1. TOPICS TO DISCUSS
1. Classification of analgesics.
2. Mechanisms of analgesic action of morphine (diagram representing pain transmission pathway with descending antinociceptive system).
3. Central and peripheral effects of morphine.
4. Main therapeutic use of morphine.
5. Other agonists of opioid receptors: codeine, fen-tanyl. Comparison with morphine. Therapeutic use. Neuroleptanalgesia.
6. Subtypes of opioid receptors and their general characteristics. Agonists-antagonists and partial agonists of opioid receptors. Comparison with morphine.
7. Opioid overdose and its treatment. Antagonists of opioid receptors.
8. Centrally-acting non-opioid analgesics: pharmacological groups, mechanisms of analgesic effect, therapeutic uses. Mechanism of trama-dol action.
9. Metabolism of paracetamol. Mechanism of hepatotoxic effect of paracetamol metabolites and its prevention.
10. Peripherally-acting analgesics (nonsteroidal anti-inflammatory drugs). Mechanism of anal-
gesic effect (diagram of arachidonic acid metabolism). Main therapeutic uses and adverse effects.
11. General characteristics and adverse effects of acetylsalicilic acid.
12. Individual characteristics of ketorolac, ibu-profen, and diclofenac. Selective inhibitors of COX-2 (coxibs).
Background information
Key terms
Pain (the term is derived from the Latin «poe-na» - punishment) is described as an «unpleas-ant sensory and emotional experience, which is a reaction of the body to noxious stimulus» sufficient to cause tissue damage. Thus, pain has a protective early warning value. Under certain pathological conditions, intense pain may be caused by a weak noxious (hyperalgesia) and even non-noxious (allodynia) stimulus.