21 Opioids III Flashcards Preview

2 Pharm Unit > 21 Opioids III > Flashcards

Flashcards in 21 Opioids III Deck (27):
1

What are the routes of administration available for hydromorphone?

IV, PO

2

Why does hydromorphone have a faster onset than morphine?

it is more lipid soluble

3

Is hydromorphone or morphine more potent?

hydromorphone is 5x more potent

4

what is vicodin?

hydrocodone + acetaminophen

5

what is hydrocodone metabolized to? What enzyme catalyzes this conversion?

hydromorphone, CYP2D6

6

what is percocet?

oxycodone + acetaminophen

7

what is oxycodone metabolized to? What enzyme catalyzes this conversion?

oxymorphone, CYP2D6

8

Why are opioids sometimes administered in combination with acetaminophen (eg vicodin, percocet)

Formulations of opioids with acetaminophen provide
additional pain relief while avoiding severe opioid side
effects.

9

What is the name of the prodrug that is converted to morphine by CYP2D6?

codeine

10

What prodrug is converted to monoacetyl morphine and morphine in the brain?

heroin

11

what opioid is used for maintenance of opioid drug addiction?

methadone

12

what is the half life of methadone?

Very long; 15 - 60 hours

13

is meperidine slower or faster onset than morphine?

faster, because it is more lipid soluble

14

is meperidine more or less potent than morphine?

1/10 as potent

15

in what type of patient does nor-meperidine have a prolonged half life?

patients with renal failure, due to decreased elimination

16

What are the signs and symptoms of serotonin syndrome?

1. Neuromuscular hyperactivity; tremor, clonus, myoclonus,
hyper-reflexia and (in the advanced stage) pyramidal
rigidity.
2. Autonomic hyperactivity; diaphoresis, fever, tachycardia
and tachypnea.
3. Altered mental status; agitation, excitement and (in the
advanced stage) confusion.

17

which opioid can cause serotonin sydrome, particularly when combined with SSRIs and MAOIs?

meperidine

18

Which two drugs are partial mu agonists?

tramadol and tapentadol

19

what metabolizes tramadol?

CYP2D6 (produces active metabolite) and CYP3A4

20

what metabolizes tapentadol?

CYP2C9, CYP2C19, and a little by CYP2D6

21

what do pentazocrine, butorphanol, and nalbuphine have in common?

they all act at opioid k receptors but also mu partial agonist/antagonist

22

what receptors does buprenorphine act on?

partial mu receptor agonist and kappa agonist

23

What is buprenorphine used for?

treating drug abuse and addiction

24

What percentage of the us population are rapid metabolizers of CYP2D6?

4-5%

25

which opioid agonists are used as antidiarrheals?

diphenoxylate and loperamide

26

which opioid antagonists are used to antagonize the GI side effects of opiates?

alvimopan and methylnaltrexone

27

What is a REMS?

Risk Evaluation and Mitigation strategy, strategy used to manage known or potential serious risks associated with a drug product; required by the RDA to ensure that the benefits of a drug outweigh the risks