Opioids

Question 0

Natural opioids; which one is more potent

Answer 0

Morphine and codeine; morphine 6-7x more potent

Question 1

Compound used to treat mod to severe pain and has sedative effects

Answer 1

Narcotics

Question 2

Where are synthetic opioids derived from

Answer 2

Morphine

Question 3

What endogenous receptor is mainly responsible for central interpretation of pain?

Answer 3

Mu1

Question 4

What are the two components of analgesia

Answer 4

Sensory or affective

Sensory: tells you location, intensity, type of pain
Affective: need a negative perception/feeling of that pain

Question 6

what are the effects for analgesic drugs

Answer 6

Analgesia, euphoria, sedation, respiratory depression, miosis, cough suppression, emesis, constipation(for diarrhea), renal: urinary retention, decrease force of contraction in labor, cardiovascular: hypotension, bradycardia, histamine release: urticaria (hives), itching

Question 7

In what situation Do we need to be aware of when giving opioids

Answer 7

If patient has head trauma bc opioid cause respiratory depression which cause reflexive cerebral vasodilation

Question 7

What’s the 1st sign of overdosing opioid

Answer 7

Pin point pupils

Question 8

Main therapeutic effects of opioids

Answer 8

Analgesia, anesthetic, cough suppressant, diarrhea, acute pulmonary edema

Question 10

What drugs should not be mixed with opioid?

Answer 10

CNS depressants -respiratory depression

MES inducers -meperidine formation of normeperidine

MAOI: meperidine–>hyperrexia rxn/HTN

Mixed agonist/antagonist

Question 11

Strong opioid agonists binds with primarily which receptor?

Answer 11

Mu receptor

Question 12

what agent is used to treat opioid addiction

Answer 12

methadone

Question 13

which opioid could be used transdermally?

Answer 13

Fentanyl

Question 14

which drug is used for immediate acute opioid overdose?

Answer 14

Naloxone

Question 15

Which drug is used as maintenance drug for opioid overdose?

Answer 15

Naltrexone

Question 16

which drug is the primary pharmacological use for opioid addiction?

Answer 16

Methadone

Question 17

what is a good way to get someone off morphine?

Answer 17

switch morphine into methadone, and slowly taper it off

Question 18

what does Gi/Go coupling do?

Answer 18

inhibit adenylyl cyclase activity–>loss of intracellular Ca and decrease release of NT

increase post synaptic opening of K+ channels–>hyperpolarization which decrease firing

Question 19

Mu1 response

Answer 19

central interpretation of pain–supraspinal analgesi

Question 20

Mu2 responses

Answer 20

supraspinal and spinal anaglesia, physical dependence, eurpho, constipation, euphoria, respiratory depression

Question 21

kappa responses

Answer 21

NO respiratory depression and no dependence
only modest supraspinal and spinal anaglesia

inhibit dopamine release–> dysphoria

Question 22

Delta

Answer 22

used for modest supraspinla and spinal analgesia. modulate hormone and NT release, regulate mu recetpor activity
a little addictive

Question 23

what does morphine metabolize into?

Answer 23

morphine-6-glucuronide

Question 24

what metabolizes to morphine

Answer 24

heroin and codeine

Question 25

Ascending pathway way pain inhibition:

Answer 25

peripheral stimulus at site of injury--> presynaptic activation of opioid receptor to Mu receptors in dorsal horn-->decrease activation of Ca--> reduce incoming pain signaling Post synaptic: opioids inhibit activation of afferent neurons via K+ conductance lead to hyperopolarization-->reduction in pain signaling pain up spinal cord to cortex binding to GABA-A--> inhibition

Question 26

what is dextromethophan primarily used for

Answer 26

cough suppressant, antitussive

Question 27

diphenoxylate primary use

Answer 27

antidiarrheal agent

Question 28

loperamide

Answer 28

antidiarrheal agent

Question 29

Tramadol

Answer 29

mu agonist plus serotonin inhibitor

Question 30

which drug blocks Kappa receptors

Answer 30

Buprenorphine

Question 31

which drugs activate Kappa

Answer 31

pentazocine, nalbuphine butorphanol

Question 32

what does morphine regulate

Answer 32

relief of moderate to severe pain, suppression of severe diarrhea

Question 33

which opioid is used for surgical settings

Answer 33

hydromorphone

Question 34

what are the benefits of using codeine

Answer 34

does not have intense respiratory depression, less chance of addiction, abuse potential. Produce less euphoria but can produce significant sedation.

Question 35

what drug is used for breakthrough pain/post surgical pain

Answer 35

oxycodone

Question 36

what is only available combined with NSAIDs

Answer 36

hydrocodone