Методические рекомендации для ведения практических занятий G041
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Методические рекомендации для ведения практических занятий |
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G-041.07.01.13-2007 |
Рев. 01 Дата ввода ревизии 31.11.2013 взамен: |
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Приложение № 10
S E M I P A L A T I N S K S T A T E M E D I C A L A C A D E M Y
METHODICAL GUIDANCE FOR CLASSES
(practical)
Specialty: General medicine
Discipline: Pharmacology-1
Chair: Pharmacology, Pharmacognosy
Course II
Theme № 9. Opioid Analgesics & Antagonists. Nonopioid Analgesics and Nonsteroidal Antiinflammatory Drugs.
Editor: assistant-professor, candidate of medical sciences ______ S.K.Seilkhanov
.
Semey – 2008
На обороте титульного листа
Ratified at the meeting of the chair
Protocol №
the ___ of ______________________ 2009.
The Head of the chair_____________________M.N.Moussin
1. The theme: Opioid Analgesics & Antagonists. Nonopioid Analgesics and Nonsteroidal Antiinflammatory Drugs.
2. The aim: To study the Pharmacodynamics & Pharmacokinetics of Opioid Analgesics & Antagonists. Nonopioid Analgesics and Nonsteroidal Antiinflammatory Drugs.
3. The objectives:
You should know:
1. To describe the sites and mechanisms of opioid actions
2. To state the properties of opioids, including pharmacokinetics and effects on tissue systems
3. To state the therapeutic uses
4. To be familiar with their untoward effects
You should be able to:
- List the receptors activated by opioid analgesics and the endogenous opioid peptides.
- Give a list of major opioid agonists, rank them in order of analgesic efficacy.
- Identify opioid receptor antagonists and mixed agonist-antagonists.
- Describe the main pharmacodynamic and pharmacokinetic properties of agonist opioid analgesics and list their clinical uses.
- List the main adverse effects of acute and chronic use of opioid analgesics.
- Describe the clinical uses of the opioid receptor antagonists.
- List two opioids used for antitussive effects and one used for antidiarrheal effects.
4. The main questions of the theme
Classify analgesics.
What are the main differences between narcotic and non-narcotic analgesics?
Describe the pharmacological effects, mode of action, preparations, doses, uses, contraindications of morphine.
What are the differences between morphine and pethidine?
How is acute morphine poisoning treated?
Describe the characteristics of dependence of morphine and the withdrawal syndrome.
Describe the differences between morphine and codeine.
Name opioid antagonists. How do they act?
Describe the major classes of opioids receptors.
What are the various effects produced by opioid-receptor activation?
Discuss naloxone, nalorphine and naltrexone as narcotic antagonists.
Write notes on “brain’s own opioids”.
Write prescriptions for next drugs and note their indications and contraindications (precautions):
1. This drug is an effective antitussive; it is free of analgesic and addictive-properties and only rarely causes constipation
2. This drug has analgesic efficacy equivalent to that of morphine; the agent is an antagonist at mu receptors
3. In some studies, this opioid agonist is reported to have analgesic efficacy no greater than that of a placebo; the drug may cause seizures in overdosage
4. This drug is a full agonist at opioid receptors. It has excellent oral bioavailability, analgesic activity equivalent to that of morphine, and a longer duration of action. Withdrawal signs on abrupt discontinuance are milder than those associated with withdrawal from morphine
5. This antagonist drug has been proposed as a maintenance drug in treatment programs for opioid addicts; a single oral dose will block the effects of injected heroin for up to 48 hours
6. This analgesic blocks cyclooxygenase irreversibly
7. Week nonsteroidal anti-inflammatory drugs prototype
8. Nonsteroidal analgesic that lacks anti-inflammatory action
9. Nonsteroidal analgesic that is derivative of propionic acid
10. Nonsteroidal analgesic that is derivative of phenylacetic acid
11. Analgesic derived from opium poppy
12. Opioid analgesic - derivative of phenylpiperidine that is used as a component of balanced anesthesia
13. Phenylpiperidine opioid analgesic that has strong antimuscarinic effect
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Morphine |
T.10,15,30, Sol.10, 20/ml, 20,100/5 ml-PO; A.1,2,3,4,5,10, 15/ml-SC,IV; Supp.5,10,20,30-PR |
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Phentanyl |
0.5/ml – for injections, 25/hr,50/hr,75/hr,100/hr – transdermal patches |
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Meperidine |
T.50,100, Syrup-50/5ml – PO, Sol.25,50,75,100 – SC,IM, 10/ml - IV |
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Methadone |
T.5,10,40 - PO; Sol.1/ml,2/ml,10/ml – PO, A.10/ml - IV |
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Nalbuphine |
10/ml, 20/ml for injections |
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Dextromethorphan |
T.5, Syrup-5,7.5,10,15/5 ml-PO |
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Pentazocine |
T.50 – PO, A.30/ml for injections |
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Propoxyphene |
T.32,65 - PO |
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Naltrexone |
C.50 - PO |
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Aspirin |
T.65,325,500–PO; C.325,500–PO; Supp.120,325,600,1200-PR |
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Diclophenac |
T.25,50,75 – PO, 0.1%-Eye drops |
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Ketorolac |
T.10-PO; A.15/ml,30/ml-IM, 0.5%-Eye drops |
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Acetaminophen |
T.325,500 - PO; Sol.100/ml – PO |
5. Teaching methods – working in pairs, the prescription writing of drugs for concrete situations; training, defining terms, solving problems, answer questions, working out examples (of the slides, of the handbooks and handouts), MCQs.
6.Literature
1.Katzung B. G., ed. 2001. Basic and Clinical Pharmacology, 8th ed., Lange Medical Books/McGraw-Hill, Appleton and Lange. PP.460-476.
2.Katzung B.G., Trevor A.J., ed. 1998, Examination & Board Rewiew. 5th ed., Stamford, Connecticut, Appleton & Lange. PP.235-242.
2.Tripathi K.D., ed.1999, Essentials of Medical Pharmacology. 4th ed., New Delhi, India, Jaypee Brothers. PP.115-147.
3.Sharma V.N., ed.1996 Essentials of Pharmacology. 1th ed., New Delhi, India, CBS Publishers & Distributors. PP.83-91.
7. Assessment Prescriptions Writing, MCQs, ECQs.
PAGE 4
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