Drug Name Coumadin

Chemical stimuli also underlie pain secondary to inflammation or ischemia (angina pectoris, myocardial infarction), or the intense pain that occurs during overdistention or spasmodic contraction of smooth muscle abdominal organs, and that may be maintained by local anoxemia developing in the area of spasm (visceral pain).
Peripheral effects concern the motility and tonus of gastrointestinal smooth muscle; segmentation is enhanced, but propulsive peristalsis is inhibited. The tonus of sphincter muscles is raised markedly. In this fashion, morphine elicits the picture of spastic constipation. The antidiarrheic effect is used therapeutically (loperamide).

 

These effects are attributed to both inhibition of phosphodiesterase (> c AMP elevation) and antagonism at adenosine receptors. In bronchial asthma, theophylline can be given orally for prophylaxis or parenterally to control the attack. Manifestations of overdosage include tonic-clonic seizures and cardiac arrhythmias as early signs.
Fluoxetine, along with sertraline, fluvoxamine, and paroxetine, belongs to the more recently developed group of SSRI. The clinical efficacy of SSRI is considered comparable to that of established antidepressants. Added advantages include: absence of cardiotoxicity, fewer autonomic nervous side effects, and relative safety with overdosage.