Opiods Flashcards
1
Q
What are Endorphins? (3)
A
- naturally occurring substances in the body
- acts on the OPIOID receptors
- 3 groups: Enkephalins, Dynorphins, Endorphins
2
Q
Where are opioid receptors found and what are the different types? (2)
A
- found in the ON NEURONES in the PNS and CNS
- Mu receptors: highest affinity for ENDORPHINS
- Delta Receptors: enkephalins
- Kappa receptors: dynorphins
3
Q
What occurs with the stimulation of the opioid receptors?
A
- Pre-synaptic Neurones: Closure of Ca2+ channels (so stops NT release)
- Post-synaptic neurones: opens K+ channels causing HYPERPOLARIZATION making it harder for neurotransmission
- results in REDUCED release of NTs (Glutamate, ACh, Serotonin, NE, Subs.P
4
Q
Name a drug of ABUSE. (no medical use).
A
Heroine aka Diamorphine
5
Q
What are other complications that may occur due to IV heroine use?
A
- the use of dirty needles predisposes one to:
>Hep. B and C
> HIV
> Bacterimia (>tricuspid endorcarditis)
6
Q
Why do people take OPIOIDS? (3)
A
- axn on Mu receptors
- PAIN RELIEF
- EUPHORIA
- SEDATION
7
Q
What are PNS effects of Opioids?
A
- warmth, flushing
- constipation
8
Q
What are the CNS effects of Opioids?
A
- In OD: > Respiratory Depression
- cough suppression
- miosis (pin-point pupils )
9
Q
What are clinical uses of opioids? (5)
A
- pain control
- diarrhoea (Loperamide)
- Acute pulmonary Edema (IV morphine helps calms the nerves)
- Cough suppression (Codeine)
- shivering from infection (give Meperidine)
10
Q
What is tolerance? (3)
A
- LESS effect of drugs over time
- HIGHER dosages of the drug is required to bring out the same affect
- —except MIOSIS and constipation persists despite tolerance
11
Q
How does acute intoxication present as?
A
- mood ranging from EUPHORIA to DEPRESSED mental status
- decr. BOWEL sounds
- decr. Respiratory rate
- miotic pupils
- —seizures (esp. with TRAMADOL and MEPERIDINE)
12
Q
How to treat acute intoxication?
A
- administer NALOXONE
- short-acting opioid antagonists
- high naloxone dose may cause WITHDRAWAL
13
Q
When and how does opioid withdrawal present as?
A
- in opioid dependant pts; withdrawal symptoms set in 6-12 hrs after last dose
- RESTLESSNESS (opp. of CNS depress.)
- yawning
- Rhinorrhea and lacrimation
- piloerection
- N.V.D
- abdominal cramps
14
Q
What drugs could be taken daily to prevent relapse?
A
- BUPRENORPHIN —a sublingual tablet
(a partial agonist at OPIOID receptors; therefore partially activates OPIOID receptors) - because it has antagonist effects; it can cause withdrawal symptoms
15
Q
What precaution is taken with the buprenorphin tablets to prevents its abuse?
A
- Buprenorphine tablet is combined with Naloxone
- naloxone is not absorbed sublingually
- if pt attempts to crush the tablet and inject it Intravenously —-NALOXONE kicks in to prevent a “high”
