Opioid Analgesics II Flashcards Preview

Pharmacology - Test #4 > Opioid Analgesics II > Flashcards

Flashcards in Opioid Analgesics II Deck (20):
1

Fentanyl onset time

7-15 minutes

2

Hydromorphone Dosing Interval

4-6 hours

3

Why to change your opioid?

Ineffective even at correct levels
Tolerance
Side effects
$$$

4

Review calculations using the table on slide #36

He says he will put one on the test

5

Drugs used to help patients with opioid induced constipation (and how they help).

Senna (Triggers fluid secretion and colonic contraction)
Polyethylene glycol (Stool Softener)
Dioctyl sodium sulfosuccinate (Stool softener)
Peripherally restricted mu antagonists

6

Name three peripherally restricted mu opioid antagonists

Methylnaltrexone
Alvimopan
Naloxegol

7

Why do opioids trigger pruritis

Heteromer w/ Gastrin releaseing peptide recetpor activates the release of Histamine from Mast cells.
Coadminister an anti-histamine

8

Which opioid side effects are associated with patients with little/no tolerance

Constipation
Itch
Miosis

9

Explain the difference between tolerence and hyperalgesia

Tolerance -- increased dose to produce equivalent effect
Hyperalgesia -- changes in opoid efficacy lead to incresed in pain intensity to a stimulus

10

How does opioid tolerance happen molecularly?

Activation of MORs by morphine causes a persisitant inhibition of Adenylyl CYclase, causing the cell to upregular AC. This increases cAMP and causes cellular tolerance to opoid effects

11

How does tolerance lead to hyperalgesia

When opioids are removed, a cell now produced more cAMP than it efer would normally. Elevated AC also promotes expression of more receptors for pain transmission.

12

Signs of opioid induced hyperalgesia

Pain not releived by opioid
Diffuse pain
Cold pressor test

13

What to do for opioid induced hyperalgesia patients

Switch between phenanthrenes and non-phenanthrenes
Use an NMDA antagonist (Methadone)
opioid detox -- switch to clonidine/diazepam

14

Important opioid drug-drug interactions

Depressants (all lower resp. rate)
Antipsychotics
TCAs
Antihistamines
Meperidine (inhibit MAOs, SSRIs --> Serotinin Syndrome)

15

Symptoms of acute overdose of morphine/heroin

Coma
Depressed Respiration
Pinpoint Pupils
Needle Marks
Mixed Poisonings common w/ barbiturates and ethanol

16

Treatment for opioid overdose?

Supportive -- Maintain Resp. and CV fxn
Naloxone (Narcan)

17

When in a withdrawl process will buprenorphine help?

More than 24 hours in
Less than 24 hours, it will trigger the withdrawl symptoms

18

opioids used to treat opioid abuse

Methadone
Buprenorphine
Suboxone, Zubsolv

19

Buprenorphine is mixed with _____ to prevent it from being IV administered. What does _____ do?

Naloxone
Its an opioid antagonist

20

opioids that help treat alcohol abuse disorder

Naltrexone and Nalmefene (used off label in US)