Flashcards in Opioid Deck (26)
What are the 3 opioid receptors?
What protein is mu receptor coupled with and where do you find these receptors?
Pre and post synaptic
How does stimulating mu receptor decrease pain?
Stimulate presynaptic mu--->decrease Ca influx--->decrease substance P (pain transmitter)
Stimulate postsynaptic mu--->increase K efflux--->membrane hyperpolarization
What are the Gi coupled presynaptic and post synaptic receptors besisdes mu?
What is the analgesia effect?
Increase pain tolerance and decrease perception and reaction to pain
What is the mechanism of morphine and what are its effect? what drug is used for overdose?
Respiratory depression--->decrease response to increase CO2
Morphine cause vasodilation or vasoconstriction? and what should we be cautious about giving morphine to head trauma pt?
Vasodilation might cause increase intracranial pressure
What are the side effects of opioid?
Increase biliary pressure
Does opioid suppress or induce coughing/vomiting?
Suppress coughing (antitussive)
How is morphine metabolized and what is the effect of the metabolite?
Opioid is contraindicated in pul dysfunction but what pul condition can opioid be benefit?
Which opioid cause mydrasis/tachycardia?
Meperidine--->anti M as well
Metabolized into normeperidine and act as a SSRI
Which opioid is used as a cough suppressant? CYP450 inhibitor increase or decrease the effect of codeine?
Decrease--->codeine is a prodrug and is needed to be metabolized into morphine
What are the full and mixed agonist of mu receptor?
What receptors do these mixed agonist work on?
Mixed agonist--->stimulate kappa receptor/block mu receptor
What would happen if you take buprenophine/nalbuphine/pentazocine and a full mu agonist like heroine at the same time?
Cause heroine withdraw:
Heroine is a full mu agonist--->buprenophine/nalbuphine/pentazocine block mu--->cause heroine withdraw
Nalbuphine and pentazocine should not be given with?
A full mu agonist--->cause withdraw
What drug is used for opioid induced constipation?
Why is suboxone used for opiate addict?
Suboxone--->combo of buprenorphine + naloxone--->if taken IV---->get withdraw instead of a high
What are the withdraw signs of opioid?
What drugs are used to manage opioid withdrawal?
Methadone and clonidine (alpha 2 agonist to offside some of the sympathetic symptoms of opioid withdraw)
What is another drug besides codeine that can be used as antitussive?
What are the mechanisms of cocaine and amphetamine? what are their withdraw symptoms?
Cocaine--->block reuptake of DA/NE/5HT
Amphetamine--->increase release and block reuptake NE
What are the withdraw symptoms of benzo/barb/alcohol?
Stimulant like--->anxiety and agitation
What is the mechanism of weed?
Bind to CB1 and CB2 cannabinoid receptors