OPIOD

POPULAR
WHY?

REASON
Desensitize the user

Induce sense of EUPHORIA

Induce sense of WELL-BEING

OPIOIDS CLASSIFICATION
1. Strong agonist (moderate to severe pain)
Morphine

Fentanyl
Meperidine/pethidine
Methadone

2. Mild to moderate agonist (mild to moderate

pain)

Codeine
Loperamide
Diphenoxylate

Oxycodone

3. Mixed agonist-antagonist

Pentazocine

Nalbuphine

Buprenorphine

INTOXICATION
APATHY

IMPAIRED
ATTENTION/MEMORY

LETHARGY

IMPAIRED
JUDGEMENT

SLURRED SPEECH

DROWSINESS

AGITATION

CONSTRICTED PUPILS

OVERDOSE
UNCONSCIOUSNESS
DEATH

REPIRATORY
DEPRESSION

COMA
PUPILLARY
CONSTRICTION

FURTHER SYMPTOMS

WITHDRAWAL
ANXIETY
RESTLESSNESS
ACHING BACK & LEGS
CRAVING MORE OPIODS

PHARMACOLOGICAL EFFECTS
1. CNS effects

i. Analgesia
Pain: sensory and affective (emotional)
Opioid reduce both components
ii. Euphoria
iii. Floating sensation, free from

anxiety & distress

Dysphoria may occur sometimes

PHARMACOLOGICAL EFFECTS
iii. Sedation

Drowsiness

Impairment of reasoning ability

No amnesia
iv. Respiratory depression

Inhibit brainstem respiratory mechanism

Reduce response to CO2

PHARMACOLOGICAL EFFECTS
v. Cough suppression
Depress cough reflex

vi. Miosis
Constriction of pupil

PHARMACOLOGICAL EFFECTS
viii. Nausea and vomiting
Activate chemoreceptor trigger zone (CTZ):
produce nausea & vomiting

PHARMACOLOGICAL EFFECTS
2. Peripheral effects
i. CVS

Hypotension: vasodilatation

histamine release
direct action

depression of vasomotor centre

Bradycardia exc pethidine (antimuscarinic

effect - tachycardia)

PHARMACOLOGICAL EFFECTS
ii. GIT

decrease GI secretions

decrease motility: constipation

iii. Biliary tract

Constrict biliary smooth muscle: biliary colic

PHARMACOLOGICAL EFFECTS
iv. Renal

antidiuretic effect

increase urethral sphincter & bladder tone:

urinary retention

v. Uterus

prolong labor, reduce uterine tone

PHARMACOLOGICAL EFFECTS
vi. Skin

cutaneous vasodilatation

flushed face, itching

due to histamine release