opioid agonists Flashcards Preview

MOHD IV > opioid agonists > Flashcards

Flashcards in opioid agonists Deck (13):
1

CYP2D6 drug interactions

cimetidine
paroxetine
fluoxetine
duloxetine
setraline
amiodarone
ritonavir

2

CYP3A4 metabolized opioids

oxycodone
tramadol
methadone
buprenorphine
fentanyl
alfentanil
sulfantanil

3

CYP3A4 interactions

macrolides
grapefruit juice
azoles
carbamazepine
St. John's wort
rifampin

4

glucuronidation

morphine
hydromorphone
oxymorphone
tapentadol

5

morphine

phenanthrene
naturally occurring
fast first pass metabolism ( renal excretion
-M-6-G->potent
-M-3-G- no analgesia-hallucinations
AE: myoclonas, pruritis

6

hydromorphone

phenanthrene
semisynthetic
glucuronidation-kidney excretion
AE myoclonus

7

codeine

phenanthrene
naturally occurring
cyp2d6 metabolism

8

Fentanyl

phenylpiperidine
synthetic
lipophilic-> good transdermal/mucosal (92%)
75% taken up in lungs
Cyp3A4
good choice with renal impairment

9

oxycodone

phenanythrene
semisynthetic
good oral available and bioavailability (87%)
CYP2D6 and CYP34A
low dose is good for renal impairment

10

methadone

diphenylheptane
synthetic
ATP binding cassette P-glycoprotein BBB restriction
CYP3A4
good choice for renal impairment

11

hydrocodone

phenanthrene
semisynthetic
CYP2D6
good for renal impairment

12

meperidine

phenylpiperidine
synthetic
avoid with renal impairment
-normeperidine metabolite causes seizures
AE myoclonus

13

cyp2D6 metabolized opioids

oxycodone
tramadol
hydrocodone
tapentadol
codeine