#Analgesics

[paxlovid]

oxycodone/acetaminophen, 10-325mg tablet

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[forensicfield]

General Drug Categories

General Drug Categories Analgesics Antacids Antianxiety Drugs Antiarrhythmics Antibacterials Antibiotics Anticoagulants and Thrombolytics Anticonvulsants Antidepressants Antidiarrheals Antiemetics Antifungals Antihistamines Read More... #forensicfield

(more…)

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#analgesics #Forensic Medicine #General Drug Categories #what are antacids #what are antianxiety drugs #what are antibacterials #what are antibiotics #what are barbiturates

[pharmazondirect]

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[zerinta]

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[divyankverma]

Global Chromatographic Silica Resins Market 2023-2032: AMR 

#hypnotics #narcotics #analgesics #nearby sedatives #and steroids.

[cherryzhang]

#chemistry #analgesics

[0firstlast1]

"In the supermarket the least expensive industrialized product after the plastic bag is apparently the beer can, in the pharmacy apparently there are no more less expensive industrialized products, not a pack with some painkillers, not a small bag with throat lozenges, maybe a package with two disposable razors is cost-effective, especially when the beard is rarely shaved.

In the photo the leftover of a disposable packaging 'immortalized' before going to recycling."

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[paxlovid]

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[randomappeal]

Analgesics & Sedatives: COX Inhibitors

COX stands for cyclooxygenase. This is an enzyme that's responsible for all kinds of stuff. There are 2 receptors that we'll deal with specifically - COX-1 and COX-2. They perform the following tasks:

GI (COX-1)

Increases mucus secretion

Increases bicarbonate

Increases mucosal blood flow

Kidney (COX-1 and COX-2)

Dilates the afferent arteriolar to increased GFR

Increases Na+ and water secretion

Cardiovascular (this one depends on the receptor)

COX-1 will cause vasoconstriction, while COX-2 will cause vasodilation

COX-1 will cause platelet aggregation, while COX-2 will inhibit platelet aggregation

COX-1 inhibition generally leads to cardiovascular benefits, while COX-2 inhibition leads to anti-inflammatory effects. However, adverse effects of this inhibition include:

GI (COX-1 Inhibition)

Peptic ulcers

GI bleeding

You've gotten rid of the extra mucus secretions, so you can have more GI bleeding now

Kidney (COX-1 and COX-2 Inhibition)

Na+ and water retention

Hypertension

Hemodynamic AKI

You're not excreting as much water and you're selfishly storing up the sodium, so you'll have too much fluid in your veins while your kidneys are saying "what gives, homie!"

Cardiovascular (COX-1 and COX-2 Inhibition)

Stroke

MI

Think clots and all the problems they cause when they escape

So now we get into the drugs. There are four this time:

Ibuprofen (Advil/Caldolor) - COX-1 and COX-2 Inhibitor

Ketorolac (Toradol) - COX-1 and COX-2 Inhibitor

Celecoxib (Celebrex) - COX-2 Inhibitor only

Acetaminophen (Tylenol, Ofirmev) - CNS COX inhibitor

Uses

Ibuprofen and Ketorolac both help with pain, inflammation and fever

Ketorolac provides pain relief similar to morphine without the respiratory depression, so it's a great alternative for folks unable to use opioids (oh happy place, here we come)

Celecoxib helps with pain and inflammation, but not fever

Acetaminophen helps with pain and fever, but not inflammation

For inflammation, think about things like RA, OA, bursitis, or tendonitis

Side Effects

These side effects are primarily for Ibuprofen and Ketorolac because they block both COX receptors, so you'll see effects in the GI, kidneys and cardiovascular system:

GI effects (N/V/D, abdominal pain)

Bleeding

Renal impairment

Increased risk for thrombotic events

Hypersensitivity - SJS (rare side effect)

Celecoxib only blocks COX-2, so you won't see issues in the GI, only the kidney and CV:

Increased risk of MI, CVA or other CV-related issues

Renal impairment

Sulfa-cross allergy (oddball, but specific to Celecoxib)

Finally, Acetaminophen has a small, but unique subset of issues:

Hypersensitivity - SJS (rare - shares this with their big brother, Ibuprofen)

Increased BP with daily use

Hepatotoxicity with excessive doses and Alcohol (more than 3 in a day)

This has a dosage limit - 2000 mg/day max for liver issues, but a healthy liver can handle up to 4000 mg/day

Nursing Considerations/Interventions

So what to do about these babies? Well couple of things:

Ibuprofen: Take it with milk, food or antacids to reduce the risk of GI effects, like bleeding

Ketorolac: You can only use this for 5 days max!

Acetaminophen: Acetaminophen and alcohol do not mix (think AA)

Acetaminophen: Assess, asses...the liver - check for pain in RUQ

All drugs

Monitor renal function - you don't want to mess up your kidneys

None of these will provide protection against MIs or CVAs, so monitor any CV issues accordingly

What if you O/D?

Acetaminophen is often used in suicide attempts, but never fear! It has an antidote called Acetylcysteine. Give this ASAP to prevent severe liver damage. You can give orally or IV, but if you give oral then dilute in water, juice or coke first.

That's all! Next up will be RA drugs.

#pharmacology #nursing school #analgesics #cox inhibitors #nclexrn prep

[prosekaren12]

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[disease]

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[rolli-zolli]

HAPPY PRIDE MONTH!!

#Anodyne 2 #Analgesic Productions #Elegy Beatty #Nano Cleaner Nova #my art #I realized once I was already almost done that I drew Elegy like a 'how to draw manga' drawing #but it's kinda cute and I didn't feel like redoing all that work so :p #this is my most high effort drawing to date this took like 15 hours #Anodyne 2 Return to Dust #Lesbian #wlw #pride month

[miloscat]

[Review] Even the Ocean (PS4)

A unique and soulful puzzle-platformer.

Anodyne 1 and 2 are really special games, so it's past time for me to catch up on the rest of the Analgesic catalogue from Melos Han-Tani and Marina Kittaka. This is their second game together, and takes on the puzzle-platformer genre but with a heavy emphasis on story.

Compared to the Anodyne games, the themes are a little more straightforward and the world more grounded than their abstract dreamlike spaces. The story deals with environmental and social issues, but with strong characters who feel very human and real through their dialogue. The story opens with the death of a minor character, but rather than exploiting it for dramatic stakes and moving on, the entire rest of the game sees you forming a friendship with her grieving partner, discussing deep topics with her and so on. As the game goes on and the stakes are further raised, it still takes the time for smaller moments and well-drawn minor characters.

This emotional content and social commentary is the strongest part of the game, not to say that the gameplay parts aren't also good. But the puzzle platforming can feel isolated or distinct from these aspects. The mechanics of it do tie into the worldbuilding which is linked to the themes though. In this sci-fi fantasy world, the main governing principle is the two energy types: light/green/vertical, and dark/purple/horizontal. Everything is built around this central idea.

Our protagonist Aliph has to balance the two energy types while blocking with a directional shield. She has a personal energy bar and when interacting with objects and obstacles this shifts between the two extremes. Charge yourself with dark and you walk faster, with light and you jump higher. But rather than a traditional health system, if you fill up completely on one or the other you die. Basically all interactable elements are aligned with either energy, and this leads to all sorts of clever puzzles along with the balancing act of managing your own tendency.

Progression through the puzzle spaces is mostly linear and I didn't find it very challenging for most of the runtime. There is a lot of customisation though, and you can choose if you want to just play the action parts or the story parts, as well as gameplay modifications to make it more manageable if you're having trouble. This makes the game very accessible, although oddly there is no option for button reassignment.

As I've come to expect with Analgesic games, there is also an extensive postgame although Even the Ocean takes it to extremes I haven't yet seen in their catalogue. You get new options to zoom around, warp, and display minimaps but most of all you get an entire new game world consisting of rough drafts and earlier versions of levels filled with developer commentary. This really opens the door on the development of the game and is really interesting from an archival perspective, having this behind the scenes content in playable form within the game itself. You get to see assets from when all the environment pixel art was made by hand (the final game uses art from larger images outside of the "dungeon" areas), as well as much more complex and difficult level design ideas.

These in-depth offerings are such a fascinating look at what the game could have been that I couldn't help but wish that some of it had made it to the final product, that we had more polished forms of these more challenging puzzles. On the other hand, the choices made to simplify the art production process I thought resulted in a fantastic end product, the interesting character designs coming through well in pixel form against the beautiful and moody backdrops.

Either way, these extras are remarkable, a candid conversation with the player on how the game was shaped and when you are directly told the rationales it's hard to argue that Melos and Marina made the right decisions to make the game memorable and accessible, and the game as a whole is much stronger and more interesting for having them. Please spend some time exploring the postgame if you give this a go! Anyway, although I have quibbles with the slow difficulty curve and the sometimes awkward menus, Even the Ocean ended up being another unique offering from Analgesic, packed full of ideas and heart.

#even the ocean #analgesic productions #indie #review #ps4

[calcium-supplement]

I’ve missed you and you’re art 😫❤️

thank you, i sure am art!!! 😎 alsp have you played either of the Anodyne games by analgesic productions? those are really fuckin good (theyre labeled 1 and 2 but they arent literal sequels), anodyne 1 is more rpgmaker vibes, anodyne 2 is like, ps2 era funkiness, god theyre so good, check them out

#cal asks #anodyne #analgesic productions

[archduchessofnowhere]

Actually historically accurate! Ludovika suffered from severe migraines that left her in bed for days

#forever annoyed at the dismissive way some authors talk about ludovika's migraines #without analgesics the pain must have been unbearable #sisi live blog #sisi (2021)

[randomappeal]

Analgesics & Sedatives: Opioids

Background: I'm in nursing school and I'm taking my last pharmacology exam. I need to pass this class, so to study I am creating these posts to help focus my efforts.

There are 3 categories of opioids - agonists, mixed and antagonists.

The agonists make up the following (roughly in order of potency, although we could have a debate over whether fetanyl should come before morphine). They all act on the Mu receptor:

Morphine

Fentanyl

Codeine

Methadone

Tramadol

Uses

Pain management

Side Effects

What do they have in common? For the most part, they cause varying degrees of:

Respiratory depression

Increased ICP

Orthostatic hypotension

Sedation

Constipation

Emesis

Dependence

What are some unique side effects to keep in mind?

Morphine

Alone in treatment for MI (think MONA - morphine, oxygen, nitroglycerin, and aspirin)

Fentanyl

Better to give this around-the-clock rather than as a pain abortive

This one treats cough as well

Codeine

This one makes you VERY sleepy

This one treats cough too

Poor feeding in infants from nursing mothers on the drug

Codeine has to be converted into morphine before it can have the same kind of effects. It won't work on people who lack the CYP2D6 enzyme that does this conversion.

Methadone

This is used to help treat opioid addiction

It's gonna cause prolonged QT interval which can lead to fatal dysrhythmias, especially Torsades de pointes with higher doses

Tramadol (Ultram)

In general, this one will have a lower risk to most side effects, including respiratory depression and dependence because it is a weak mu agonist (but the risk is still there)

Serotonin syndrome is the adverse effect biggie (if administered with other serotonin enhancers). - Look for altered mental status, neuromuscular abnormalities and autonomic hyperactivity (Volpi-Abadie et al., 2013) - Careful with SSRI, SNRI, Tricyclics, MAOIs, and triptans

Nursing Considerations/Interventions

Assess, assess, the CNS (be VERY careful with CNS depressants and anticholinergics)

Establish ECG baseline for methadone & monitor heart rhythm

Monitor for abuse/dependence

Assess the GI for normal function (anyone who's taken fentanyl knows what it's liked to be stopped up good with this drug)

Mixed Opioids

Suboxone (Buprenorphine & Naloxone) is a combination drug made up of an agonist and antagonist. Buprenorphine is a partial Mu agonist and a Kappa antagonist, while Naloxone is a Mu/Kappa antagonist. Why give both together? It discourages abusers from shooting it up for a quick high because naloxone isn't readily absorbed sublingually, but it's very effective parenterally.

Unlike the above drugs, this one acts on both Mu and Kappa receptors. What's the difference? Only Mu causes those adverse baddies - respiratory depression, euphoria and physical dependence. Why not use Mu? Good question and not one I have time to check, but if I were a betting gal I'd say Kappa isn't as good at the pain relief as Mu.

Side Effects of Suboxone

Just like methadone, it's gonna cause prolonged QT interval which can lead to fatal dysrhythmias

It'll spasm out on your Sphincter of Oddi - this is the port that connects your bile duct and your pancreas to the small intestine

Nursing Considerations/Interventions for Suboxone

Asses, assess the....ECG

Assess pancreas and liver - look for RUQ and epigastric region pain (pancreas goes across the top, liver is in the right-hand corner)

What if you OD?

Naloxone to the rescue. This is a Mu and Kappa antagonist. It's gonna knock off the drugs hanging out in opioid receptors and block anyone else from joining the party.

Nursing Considerations/Interventions for Naloxone

It has a short half-life, so you may need multiple doses to bring the patient back to normal

If the overdose isn't caused by opioid then Naloxone ain't gonna do squat to help them - good test to check if their symptoms are due to opioids (adults only)

Babies are different - you can use this in babies with respiratory depression

Patient is probably gonna feel pain pretty quick because you just knocked out all the happy players

And that's all, folks. Next up, COX inhibitors. You may preemptively laugh if you wish.

References

Volpi-Abadie, J., Kaye, A. M., & Kaye, A. D. (2013). Serotonin syndrome. The Ochsner journal, 13(4), 533–540. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3865832/

#pharmacology #analgesics #nursing school #nclexrn prep