.
Indications for use
Since there is a high risk of drug dependence as a result of taking drugs of this category, they are indicated for pain relief only in exceptional cases:
- prolonged pain with a malignant tumor;
- dullness of pain in case of a severe burn;
- pain relief during childbirth;
- providing antitussive action in case of chest injury;
- pain relief for myocardial infarction;
- prediction during anesthesia;
- anesthesia in the postoperative period.
When is it forbidden to take painkillers?
Based on the mechanism of action of analgesics, some patients are prohibited from taking these funds.
Contraindications include:
- The use of drugs by children under the age of ten years. Paralysis may occur.
- Impaired functioning of the respiratory system. This is due to the fact that analgesics directly affect the depressing centers of the brain, providing gas exchange.
- Removal of pain in surgery (which makes diagnosis much more difficult) in an “acute abdomen” state of unknown origin.
- Pathology of liver function.
- Renal failure.
- Opiates have the ability to tone the blood vessels of the brain, so their administration to patients with traumatic brain injury or increased intracranial pressure is prohibited.
- Drug addiction in any manifestation.
- Old age. If we talk about the age category of patients, then, as a rule, they suffer from renal and hepatic insufficiency, which is aggravated by the action of analgesics.
- Childbearing and the period of breastfeeding. Even at the lowest dosage, opiates cross the placenta, causing harm to the baby.
The last two groups are patients to whom narcotic drugs can be used only in cases of emergency.
Side effects
Regardless of which drug is administered as an anesthetic, the following side effects are observed:
- Gastrointestinal problems.
- Toxic megacolon.
- Urinary retention.
- Disturbances in the central nervous system.
- Lowering blood pressure.
Symptoms of acute poisoning and overdose
Exceeding the permitted dose when taking strong painkillers can cause intoxication, which is expressed by the following symptoms:
- overexcitation;
- unusual talkativeness;
- hyperreactivity;
- thirst and dry mouth;
- itching on face and neck.
After 30 minutes, a person feels weak and exhausted. The effect of drug poisoning is expressed by dizziness, confusion, drowsiness.
It should also be remembered that painkillers in injections have a stronger effect on the body and have pronounced side effects.
Overdose in most cases is the result of deliberate actions aimed at getting euphoric. In cases where the excess was significant, the person may fall into a coma. A severe overdose is expressed by the following symptoms:
- narrowing of the pupils;
- convulsive condition;
- impaired breathing;
- cyanotic complexion;
- lowering pressure and body temperature.
Treatment of acute poisoning and overdose
People with pronounced drug intoxication must be immediately taken to a medical facility. Among the most effective drugs for the treatment of opium poisoning is Naloxone.
Its action is based on the displacement of morphine from opium receptors. As a result of the action of the medicine, the respiratory function returns to normal, consciousness returns. If improvement does not occur, then poisoning is caused by other causes.
Along with the use of Naloxone, the patient is given gastric lavage and prescribed analeptics, neoanthropes, vitamin complexes and antibacterial drugs.
Non-narcotic analgesics: differences
Keep in mind the following important warning. Narcotic drugs, due to the nature of the action and danger, can only be used as directed by a doctor. And exclusively in a hospital.
An alternative is non-narcotic analgesics that affect the peripheral nervous system. They are often used to eliminate acute pain. There are good enough painkillers for oncology, but not drugs. These drugs are just as effective, but safer. True, they are used to relieve not too intense pain.
The principle of their action is to reduce the production of prostaglandin. This substance is responsible for the occurrence of various types of inflammation. In addition, such drugs have anti-inflammatory, antipyretic, analgesic effects.
Analgesics are available in the form of injections, suppositories, ointments, sprays, plasters, tablets. They contain various active components.
Such drugs are widely used in dental and domestic practice. They must be used in accordance with the attached instructions.
The advantage of painkillers over drugs is that they do not have a psychotropic effect, are not addictive, euphoric and addictive.
Is vodka a drug?
Everyone knows the historical events when the Prohibition was introduced, and the negative reaction of society to this. Most people are convinced that alcohol cannot be equated with narcotic substances, considering it to be part of Russian culture. At the same time, regular use of vodka in large volumes has been observed only since the beginning of the last century.
Given the effect of alcohol on the human body, it can be compared with narcotic drugs. In small doses (up to 50 ml), vodka has a mild analgesic and sedative effect. In large quantities (from 250 ml), it acts as a psychotropic drug, namely: a person loses self-control, personal qualities are destroyed, and withdrawal syndrome develops.
The consequences of drinking vodka
Sometimes you may hear the question: “What is better to anesthetize: vodka or drugs?” It is definitely impossible to answer this question. It all depends on the specific situation. But it can be argued that the consequences of the systematic use of alcohol are no less dangerous than from drugs:
- Deterioration of fine motor skills. Addiction to vodka contributes to the degradation of the nervous system. This leads to trembling of the extremities, erratic and incoherent speech, and a delayed reaction.
- If a person regularly consumes a moderate amount of alcohol for five years or more, the risk of stroke and heart attack increases significantly.
- Dissociation of neural connections, which affects the work of the brain. A person does not perceive new information, memory worsens.
- Alcoholism is the cause of atrophy of blood vessels and deterioration of the cardiovascular system.
- In some cases, urolithiasis appears. Men and women are equally affected by it. It manifests itself with acute bouts of pain. Not all types of stones can be withdrawn, therefore, periodically occurring pains can accompany a person throughout life.
- Alcohol abuse contributes to the development of liver cirrhosis, which is fatal.
Conclusion
The article provides information on narcotic painkillers. The mechanism of action, contraindications and indications for admission are described. A comparison of these drugs with non-narcotic analgesics and alcohol is given.