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Pharm 3 > Opiates > Flashcards

Opiates Flashcards

(53 cards)

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1
Q

Define acute pain

A

short term with easily identifiable cause- warning of damage or disease by body, has physio purpose

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2
Q

Define chronic pain

A

persists longer than should, constant or intermittent but outlives purpose

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3
Q

Name 5 types of pain

A

Acute, chronic, neuropathic, visceral, somatic

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4
Q

Nociception

A

ability to perceive pain

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5
Q

Analgesia

A

loss of sensitivity to pain without loss of consciousness

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6
Q

Hyperalgesia

A

Increased response to painful stimuli when tissue already damaged

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7
Q

Allodynia

A

Pain caused by stim that wouldnt normally cause

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8
Q

Physio changes in pain (5)

A

CV (increased symp), HPA stress response, hyperglycemia (increased glycogenolysis), ileus (reduced GI), reduced immune function (wound healing)

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9
Q

What drugs are antitussive

A

Codeine and butorphanol

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10
Q

What drug is an emetic

A

hydromorphone

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11
Q

Three types of analgesics

A

Block transduction, block trasmission in sensory nerves, block/change transmission in spinal pathways (perception)

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12
Q

Which analgesic drugs block transduction

A

NSAIDs

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13
Q

Which analgesic drugs block transmission

A

Locals

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14
Q

Which analgesic drugs block spinal transmission/alter perception

A

Opioids, A2Agonsits, NMDAs, NSAIDs, locals

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15
Q

A2Agonists, NMDAs and opioids all work on ____ sites of action

A

CNS and spinal

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16
Q

Cannabinoids work at what site of action

A

CNS

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17
Q

NSAIDS work at what sites of action

A

Spinal cord and peripheral

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18
Q

What are the three receptors

A

delta, kappa, mu (OP1,2,3)

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19
Q

What is the ceiling effect

A

Dose at which no effects can be produced anymore

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20
Q

Receptors, which do dogs have many of? which do horses have many of?

A

Dogs- mu, horses- K

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21
Q

What systems are effected by the pharmacological actions of opioids

A

CNS (analgesia, mood, sedation, RR, nausea/vomiting), GI- constipation; CV- bradycardia, hypotension

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22
Q

Describe the effect of opioid analgesia at teh spinal cord

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A

Hyperpolarization of neural cells via increased K activity

23
Q

What are the two levels of action of CNS analgesia

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A

Spinal cord- modulation of substance P and supraspinal decreased affective pain response (fear/anxiety)

24
Q

Which receptor provides the most analgesia

25
Which species experience myosis
dogs, primates
26
Which species experience mydriasis
small ruminants, cows, horses
27
How is ventilation depressed in opioid analgesia
Depressed PCO2 sensitivity in brainstem
28
How can ventilatory depression be reversed
Naloxone
29
What can reverse CV effects of opioids
Anti-cholinergic agents (to increase HR and BP)
30
What receptors does morphine act on
Mu- full agonist
31
Describe solubility and BBB of morphine
Low lipid solubility, low BBB
32
Morphine- metabolism
Glucuronic conjugation into M6G and M3G
33
Why is morphine less effective in cats
Less glucuronidation
34
What is the potency 1 prototype for all opioid receptor classes
Morphine
35
Side effects- morphine
Vomiting
36
Butorphanol- type
Agonist-antagonist (K, mu)
37
What drug can preserve analgesia and still reverse mu agonists
Butorphanol (k-ag, mu-antag)
38
What drug is best for patients with cardiac or respiratory issues
Butorphanol - less CV and respiratory depression
39
What drug is best in horses and ruminants
Butorphanol
40
What type of drug is buprenorphine
Partial mu agonist
41
Level of analgesia- morphine
moderate to high
42
Level of analgesia- butorphanol
mild
43
Level of analgesia- buprenorphine
mild to moderate
44
Advantages of buprenorphine
High bioavailability
45
What type of drug is naloxone
Full antagonist
46
Fentanyl - type
Opioid agonist
47
Fentanyl- potency
100x more than morphine (dosing 100x less)
48
Better CV drug - morphine or fentanyl - why
Fentanyl bc less histamine release
49
Meperidine- type
mu agonist
50
What drug is best in geriatric and young patients
Meperidine
51
What drug is the only opioid to cause increased HR
Meperidine ( like atropine)
52
Describe neuroleptanalgesia
Combination of analgesic with sedative (ex. alpha-2 agonist with phenothiazines)
53
Which drug has a short half life compared to others
Naloxone

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