Opioid Analgesics
ACTIONS:
Binds with opioid receptors within CNS, causing inhibition of ascending pain pathway. Alters perception of and emotional response to pain.
INDICATIONS:
Relief of moderate to severe pain (usually in combination with non-opioid analgesics).
SIDE EFFECTS:
Alert: Effects are dependent on dosage amount. Ambulatory pts, pts not in severe pain may experience dizziness, nausea, vomiting, hypotension more frequently than those in supine position or having severe pain.
Frequent: Drowsiness, dizziness, hypotension (including orthostatic hypotension), anorexia..•‡ Occasional: Confusion, diaphoresis, facial flushing, urinary retention, constipation, dry mouth, nausea, vomiting, headache.
Rare: Allergic reaction, depression, paradoxical CNS hyperactivity, nervousness in children, paradoxical excitement, restlessness in elderly, debilitated pts.
ADVERSE EFFECTS/ TOXIC REACTIONS:
Overdose results in respiratory depression, skeletal muscle flaccidity, cold/ clammy skin, cyanosis, extreme drowsiness progressing to seizures, stupor, coma. Hepatotoxicity may occur with overdose of acetaminophen component of fixed-combination product. Tolerance to analgesic effect, physical dependence may occur with repeated use. Antidote: Naloxone.
INTERACTIONS:
DRUG: Alcohol, other CNS depressants may increase CNS effects, respiratory depression, hypotension. CYP3A4 inhibitors (clarithromycin, ketoconazole) may increase toxicity. CYP3A4 inducers (carbamazepine, rifampin) may decrease concentration/effects. MAOIs may produce serotonin syndrome.
HERBAL: Gotu kola, kava kava, St. John’s wort, valerian may increase CNS depression.
FOOD: Grapefruit products may increase the potential for respiratory depression.
LAB VALUES: May increase serum amylase, lipase.
OxyContin®, Percodan®, Percocet®
Chapter 16: Stabilize & Bind Medicinals
Enters: Lu, LI, K, Sp, Ht.
Temperature: warm
Taste: sour, astringent, toxic
Caution: Excess conditions
Note: overdose may arrest Zhong Qi and lead to death
ACTIONS:
Relieve pain, Settle Shen, astringe Lung; astringe Large Intestine; stabilize lower Jiao
INDICATIONS:
Deficiency pain in the chest, abdomen, tendons, bones, and epigastrium; chronic cough d/t Lung Qi or Yin deficiency; chronic diarrhea or dysentery d/t Spleen Yin & Qi deficiency; chronic diarrhea or dysentery; polyuria, spermatorrhea, vaginal discharge d/t Instability of the lower Jiao.
Tongue: pale, swollen
Pulse: floating, thready
RATIONALE:
By suppressing Shen and containing Kidney Fear, oxycodone allows separation from pain. If overused, it will disconnect the Heart and Kidneys, which may cause sleep disturbances and anxiety. A sour taste relaxes sinews so relieving pain. Astringent properties contain body fluids and Qi holding stool, urine and sperm. Prolonged use at high doses will cause Qi stagnation, manifesting in dyspnea and constipation. Overdose will lead to constraint of Zhong Qi, causing cardiac arrest and inability of the Kidney to grasp Lung Qi, leading to respiratory arrest.
MODIFICATIONS:
To counteract side effect of Qi stagnation add Chai Hu
Copyright ©2016 by Galina V. Roofener. All rights reserved.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the author. Permission may be obtained directly from Galina V. Roofener by email GR@AsianTherapies.org