The opioids form the third group of pain killers. They work on specific opioid receptors in the body, which are mainly located in the brain and the spinal cord. Because of the different effector site (opioid receptors), they can be used with additional effect in combination with the other pain killers like paracetamol (central anti-prostaglandin effect) and NSAIDs (peripheral anti-prostaglandin effect).
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Well known examples of opioids are codeine, morphine and pethidine.
They can be categorised according to their effect in:
low,
intermediate and
high efficacy.
The side effects differ in severity between the different preparations, but are generally:
mental state: drowsiness, decreased alertness (careful with driving a car etc!), sedation (or sometimes agitation, especially in children), euphoria or dysphoria (e.g. some patients describe it like if their body does not belong to them anymore), dependence and addiction
respiratory: depression of breathing and cough; extreme caution is warranted with asthma or chronic obstructive lung disease
intestines: nausea and vomiting, constipation (never take opioids together with anti-diarrhoeal drugs, because the constipation can become extremely severe), constricts the gall bladder sphyncter and can make a gall crisis worse
difficulty in passing urine (careful when taking other drugs like anticholinergics, which are often prescribed to unblock your nose during a cold or flu)
tolerance, i.e. decreased effect when you take opioids for a long time or
repeatedly
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