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1. ANALGESICS
INDIAN DENTAL ACADEMY
Leader in continuing dental education
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4. Definition: IASP
 Latin word “POENA” meaning “PUNISHMENT”
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5. 
Nociception

Transduction

Transmission

Perception

Modulation
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7. Definition:
 Greek word ANA-without , ALGESIA-pain
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8. 
Opioid or Centrally acting or Narcotic

Nonopioid or Peripheral acting or non- narcotic
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9. 
Produce inhibition of neuronal activity

Inhibit release of neurotransmitters by closing voltage gated calcium
channels

Activate descending inhibitory systems

Inhibit post synaptic neurons by increasing potassium channel
conductance
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10. Mu
 Kappa
 Delta
 sigma
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11. Inhibit synthesis of prostaglandins
 Inhibition of free radical formation
 Inhibition of cytokine synthesis or cellular signaling
mechanisms mediating inflammation
 Inhibition of prostaglandins in hypothalamus, spinal
cord and inhibiting nitric oxide synthesis in
macrophages-PARACETAMOL
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12. OPIOIDS
 Respiratory depression
 Nausea and vomiting
 Hypotension
 Constipation
 Urinary retention
 Physical dependance
 tolerance
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13. NSAIDS
peptic ulcers, GI bleeding
Na & water retention, renal failure
Bleeding, agranulocytosis
Asthma, skin rashes, pruritis, angioedema
ASPIRIN: salicylism at doses of 3-6gms/day
Reyes syndrome
Acute salicylate poisoning
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14. 
Persistent pain requires prophylactic therapy

Use oral medication whenever possible

Doses should be determined on individual basis

Keep it simple

Insomnia must be treated vigorously

Admission is sometimes necessary to achieve pain control

Balance between degree of relief and unwanted side effects
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15. 
Efficacy and ceiling effect

Speed of onset and duration of action

Specific side effects and metabolism

Dysphoria

Toxic metabolites

Partial agonists and mixed agonists and antagonists
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16. 
Clinician should know minimal number of drugs

Analgesic and antipyretic uses

Anti-inflammatory use
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Consider substitution if there is no response with one drug

Avoid using multiple nsaids

Topical or systemic administration

Nsaids in pregnancy
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17. 
Severity of pain

Medical history

Known allergy
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18. OPIOIDS
 NSAIDS
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20. Anti depressants
 Anti convulsants
 Alpha 2 adrenergic agonists
 Anti epileptics
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22. Essentials of medical pharmacology 5th edition- KD Tripathi
 Post graduate medical journal(dec 1984)-Robert G Twycross
 Clinical implications of cox-2 inhibitors for acute dental pain
management-JADA 2005(136)
 The efficacy of combination analgesic therapy for relieving dental painJADA 2002(133)
 Drugs for pain management in dentistry- Australian dental journal
2005 (50)
 Newer NSAIDS-A review of their therapeutic potential and adverse
drug reactions Journal, Indian academy of clinical medicine 2002(3)
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23. Thank you
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Leader in continuing dental education
www.indiandentalacademy.com