Exam 4: Opioid Analgesics-Part 2 Flashcards Preview

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Flashcards in Exam 4: Opioid Analgesics-Part 2 Deck (106)
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1

Desired Clinical Effects of Opioid Drugs...KNOW THIS, OWN IT: Potent _______....Sedation and ________.....______ suppression

analgesic...euphoria....cough

2

Desired Clinical Effects of Opioid Drugs...KNOW THIS, OWN IT: GI effects- _______ smooth muscle tone, _____ propulsion and motility, used for treatment of _______.

increases....decreases....diarrhea

3

Adverse Reactions: Physical _______

addiction

4

Adverse Reactions: _______ depression (____ related)...dcreases brainstem sensitivity to _____.

respiratory...dose....CO2

5

Adverse Reactions: Opioids directly stimulate the chemoreceptor trigger zone the in medulla to produce ______ and _______. BUT don't worry, regular, repeated dosing prevents this by depressing its center (floor of fourth ventricle).

nausea and vomiting

6

Adverse Reactions: this reason is why opiods are given to stop diarrhea (off label)...

MAD constipation yo

7

Adverse Reactions: pinpoint pupils (scientifically named ______)... this is a diagnostic for addiction.

Miosis

8

Adverse Reactions: When on opioids, the production of _____ is stimulated and there for you retain urine, this can be an issue if the pt has _______ problems already.

ADH....prostate

9

Adverse Reactions: Opioids can occasionally stimulate _____ effects: anxiety, restlessness, nervousness, dysphoria

CNS

10

Adverse Reactions of Opioid Drugs-Cardiovascular: _______ the vasomotor center and stimulates the vagus nerve so at high doses you can get _____tension, _______cardia, and syncope.

depress....HYPOtensino....tom Bradycardia

11

Adverse Reactions of Opioid Drugs-Biliary tract _______
– Biliary colic (watch in patients with gallstones)

constriction

12

Adverse Reactions of Opioid Drugs: ________ release! causing itching and urticaria...

histamine

13

Adverse Reactions of Opioid Drugs-Pregnancy and lactation....______ labor; depress fetal _______ if given near term.....Infants born to addicts have marked depressed respiration and experience withdrawal....Cross into _______.....morphine and codeine=FDA Pregnancy category “___”

prolong....respiration....breast milk..."C"

14

Adverse Reactions of Opioid Drugs--Severity of side effects is proportional to ______.

efficacy... HA I bet you thought it would be potency

15

Adverse Reactions of Opioid Drugs--Overdose: Major symptom: ________ depression, Pinpoint pupils, Coma, Treated with antagonist = ________

respiratory...naloxone

16

Adverse Reactions of Opioid Drugs-Withdrawl: Occurs after abrupt discontinuance of drug....Yawning, lacrimation, perspiration, rhinorrhea, gooseflesh and piloerection (“_______”), irritability, nausea, vomiting, tachycardia, tremors, chills

"cold turkey"

17

Hypersensitivity Reactions to Opioids--Most are ________ – Skin rashes, urticaria...Differentiate from symptoms caused by histamine release (itching)..If true allergy, avoid.....Some preparations contain _________ (allergy to sulfites)

dermatologic...sodium bisulfite

18

Clinical indications- Dentistry: ________ & ________, in medicine-those two AND _______, _______.

Analgesia, sedation....cough suppression and diarrhea

19

Opium = dried juice obtained from unripe seed capsules of poppy plant (Paparer somniferous)...25% of the dried juice consists of the ______: morphine, codeine

alkaloids

20

Heroin is a ________ morphine product.

synthesized

21

Please name the 8 PURE agonists

1.morphine 2. oxycodone(percocet) 3.hydrocodone(vicodin) 4.codeine 5.dihydrocodeine 6.propoxyphene (withdrawn) 7.meperidine 8.fentanyl (most potent)

22

What is the mixed agonist/antagonist that is Equally as potent as morphine?

METH-a-done

23

What schedule is Methadone?

II (mixed agonist/antagonist for detox/chronic pain)

24

Methadone inhibits _______ pain pathways.

ascending

25

Methadone produces generalized _____ depression.

CNS

26

Mathadone has SUPERIOR ______ efficacy.

oral

27

Methadone has a ____ duration of action.

long (6 to 12 hours)

28

Methadone was initially used as a maintenance regimen for ______ abuse = FDA approved detoxication and maintenance programs & ______ therapy.

heroine..chronic pain

29

When you hear pure antagonist, think of the _______!!!! (reversing some of the negative effects of opioids.

Antidote

30

KEEP a drug of this type in the dental offices that administer sedation to reverse effects...its effects occur in ___ to ___ MINUTES and last for ___-___ hours...What are 2 examples of this?

A pure antagonist..1 to 2 minutes....1 to 4 hours....nal-ox-one & nal-trex-one