Opioid Definition

Question 1

What does the term opioid refer to

Answer 1

Opiates

Derived compounds

Natural and synthetic analogs

Question 2

Endogenous opioids

Answer 2

Endorphins

Dynorphins

Enkephalins

Question 3

Opiates example

Answer 3

Morphine

Codeine

Question 4

Semisynthetic opioids example

Answer 4

Buprenorphine

Heroin

Oxycodone

Question 5

Fully synthetic opioids example

Answer 5

Fentanyl

Methadone

Question 6

What does endogenous mean

Answer 6

Natural opioids

Question 7

Three receptors of opioids

Answer 7

Mu

Kappa

Delta

Question 8

Which receptor are we mostly worried about

Answer 8

Mu

Question 9

Location of Mu receptors

Answer 9

Brain regions : pain , respiration , and reward system

Spinal cord

GI system

Peripheral regions

Question 10

Prefrontal cortex Mu receptors function

Answer 10

Executive functioning

Question 11

Thalamus mu receptors binding

Answer 11

Pain receptor - analgesia

Question 12

Part of the Brain that is associated with euphoria (mu receptors activation)

Answer 12

NAc and VTA

Question 13

What happens when mu receptors are activated in CNS

Answer 13

Analgesia effect

Sedation

Euphoria

Pupil constriction (small)

Decrease : RR and HR

Nausea

Question 14

Body response to mu receptor activation in gut

Answer 14

Decrease mobility - constipation

Question 15

Positive reinforcement with Opioids

Answer 15

Opioids cause dopamine to release in the brainstem.

Our bodies like them

Seek out more opioids to get that reward feeling again

Question 16

Negative reinforcement from Opioid usage

Answer 16

Decrease utilization of the amygdala blunts are ability to fear, become anxious or stress.

Question 17

Opioid usage on PFC

Answer 17

When Opioids bind to the mu receptors of PFC, our ability to have executive function decreases.

We make bad decisions.

Question 18

What causes vulnerability to SUDs

Answer 18

50/50

Part: Genetics

Part: Environment

Question 19

Full agonist

Answer 19

Completely binds to the receptor and activates it. Mimicks the NTs

Question 20

Full antagonist

Answer 20

Completely blocks receptors to not activate them (Reuptake Inhibitors)

Question 21

How does Naloxone bind to mu receptors

Answer 21

It acts as a full antagonist blocking the receptor

Question 22

How does Buprenorphine bind to mu receptors.

Answer 22

It is a partial agonist. It slightly activates the receptors but does not bind to all of them

Question 23

What is an example of a full agonist for Mu receptors

Answer 23

Methadone, Fentanyl, Morphine

Question 24

How does Buprenorphine work

Answer 24

It allows for some activation of Mu receptors, however, it can block of other portion of receptors as well. It is a maintenance drug.

Question 25

What type of class is Buprenorphine in

Answer 25

III It is allowed office base (DATA 2000)

Question 26

How does precipitated withdrawal occur

Answer 26

A partial agonist (Buprenorphine as high affinity for receptors) knocks off full agonist from receptor causing a dip in activation. "The partial agonist always win, do NOT decrease or d/c." It is important to discuss timing. Risk of too much agonist on receptors before the addition of a partial agonists.

Question 27

How does Naltrexone work:

Answer 27

Naltrexone blocks agonist for attaching to those mu receptors. Antagonist is out front like a goalie blocking the drug or NT to get into goal. Use baseball analogy: Agonist - fully in glove tight partial agonist - in glove but not as tight Antagonist: - Goalie, not in glove

Question 28

Tolerance

Answer 28

Needing more to produce the same effect

Question 29

Sx that develop from rapid tolerance

Answer 29

Euphoria Analgesia Nausea Decreased respiration

Question 30

Sx that develop from little to no tolerance

Answer 30

Constipation Pin point eyes

Question 31

How to lose tolerance

Answer 31

To go without that substance for a long time. Often achieved in detox or with naltrexone usage.

Question 32

What does Opioid intoxication look like

Answer 32

Everything drops: Low RR and HR Hypotension Hypothermia Sedation Slowed movement Slurred speech Pinpoint eyes Lower pain and stress

Question 33

What does Opioid Overdose look like

Answer 33

Loss of consciousness Pinpoint eyes Decreased RR No breathing

Question 34

Treatment for Opioid Overdose

Answer 34

Narcan

Question 35

Withdrawal

Answer 35

Abrupt stop of Opioids

Question 36

s/s of withdrawal

Answer 36

Everything goes faster: Elevated HR High blood pressure Increased temp Sweating Runny Nose GI issues (Cramps, diarrhea, nasuea) Pupil dilation Muscle spasms

Question 37

Onset of withdrawal for short acting Opioids

Answer 37

6 - 12 Hours

Question 38

Symptom peaks for short acting opioids

Answer 38

36 - 72

Question 39

How long is withdrawal for short acting opiods

Answer 39

roughly 5 days

Question 40

example of short acting opioids

Answer 40

Oxy, heroine

Question 41

Example of long acting opiods

Answer 41

Methadone

Question 42

Onset of withdrawal for long acting opioids

Answer 42

36 - 48

Question 43

Symptom peak for long acting opioids

Answer 43

72 hours

Question 44

Duration of withdrawal for long acting opioids

Answer 44

up to 3 weeks