L 28 Opioids

Question 1

What are the Endogenous Opioids?

Answer 1

Endorphins
Enkephalins

Dynorphins
Endomorphins

Question 2

Endomorphins receptor?

Answer 2

Mu

Question 3

Dynorphins receptor?

Answer 3

Kappa

Question 4

Enkephalins receptor?

Answer 4

Delta

Question 5

Heroine is converted to?

Answer 5

Morphine

Question 6

Difference between Heroin and Morphine?

Answer 6

Heroin= 2-4x more potent

crosses BBB faster

Question 7

What drug is available as a suppository?

Answer 7

Hydromorphone

Question 8

Hydromorphone potency? duration?

Answer 8

Hydro=
8-10x more potent
shorter duration

Question 9

What drug is the same as hydromorphone?

Answer 9

Oxymorphone

Question 10

Codeine potency? efficacy?

Answer 10

Codeine=
1/10 the potency of morphine
lower efficacy

Question 11

What is Codeine converted to?

Answer 11

morphine

-> by CYP450 2D6

Question 12

Oxycodone potency?

Answer 12

10x potency of Codeine

Question 13

What mixtures contain Codeine?

Answer 13

Acetaminophen

NSAID

Question 14

What are the Synthetic Compounds?

Answer 14

Meperidine

Fentanyl

Methadone

Question 15

Meperidine potency? Duration?

Answer 15

1/8th potency of morphine

short

Question 16

Meperidine SE?

Answer 16

toxic metabolite builds up

= seizures

Question 17

Advantages of Meperidine?

Answer 17

dec SM spasms than Morphine

no miosis

Question 18

Fentanyl potency? Onset? Duration?

Answer 18

80-100x potency of morphine

fast onset

short duration

Question 19

How is Fentanyl administered?

Answer 19

I.v. for anesthesia

Question 20

Methadone potency?

Answer 20

I.v. potency similar to morphine

oral= 4x more potency

Question 21

Methadone Tx?

Answer 21

narcotic dependence

Question 22

Methadone duration?

Answer 22

inc w/ repeated use

Question 23

What are the Opioid Antagonists?

Answer 23

Naloxone
Naltrexone

Methylnaltrexone
Naloxagol

Question 24

What are signs of OD?

Answer 24

stupor, coma

RR low

pinpoint pupils

low body temp

placid SM, jaw relaxed

Question 25

Naloxone efficacy?

Answer 25

not effective orally

Question 26

Naltrexone efficacy?

Answer 26

effective orally or injected

Question 27

Methylnaltrexone Tx?

Answer 27

opioid induced constipation

Question 28

Methylnaltrexone quaternary?

Answer 28

doesn't cross BBB

Question 29

Naloxegol Tx?

Answer 29

opioid induced constipation

Question 30

What are the Mixed Agonist-Antagonist drugs?

Answer 30

Butorphanol Nalbuphine

Question 31

Butorphanol MOA? Available as?

Answer 31

Kappa agonist Mu antagonist nasal spray

Question 32

Butorphanol potency?

Answer 32

5x more potent in women

Question 33

Nalbuphine MOA?

Answer 33

Kappa agonist | Mu antagonist

Question 34

Nalbuphine advantages?

Answer 34

little dysphoria compared to nalorphine less abuse potential than morphine

Question 35

Tramadol MOA?

Answer 35

Mu & Delta agonist (-) reuptake of NE, SE a2 adreno agonist

Question 36

Tapentadol MOA?

Answer 36

Mu & Delta agonist (-) NE reuptake

Question 37

What drugs have actions that are synergistic for analgesia? and are antidepressant?

Answer 37

Tramadol Tapentadol