12c - Opioid Analgesics Flashcards
(32 cards)
Types of Pains
What are 3 types of pain?
- Somatic Pain
- Visceral Pain
- Neuropathic Pain
What is somatic pain?
- A localized pain “I feel it here”
- Mostly comes from superficial areas of body (skin or muscle)
What is visceral pain?
- A pain described in a vague or general term “I feel it deep inside”
- Originates from internal organs
What is neuropathic pain? How is it described as?
Pain related to diseases or damage to the nervous system.
- Burning or shooting pain
- Chronic + Severe + Debilitating + Resistant to common alalgesics
What are 2 natural analgesics?
- Endorphins
- Enkephalins
What are the 3 types of opioid receptors?
- Mu (Most focused on)
- Delta
- Kappa
What is the primary CNS effect for opioid analgesics?
Analgesia (pain relief)
- Pain relief quick and efficient when given IV
Pain relief is main reason they are given
What are other CNS effects of opioid analgesics?
- Nausea + Vomiting🤮
- Miosis (constricted pupils)
- Euphoria + Dysphoria
- Anxiolysis/Sedation(Calming)
- Physical dependence and tolerance
- Significant Constipation
What are 3 systems where opioids have complex interactions?
- Respiratory
- GI
- Cardiovascular
What is the respiratory effect pf opioids?
Causes significant resp depression
- Most likely cause of death in ODs
ODs = overdoses
Slow breathing pattern is a side effect as mentioned before. What do you see though exactly?
- Slow, slightly deeper pattern initially
- 6-8 breaths/min (800-1000mL)
- Completely stopping respiration if depression continues
- Dull the cough reflex
Where are opioid receptors found?
In the lungs.
Can morphine be nebulized?
YES IT CAN :)
What is the cardiovascular effect of opioids?
Potential to ↓BP
- Dose dependent + Vary in severity
Why does BP↓?
Due to histamine release caused by some opioids.
- Leads to vasodilation
Why can vasodilation be beneficial?
Less vascular resistance –> Less work for the heart –> Less O2 demand –> Less ischemia.
Less cardiac stress also caused by removing pain
What are 3 types of opioid analgesics?
- Morphine
- Dilaudid (Hydromorphone)
- Sublimaze (Fentanyl)
Drug: Morphine
What is Morphine?
A naturally occuring opioid that causes histamine release.
Drug: Morphine
What’s important to remember about morphine?
All other opioids are compared to morphne, so morphine is given a relative potency of 1
Drug: Diluadid (Hydromorphone)
What is it? Where is it often prescribed?
A semi-synthetic and more potent version of morphine (10x more strong vs morphine)
- Prescribed in ICU settings
Drug: Sublimaze (Fentanyl)
What is it?
A full synthetic version of morphine that is 100x stronger vs morphine.
Sublimaze (Fentanyl)
How is this drug different vs morphine?
- Slightly faster onset time
- Shorter duration
- Less CVS side effects
VERY USEFUL DRUG FOR SHORT PROCEDURES
What are 2 fentanyl deravitives that are used in the OR mainly?
R+S
- Remifentanil (200x stronger vs morphine)
- Sufentanil (1000x stronger vs morphine)
What is a fentanyl derivative that’s used as a large animal tranquilizer?
Carfentanil (10,000x stronger vs morphine)
