8 - Opioid analgesics and narcotic antagonists

Abstract

Publisher Summary This chapter discusses several opioid analgesics and narcotic antagonists and their side effects. Alfentanil is a potent short-acting opioid with a rapid onset and short duration of action. It is, therefore, the ideal analgesic for focused and ambulatory interventions. Patients with migraine who use daily codeine or other opioids may be more susceptible to chronic daily headaches; this is evident in opiate overuse. Recreational use and abuse of codeine cough syrup is also becoming more frequent. The most frequently mentioned negative effects include taste disturbance, prolonged sedation beyond the desired effect, loss of co-ordination, lethargy, constipation, and urinary retention. Combined spinal-epidural anesthesia for mobile analgesia in labor is now widely used. It offers the advantage of rapid onset of analgesia with the flexibility of epidural top-ups later in labor. Symptoms include severe pruritus, flushing, swelling, urticaria, severe headaches, nausea, general malaise, hypotension, and tachycardia. Fentanyl can be used transdermally because of its high solubility in both fat and water; it had low molecular weight, high analgesic potency, and fewer adverse effects, especially gastrointestinal symptoms include nausea, vomiting, and constipation. The most serious adverse effect reported is hypoventilation and skin reactions.