Opioids Flashcards

0
Q

Natural opioids; which one is more potent

A

Morphine and codeine; morphine 6-7x more potent

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1
Q

Compound used to treat mod to severe pain and has sedative effects

A

Narcotics

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2
Q

Where are synthetic opioids derived from

A

Morphine

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3
Q

What endogenous receptor is mainly responsible for central interpretation of pain?

A

Mu1

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4
Q

What are the two components of analgesia

A

Sensory or affective

Sensory: tells you location, intensity, type of pain
Affective: need a negative perception/feeling of that pain

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6
Q

what are the effects for analgesic drugs

A

Analgesia, euphoria, sedation, respiratory depression, miosis, cough suppression, emesis, constipation(for diarrhea), renal: urinary retention, decrease force of contraction in labor, cardiovascular: hypotension, bradycardia, histamine release: urticaria (hives), itching

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7
Q

In what situation Do we need to be aware of when giving opioids

A

If patient has head trauma bc opioid cause respiratory depression which cause reflexive cerebral vasodilation

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7
Q

What’s the 1st sign of overdosing opioid

A

Pin point pupils

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8
Q

Main therapeutic effects of opioids

A

Analgesia, anesthetic, cough suppressant, diarrhea, acute pulmonary edema

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10
Q

What drugs should not be mixed with opioid?

A

CNS depressants -respiratory depression

MES inducers -meperidine formation of normeperidine

MAOI: meperidine–>hyperrexia rxn/HTN

Mixed agonist/antagonist

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11
Q

Strong opioid agonists binds with primarily which receptor?

A

Mu receptor

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12
Q

what agent is used to treat opioid addiction

A

methadone

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13
Q

which opioid could be used transdermally?

A

Fentanyl

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14
Q

which drug is used for immediate acute opioid overdose?

A

Naloxone

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15
Q

Which drug is used as maintenance drug for opioid overdose?

A

Naltrexone

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16
Q

which drug is the primary pharmacological use for opioid addiction?

A

Methadone

17
Q

what is a good way to get someone off morphine?

A

switch morphine into methadone, and slowly taper it off

18
Q

what does Gi/Go coupling do?

A

inhibit adenylyl cyclase activity–>loss of intracellular Ca and decrease release of NT

increase post synaptic opening of K+ channels–>hyperpolarization which decrease firing

19
Q

Mu1 response

A

central interpretation of pain–supraspinal analgesi

20
Q

Mu2 responses

A

supraspinal and spinal anaglesia, physical dependence, eurpho, constipation, euphoria, respiratory depression

21
Q

kappa responses

A

NO respiratory depression and no dependence
only modest supraspinal and spinal anaglesia

inhibit dopamine release–> dysphoria

22
Q

Delta

A

used for modest supraspinla and spinal analgesia. modulate hormone and NT release, regulate mu recetpor activity
a little addictive

23
Q

what does morphine metabolize into?

A

morphine-6-glucuronide

24
Q

what metabolizes to morphine

A

heroin and codeine

25
Q

Ascending pathway way pain inhibition:

A

peripheral stimulus at site of injury–> presynaptic activation of opioid receptor to Mu receptors in dorsal horn–>decrease activation of Ca–> reduce incoming pain signaling

Post synaptic: opioids inhibit activation of afferent neurons via K+ conductance lead to hyperopolarization–>reduction in pain signaling pain up spinal cord to cortex

binding to GABA-A–> inhibition

26
Q

what is dextromethophan primarily used for

A

cough suppressant, antitussive

27
Q

diphenoxylate primary use

A

antidiarrheal agent

28
Q

loperamide

A

antidiarrheal agent

29
Q

Tramadol

A

mu agonist plus serotonin inhibitor

30
Q

which drug blocks Kappa receptors

A

Buprenorphine

31
Q

which drugs activate Kappa

A

pentazocine, nalbuphine butorphanol

32
Q

what does morphine regulate

A

relief of moderate to severe pain, suppression of severe diarrhea

33
Q

which opioid is used for surgical settings

A

hydromorphone

34
Q

what are the benefits of using codeine

A

does not have intense respiratory depression, less chance of addiction, abuse potential. Produce less euphoria but can produce significant sedation.

35
Q

what drug is used for breakthrough pain/post surgical pain

A

oxycodone

36
Q

what is only available combined with NSAIDs

A

hydrocodone