2. Opioid Analgesics Flashcards
(10 cards)
1
Q
Opioid Analgesics - Available Drugs
A
- Morphine
- Fentanyl
- Codeine
- Heroin
- Methadone
- Meperidine
- Dextromethorphan
- Diphenoxylate
2
Q
Opioid Analgesics - MOA
A
- Agonists of opioid receptors to modulate synaptic transmission
- mu = morphine
- delta = enkephalin
- kappa = dynorphin
- Open K channels, close Ca channels –> reduced synaptic transmission
- Inhibit release of ACh, NE, 5-HT, glutamate, substance P
[Morphine, Fentanyl, Codeine, Heroin, Methadone, Meperidine, Dextromethorphan, Diphenoxylate]
3
Q
Opioid Analgesics - Clinical Use
A
- Pain
- Acute pulmonary edema
- Cough suppression - Dextromethorphan
- Diarrhea - Loperamide, Diphenoxylate
- Maintenance programs for addicts - Methadone
[Morphine, Fentanyl, Codeine, Heroin, Methadone, Meperidine, Dextromethorphan, Diphenoxylate]
4
Q
Opioid Analgesics - Toxicities
A
- Addiciton
- RESPIRATORY DEPRESSION
- Constipation
- MIOSIS (PINPOINT PUPILS)
- ADDITIVE CNS DEPRESSION with other drugs
- No tolerance development in constipation or miosis
- May cause smooth muscle spasm in sphicter of Oddi –> biliary colic
- Treat overdose with Naloxone or Naltrexone (Opioid receptor antagonists)
[Morphine, Fentanyl, Codeine, Heroin, Methadone, Meperidine, Dextromethorphan, Diphenoxylate]
5
Q
Butorphanol - MOA
A
- Partial agonist at mu opioid receptor
- Agonist at kappa receptors
6
Q
Butorphanol - Clinical Use
A
- Pain - causes less respiratory depression than full agonists
7
Q
Butorphanol - Toxicities
A
- Withdrawal if already on a full opioid agonist
8
Q
Tramadol - MOA
A
- Very weak opioid agonist
- Also inhibits 5-HT and NE reuptake
Works on multiple neurotransmitters
- “Tram it all in”
9
Q
Tramadol - Clinical Use
A
- Chronic pain
10
Q
Tramadol - Toxicities
A
Similar to opioids
- Addiciton
- RESPIRATORY DEPRESSION
- Constipation
- MIOSIS (PINPOINT PUPILS)
- ADDITIVE CNS DEPRESSION with other drugs
Decreases seizure threshold
