lower dependency potential than opioids and withdrawal symptoms are not as
severe. Commonly used narcotic agonist-antagonists are Pentazocine (Talwin),
Butorphanol tartrate (Stadol), duprenorphine (Buprenex), and nalbuphine
hydrochloride (Nubain). Their pharmacokinetics, adverse, and side effects are
similar to morphine.
See Narcotic Agonist-Antagonists listed in the Appendix.Detailed tables show
doses, recommendations, expectations, side effects, contraindications, and more;
available on the book’s Web site (see URL in Appendix).
NARCOTIC ANTAGONISTS
Narcotic antagonists (see chart) are antidotes for overdoses of narcotic analgesics.
They have a higher affinity to the opiate receptor site than the narcotic analgesic
and block the narcotic analgesic from binding to the opiate receptor site. They
also reverse the respiratory and CNS depression caused by the narcotics.
Naloxone (Narcan) is a narcotic antagonist and can be used to determine if an
unconscious patient has used an opioid narcotic drug. If the patient wakes up
after Narcan is administered intravenously, the patient is likely to have ingested
or injected an opioid narcotic.
Summary
Pain is sensed when a nerve ending is stimulated sending an impulse along the
neural pathway to the brain that interprets the impulse as pain. Pain is assessed
in a patient by asking the patient to describe the intensity of the pain on a pain
scale—the higher the value, the more severe the pain. Besides intensity, pain is
assessed according to onset, duration, frequency, what started the pain (precipi-
tating cause), and what relieves the pain.
There are six classifications of pain: acute pain, chronic pain, visceral pain,
somatic pain, neuropathic pain, and psychogenic pain. Pain can be treated non-
pharmacologically or pharmacologically.
Nonpharmacological pain treatment includes massage, imagery, music, dis-
traction, humor, acupuncture, chiropractic interventions, hypnosis, herbal thera-
pies, therapeutic touch, and transcutaneous electronerve stimulation. Surgical
interventions are also sometimes performed to relieve pain.
CHAPTER 16 Narcotic Agonists^311