Opioids and NSAIDs: Mechanisms, Actions, and Effects

Opioids: Neuroanatomic Basis of Pain

Pain stimulus, receptors, thermoreceptors, mechano, chemo, polymodal. Nerve fibers – A, C – SNC.

Analgesia

State of inhibition or suppression of pain without loss of sensory capacity; consciousness is unaltered.

Endogenous Opioid System

  • Peptides endogenous antigens: proopiomelacortina derived from the proenkephalin and the prodynorphin.
  • Widely distributed in the body.

Opioid Receptors

Mu (?), kappa (k), sigma (or), and delta (A) receptor subtypes exist. Present in CNS,

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Pediatric Kidney Conditions: Pyelonephritis, Cystitis, Nephrotic Syndrome, PSGN

Pyelonephritis: Diagnosis and Treatment

Diagnostic Criteria:

  1. Fever >38°C
  2. Pyuria (>5-10 WBC)
  3. Bacteriuria >105 CFU/ml
  4. Signs of bacterial infection in blood test (leukocytosis, CRP >20mg/l)
  5. Abdominal or flank tenderness
  6. Abnormalities in kidney ultrasound

Treatment:

  1. Gentamicin 7 days (not longer). After antibacterial sensitivity testing, other antibiotics should be continued for 10-14 days.
  2. Cefuroxime (second generation cephalosporin) 10-14 days.
  3. Amoxicillin alone is not recommended.
  4. If the fever has
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NSAIDs, Glucocorticoids, and Immunosuppressants: Side Effects and Patient Care

Side Effects of NSAIDs

Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause a range of side effects, particularly affecting the gastrointestinal and renal systems.

Gastrointestinal System

  • Dyspepsia
  • Nausea
  • Vomiting
  • Ulcers and potential hemorrhagic risk with chronic use

Renal System

  • Renal involvement/nephrotoxicity
  • Renal failure may occur after years of chronic abuse

Other

  • Bronchospasm
  • Rashes
  • Other allergic-type reactions

Drug Interactions: Anticoagulants and Flu Medications

Individuals taking anticoagulants

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