Chapter 6 Flashcards
(28 cards)
Dried juice from the unripe seed capsules of the opium poppy
Opium
Mechanism of action of opium
Enkephalins
Endorphins
Dynorphins
Important recepters for opium include:
Mu
Kappa
Delta
Pharmacokinetics of opioids
ADME
- absorption
- distribution
- metabolism
- excretion
Pharmacologic effects of opioid
Analgesia Sedation and euphoria Cough suppression GI effects Adverse reactions
Sedation and euphoria of opioid
k-recepter stimulation
Potentiate analgesic effect; relieve anxiety
Additive with other CNS depressants
Remove pain; euphoria results
Cough suppresion of opiods
Depressive cough center in medulla
Antitussive effect requires lower dose
GI effects of opiods
Increases the smooth muscles tone
Decreases GI’s propulsive contractions and motility
Adverse effect respiratory depression from opiods
Cause of death with overdose
Elderly - decrease in pulmonary ventilation
Reduced ventilation produces vasodialation
Vasodilation results in intracranial pressure
Mask CNS diagnostic symptons
Hyperthyroidism
Hypothyroidism
Adverse reactions: Nausea and Emesis
Constipation
Miosis
Urinary retention & antiduretic effect
CNS effects
What are the CNS effects when associated to the adverse reaction of nausea and emesis
Anxiety
Restlessness
Nervousness
Dysphoria
Adverse reactons: Cardiovascular effects
Biliary tract constriction
Histamine release
Pregnancy and nursing considerations
What are the pregnancy and nursing considerations
FDA pregnancy category C - morphine, codeine
Infant born to addict
Depressed respiration
Withdrawal symptons
Allergic reactions to opiods
Dermatologic
- Skin rashes
- Urticaria
- Contact dermatitis
Formulated with sodium bisulfate
Some brands of opiod analgesic combinations - be aware of sulfite hypersensitivity
Drug interactions with opiods
Sedation
Respiratory depression
Interact with monoamine oxidase (MAO) inhibitors
Interact with antipsychotic agents such as chlorpromazine
What are the two signs of addiction
Craving
Loss of ability to stop using and loss of ability to control amount
Chronic administration
Tolerance occurs except to miosis and constipation
Habituation
Dependence
Adverse reactions: Addiction
Degree of addiction potential is proportional to analgesic strength
Dependent on the drug’s ability to produce euphoria and reduce anxiety
Length of administration
Development of tolerence
Treatment for opiod addiction
Substituting oral opiod for infectable form
Cold turkey - abrupt withdrawal
Methadone maintence
Adminstering naltrexone (Trexan)
Morphine
Prototype opiod
Parenterally - postoperative pain in hospitalized puts
Orally - treatment of terminal illnesses
Sustained-released tablets - outpatient use in terminally ill
Oxycodone + aspirin =
Percodan
Oxycodone + acteminophen =
Percocet, Tylox
Hydrocodone
Hydrocodone > hydromorphone
Hydrocodone + ibuprofen
Hydrocodon + actemeninophen
Hydrocodone ER
