Narcotics produce pharmacological effects when administered to a patient. Some of these effects are desirable, while others are undesirable. Always remember that the legitimate use of these agents is implied in our discussion.
a. Analgesic Effect. Analgesia means relief of pain without the loss of consciousness. Analgesia is the most common use of narcotics. Although the exact mechanism of action by which narcotics act is unknown, it is thought that analgesia is obtained by the action of these agents on the cerebral cortex. The relief of pain is enhanced because narcotics raise a patient's pain threshold and thus produce a calming and soothing effect. Narcotic agents have particular application in the relief of continuous, dull pain. Consequently, these drugs are widely used in patients who are terminally ill.
b. Antitussive Effect. An antitussive agent acts to control or prevent cough. Some narcotics will depress the cough center of the brain and produce this antitussive effect. In general, the antitussive dose of a narcotic is lower than the analgesic dose of that same drug. Before progressing, it should be noted that a narcotic is not indicated for all types of coughs. Indeed, sometimes it is useful for a patient to cough in order to remove substances from the lungs.
c. Mood Alteration Effect. Some narcotics will produce a mood alteration in patients. The types of mood changes can be classified in two categories.
(1) Dysphoria. Dysphoria is a mood alteration characterized by feelings of anxiety, fidgetiness, or being ill at ease.
(2) Euphoria. Euphoria is characterized by an exaggerated feeling of well-
d. Gastrointestinal Effect. Narcotics produce some significant effects upon the gastrointestinal system (that is, stomach and intestines). Some narcotics are used specifically for their effect upon this system of the body.
(1) Decrease gastrointestinal motility. Narcotics decrease the peristaltic (wavelike) movements of the gastrointestinal tract. Consequently, they may cause constipation. This effect of narcotics is the basis of their being used to treat diarrhea. When used to treat diarrhea, the agents are referred to as antidiarrheals.
(2) Stimulate the chemoreceptor trigger zone. The chemoreceptor trigger zone (CTZ) is located at the base of the brain. When stimulated, the CTZ produces nausea and vomiting. Like many other categories of drugs, narcotics can stimulate the chemoreceptor trigger zone and cause nausea and vomiting.
e. Respiratory System Effect. Narcotics cause respiratory system depression because they reduce the sensitivity of the medullary centers to carbon dioxide in the blood. This depression of the respiratory system usually occurs at higher narcotic doses.
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