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Pharm U3 > 6) Narcotics > Flashcards

6) Narcotics Flashcards

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1
Q

What is the class for Morphine

A

Opioid

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2
Q

What is the mechanism for Morphine

A

Mu-opioid receptor agonist

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3
Q

What are the therapeutics for Morphine

A

Severe analgesia, mood alteration, antitussive, sedation

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4
Q

What are the important side effects for Morphine

A

Miosis, constipation, respiratory depression

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5
Q

What are the other side effects for Morphine

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

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6
Q

What are the miscellaneous for Morphine

A

2 major active metabolites: M6 (more potent/active), M3 (little affinity); intraspinal administration possible

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7
Q

What is the class for Codeine

A

Opioid

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8
Q

What is the mechanism for Codeine

A

Mu-opioid receptor agonist (low receptor affinity); demethylated to form morphine (10% of oral ingestion, via CYP2D6)

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9
Q

What are the therapeutics for Codeine

A

Moderate analgesia, antitussive (found in many cough medicines)

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10
Q

What are the important side effects for Codeine

A

Miosis, constipation, respiratory depression

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11
Q

What are the other side effects for Codeine

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

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12
Q

What are the miscellaneous for Codeine

A

10% of Caucasians unable to convert codeine to morphine (can still experience side effects, though)

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13
Q

What is the class for Tramadol (Ultram)

A

Opioid

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14
Q

What is the mechanism for Tramadol (Ultram)

A

Mu opioid receptor agonist (weak); some NE/5HT uptake inhibition (leading to analgesia); synthetic codeine analog

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15
Q

What are the therapeutics for Tramadol (Ultram)

A

Moderate (not severe) analgesia

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16
Q

What are the important side effects for Tramadol (Ultram)

A

Miosis, constipation, respiratory depression

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17
Q

What are the other side effects for Tramadol (Ultram)

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

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18
Q

What are the miscellaneous for Tramadol (Ultram)

A

1 metabolite: demethylated, more potent analgesic

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19
Q

What is the class for Fentanyl (Duragesic)

A

Opioid

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20
Q

What is the mechanism for Fentanyl (Duragesic)

A

Mu-opioid receptor agonist (strong); highly lipid-soluble

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21
Q

What are the therapeutics for Fentanyl (Duragesic)

A

Severe analgesia after identification of dose level via other opiod (e.g., morphine)

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22
Q

What are the important side effects for Fentanyl (Duragesic)

A

Miosis, constipation, respiratory depression

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23
Q

What are the other side effects for Fentanyl (Duragesic)

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

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24
Q

What are the miscellaneous for Fentanyl (Duragesic)

A

IV, transdermal; do not change dose more than 1/week (long half-life); intraspinal administration possible

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25
What is the class for Methadone (Methadose)
Opioid
26
What is the mechanism for Methadone (Methadose)
Mu-opioid receptor agonist
27
What are the therapeutics for Methadone (Methadose)
Chronic, severe pain; treatment of heroin and opiod addicts
28
What are the important side effects for Methadone (Methadose)
Miosis, constipation, respiratory depression
29
What are the other side effects for Methadone (Methadose)
Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
30
What are the miscellaneous for Methadone (Methadose)
90% bound to plasma protein, accumulates in tissues (thus, extended duration of action); do not change dose more than 1/week (long half-life)
31
What is the class for Oxycodone
Opioid
32
What is the mechanism for Oxycodone
Mu-opioid receptor agonist
33
What are the therapeutics for Oxycodone
Moderate to severe analgesia
34
What are the important side effects for Oxycodone
Miosis, constipation, respiratory depression
35
What are the other side effects for Oxycodone
Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
36
What are the miscellaneous for Oxycodone
Oxycontin is extended release
37
What is the class for Meperidine (Demerol)
Opioid
38
What is the mechanism for Meperidine (Demerol)
Mu-opioid receptor agonist
39
What are the therapeutics for Meperidine (Demerol)
Don't use this
40
What are the important side effects for Meperidine (Demerol)
Miosis, constipation, respiratory depression; mental status changes and seizures (normeperidine)
41
What are the other side effects for Meperidine (Demerol)
Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
42
What are the miscellaneous for Meperidine (Demerol)
1 metabolite: normeperidine
43
What is the class for Propoxyphene (Darvon)
Opioid
44
What is the mechanism for Propoxyphene (Darvon)
Mu-opioid receptor agonist (weak)
45
What are the therapeutics for Propoxyphene (Darvon)
Don't use this
46
What are the important side effects for Propoxyphene (Darvon)
Miosis, constipation, respiratory depression; CNS toxicity (norpropoxyphene)
47
What are the other side effects for Propoxyphene (Darvon)
Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
48
What are the miscellaneous for Propoxyphene (Darvon)
1 metabolite: norpropoxyphene (has long half-life)
49
What is the class for Loperamide (Imodium)
Opioid
50
What is the mechanism for Loperamide (Imodium)
Slows peristalsis via opioid receptors in intestine, and possibly decreased GI secretion
51
What are the therapeutics for Loperamide (Imodium)
Diarrhea
52
What are the important side effects for Loperamide (Imodium)
Miosis, constipation, respiratory depression
53
What are the other side effects for Loperamide (Imodium)
Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
54
What are the miscellaneous for Loperamide (Imodium)
Meperidine congener
55
What is the class for Diphenoxylate (Lomotil)
Opioid
56
What is the mechanism for Diphenoxylate (Lomotil)
Slows peristalsis via opioid receptors in intestine, and possibly decreased GI secretion
57
What are the therapeutics for Diphenoxylate (Lomotil)
Diarrhea
58
What are the important side effects for Diphenoxylate (Lomotil)
Miosis, constipation, respiratory depression
59
What are the other side effects for Diphenoxylate (Lomotil)
Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
60
What are the miscellaneous for Diphenoxylate (Lomotil)
Meperidine congener
61
What is the class for Naloxone (Narcan)
Opioid antagonist
62
What is the mechanism for Naloxone (Narcan)
Competitive mu-, delta-, and kappa-opioid receptor antagonist
63
What are the therapeutics for Naloxone (Narcan)
Acute opioid toxicity (depressed RR best predicts reponse)
64
What are the important side effects for Naloxone (Narcan)
Can precipitate withdrawal (flu-like symptoms of nausea, vomiting, diarrhea; piloerection, yawning, irritability)
65
What are the miscellaneous for Naloxone (Narcan)
Continuous parenteral infusion, as lasts only 15-30 minutes (oral almost completely metabolized by liver); patient has normal mental status
66
What is the class for Naltrexone (Revia)
Opioid antagonist
67
What is the mechanism for Naltrexone (Revia)
Mu-opioid receptor antagonist
68
What are the therapeutics for Naltrexone (Revia)
Alcoholism
69
What are the important side effects for Naltrexone (Revia)
May produce a prolonged withdrawal state (nausea, vomiting, piloerection, yawning)

Pharm U3 (13 decks)

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