The resident's electronic handbook ...
ANALGESICS
NSAID
OPIOIDS
02/16/96 kaufmannm@ubaclu.unibas.ch
Nonsteroidal
Anti-inflammatory Drugs - Overview
Salicylates Paracetamol Benzothiazin Propionic Mefenamin Ketorolac acid acid
Aspirin Panadol Felden Brufen Ponstan Tora-Dol
Aspegic
Dose in
(mg) p.o. 25-1000 325-1000 20 200-800 500 ---
Dose interval
in hours 4-6 4-6 12-24 8-12 6-8 8-12
Dose in
mg i.v. 500 10-30
Maximum intensity
in hours 2 0.5-1 2-4 1-2 2 0.5-0.75
Duration of analgesic
effect in hours 4-6 4-6 24 4-6 4-5 4-5
Analgesic effect +++ +++ +++ +++ ++ ++
Anti-inflammatory
effect +++ --- +++ +++ ++ ++
Antipyretic
effect +++ +++ + +++ + +
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Nonsteroidal
Anti-inflammatory Drugs - Side effects
Salicylates Paracetamol Benzothiazin Propionic Mefenamin Ketorolac
acid acid
Gastric
irritation +++ --- ++ ++ +++ +++
Gastric
ulceration +++ --- + + ++ ++
Platelet
dysfunction + --- + +
Hemolytic
anemia ++ ++
Renal
dysfunction + + + ++ ++
Hepatic
dysfunction ++ +++ + + + +
Allergic
reactions +++ --- + + + +
CNS tinnitus --- insomnia headache headache headache
dizziness dizziness confusion
dysopia
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Morphine Methadone Pethidin Alfentanil Fentanyl Nalbuphin
analgesic
potency 1 1 0.1 30 125 1
dose i.v.
(mg/kg) 0.1 0.1 0.5 0.025-0.1 0.025-0.3 0.15-0.3
dose s.c.,
i.m.(mg) 5-20 0.1/kg KG 25-150
Repeat dose
after 3-5h 3-5h 3-5h 5-10min 30-60min 5h
Peak analg.effect
i.v. max
after 30min 10-30min 90min 1min 3min 3min
Activity
time 3-5h 3-5h 3-5h 5-10min 30-60min 5h
Elimination
half-time 3h 15-40h 4h 90min 3.5h 3h
Metabolism liver/kidney liver liver liver liver liver
Secretion bile bile bile bile bile bile
kidney kidney kidney kidney kidney kidney
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- Ventilation: for all after 15 minutes maximal depression
- Sedation: Dose dependent
Morphine Methadone Pethidin Alfentanil Fentanyl Nalbuphin
Nausea/vomiting ++ ++ ++ ++++ ++ +
Thoracic rigidity ++++ ++
Miosis ++ ++ ++ ++
Bradycardia + ++
Cardiovascular compensationdepressed by all opiods
Gastrointestinal depressed motility
Biliary muscles tonus ++ ++ ( + ) ++ ++ ++
Bronchial muscles tonus ++ ++ + ++ ++ ++
Histamine release ++ ++
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