A Close Look at Pain - Pharmacology

Narcotic agonists are medications that relieve pain. These are safe and effective when properly administered. These medications are opioid based and are used to treat acute or chronic pain from trauma, tumor growth, and from surgical proce-dures. They are also used to treat pain caused by the progression of diseases or complications from other conditions.

For example, pain from sickle cell crisis can be debilitating and require the patient to receive a narcotic analgesic such as morphine. This medication blocks the pain and creates a euphoric effect giving the patient relief from the pain of the disease.

However, fear of inducing addiction or respiratory depression interferes with pain management. Addiction is rare in clinical practice. Some patients who are treated with opioid analgesics can develop a tolerance to the medication requiring an increased dose to maintain pain relief. However, the need to increase the dose of the medication is usually related to an increase in pain due to disease progression or complications. Physical dependence on a medication occurs when the physiological condition of the patient is altered.

Increased doses of opioid analgesics also expose the patient to adverse side effects such as respiratory depression. Opioid analgesics can cause some respiratory depression. However, this effect usually does not occur with long-term use such as with cancer patients. Prescribers avoid this side effect by titrating doses over time to deliver pain relief without adversely affecting the respiratory system.


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