Opioids Flashcards

(32 cards)

1
Q

Where do opioids come from

A

Poppies - papavar somniferum. After it dies the middle swells where opium is extracted

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2
Q

What drugs to opium turn into

A

Morphine, codeine, Thebaine,

Morphine - heroin or hydro morphine

thebaine - oxycodone, etorphine

They all belong to narcotic analgesics

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3
Q

Pharmacokinetics of opioids

A

Administered in all possible routes, absorption distribution depends on compound. Mainly metabolized in the liver

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4
Q

Half life of certain drugs (heroin, morphine, fentanyl, oxycodone, hydro morphine)

A

Heroin - 15-30 min
morphine - 2 hrs
Hydro morphine - 2.5hrs
Oxycodone - 3-5 hrs
Fentanyl - 3-7hrs

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5
Q

What are the 3 opioid receptors

A

Mu (u) - most important- high affinity for morphine, located in brain and spinal cord
Delta (S) - forebrain, regulate motor, cognitive, and olfaction
Kappa (K) - regulate pain, hunger, temp. Located in hypothalamus, amygdala, etc.

All are G proteins metabotropic receptors with several actions

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6
Q

Postynaptic inhibition of opioids

A

Open k+ channels, so they leave the cell (inhibitory) causes a change within the neuron

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7
Q

Axoaxonix inhibition

A

Closes Ca2+ channels, opioid neurons cause transmitters of calcium to close and block calcium receptors

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8
Q

Endorphins

A

Made in the pituitary, target mainly forebrain and spinal cord.

Functions: analgesia (#1), cardio and resp. Depression, vomiting, atitussive, etc.

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9
Q

Analgesia and opioids

A

Inhibits pain, both endocrine and neural responses are modulated on multiple levels

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10
Q

How do opioids reduce pain

A

Cause release of interneruons that inhibit activation of spinal cord neurons

Descending modulatory pathways - inhibit excitatory neurons, and block downstream signals resulting in no transmission (mainly PAG pathway)

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11
Q

What forms of pain control depend on opioids

A

Accupuncture, releases endogenous opioids

Gene therapy, gene for proenkephalin through a modified virus

Dual inhibition of peptidases, inhibits two enzymes that degrade enkephalin

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12
Q

Partial agonists

A

Produce weaker biological effects. Act as agonists for some receptors and antagonists for others - morphine

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13
Q

Neutral antagonists

A

Drugs that produce no pharmacological activity - from morphine such as nalaxone and nalorphine

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14
Q

What areas do opioids produce the most important effects

A

The CNS and gastrointestinal tract, can relief diarrhea and coughing

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15
Q

NOP-R

A

One of 4 opioid receptors, in the CNS and peripheral nervous system

With u-receptor is effective in reducing pain without narcotic side effects

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16
Q

Endorphins

A

Group of endogenous peptides that stimulate mu and delta receptors, reducing pain and enhancing general mood

17
Q

Proenkephalin

A

A large opioid pro peptide precursor. Broken down to form smaller active opioids called enkephalins in the brain

18
Q

Are opioid receptor mediated cellular changes inhibitory to excitatory

19
Q

Early pain vs. Second pain

A

First is immediate
Second is after - more emotional, opioids as analgesics mainly reduce secondary pain

20
Q

Where do opioids mainly inhibit pain

21
Q

Cross - dependence

A

Withdrawal sings occurring in a dependent individual can be terminated by administering drugs in the same class

22
Q

Brain areas in opioid abstinence syndrome

A

Several areas do, no particular one. Gastrointestinal tract and autonomic nervous system involved

23
Q

Structure involved in reinforcement of drugs

A

NAcc - a limbic structure, important for reinforcement value of many abused substances

24
Q

how is withdrawal in opioids explained

A

Himmelsbach hypothesized that the nervous system adapts to presence of a drug (tolerance) when the drug is taken away, the adapted function continues (withdrawal) -

Morphine inhibits cAMP, so when taken away larger amount of it are produced

25
Electroacupuncture
30 minutes of EA 12 hours after drug administration reduced signs of withdrawal, gets better the more you do it
25
Treatment for opioid use disorder
1st - detoxification 2nd - support and counseling (methadone maintenance program) 3rd. Buprenorphine maintenance 4. Narcotic antagonists - blocks effects of self administered opioids 5. Vaccines for addiction treatment
26
Neural adaptation observed following chronic opioid use
Increased firing rate of neurons in the locus coeruleus
27
Suboxone (burprenorphine and naloxone) and naloxones purpose in it
A combination of the two drugs. Naloxone within it is intended to interfere with attempts to abuse suboxone when take intravenously
28
Symptoms of opioid withdrawal include
Hyperalgesia, diarrhea, and flu-like symptoms
29
Cross-tolerance
When tolerance for one opioid drug, effectiveness for others also declines
30
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