Articles: opioid-analgesics.
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Opioid receptors are described and differentiated by their affinities for specific agonists and antagonists. Their sites of action and receptor activities are discussed. Tachyphylaxis and tolerance are described and methods for overcoming these problems are recommended. Suggestions are made regarding future drugs to act at specific receptors.
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Randomized Controlled Trial Clinical Trial
Gastric fluid volume, pH, and emptying in elective inpatients. Influences of narcotic-atropine premedication, oral fluid, and ranitidine.
One hundred and twenty healthy, elective surgical inpatients were randomly assigned to one of four groups. Between two and three hours before the scheduled time of surgery all patients ingested a marker dye, phenol red, 50 mg in 10 ml water, with placebo tablet alone (Groups 1 and 2), placebo tablet with 150 ml oral fluid (Group 3), or oral ranitidine 150 mg with oral fluid 150 ml (Group 4). Patients in Group 1 received oral diazepam or no premedication, while those in Groups 2, 3, and 4 received IM narcotic and atropine one hour preoperatively. ⋯ Mean pH values were Group 1: 2.99; Group 2: 3.03; Group 3: 3.44; Group 4: 5.28. The amount of phenol red in the samples indicated at least 90 per cent gastric emptying had occurred in 90 per cent of patients. We conclude that, in healthy patients, 150 ml oral fluid is almost completely emptied from the stomach within two hours of ingestion, even when followed one hour later by narcotic-atropine premedication.
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Anasth Intensivther Notfallmed · Oct 1988
[Continuous intrathecal opiate therapy with a portable drug pump in cancer pain].
Terminal cancer patients report substantial pain frequently. Pain control can be achieved in many patients with conventional methods and analgesics. However, significant numbers of patients remain in pain. ⋯ No serious complications like meningitis or other infections were observed. Postmortem examination also could not detect changes of the cord or signs of arachnoiditis due to intrathecal narcotics or the implanted catheter. We conclude, that continuous intrathecal narcotic infusion by means of small portable pump is a very efficient method to control terminal cancer pain and enables treatment on an outpatient basis until death.