Narcotic analgesics

Analgesics are a group of medicines that have the ability to weaken or eliminate the feeling of pain. By their nature, pharmacological effects and effects on the body, analgesics are divided into two groups: narcotic and non-narcotic.

Narcotic and non-narcotic drugs

Non-narcotic drugs include:

1. Preparations based on salicylic acid: aspirin, sodium salicylate.
2. Preparations based on pyrazolone: ​​analgin, amidopyrine, butadione.
3. Preparations based on aniline: paracetamol, panadol, phenacetin.
4. Preparations based on alkanoic acids: diclofenac sodium, brufen.
5. Others: natrofen, piroxicam, dimexide, chlorotazole.

Narcotic drugs:

1. Tincture and extract of opium.
2. Alkaloids of opium: preparations containing morphine and codeine.
3. Semisynthetic analogues of morphine: ethylmorphine, hydrocodone, etc.
4. Synthetic substitutes for morphine: estocin, butorphanol, buprenorphine, methadone, sufentanil, alfentanil, oxymorphone, levorphanol, propoxyphene, nalbuphine, nalorphine, fentanyl, promedol, tramadol, tramal.

Pharmacology of narcotic analgesics

Most of these analgesics are derivatives, synthetic or semi-synthetic analogues of morphine. Depending on the structure, they are either agonists or agonist-antagonists of opioid (pain) receptors.

1. Agonists: morphine, hydromorphone, oxymorphone, methadone, meperidine, fentanyl, alfentanil, sufentanil, remifentanil, levorphanol, oxycodone.
2. Partial agonists: codeine, hydrocodone, propoxyphene, diphenoxylate.
3. Antagonist agonists: buprenorphine, nalbuphine, butorphanol, pentazocine, nalorphine (mixed-agent preparations are agonists or partial agonists for one type of receptor and antagonists to others, which reduces the risk of respiratory depression, intestinal effects and other side effects).
4. Antagonists: naloxone, naltrexone, nalmefene.

The last group on the list does not refer to narcotic drugs, but is their antagonists having the properties to block the effect of narcotic analgesics. They are used in overdoses of narcotic drugs to neutralize their effects.

Effects on the body

For narcotic analgesics, the following properties are characteristic:

1. A strong analgesic effect, which allows them to be used for injuries and diseases accompanied by severe pain.
2. Influence on the central nervous system, manifested in a strong euphoria, and causing mental and physical dependence with prolonged admission.
3. The emergence of an abstinence syndrome in people with developed dependence.

Pharmacological properties of such drugs, in addition to the pronounced analgesic effect, are drowsiness, respiratory depression and cough reflex, strengthening the tone of the bladder and intestines. They can also cause nausea, vomiting, disturbances from central nervous system (hallucinations) and other side effects.

Mechanism of action

Drugs of this group have an impact on the limbic part of the brain, which is responsible for emotional evaluation, which distorts the emotional and mental assessment of pain, suppresses the fear caused by it. Increasing the production of endorphins, which are pain receptor agonists (ie, suppress them), which leads to their inhibition and reduction of pain. Under the influence of the drug, the centers of pleasure and joy are activated in the brain, a feeling of lightness, detachment, bliss is created, which leads to the emergence of mental dependence.