Opioids Flashcards Preview

Toxicology > Opioids > Flashcards

Flashcards in Opioids Deck (13):
1

What is the opiod toxidrome?

· Miosis, respiratory depression, CNS depression

2

How does clonidine work for opiate withdrawal

Clonidine binds to alpha 2 adrenergic receptos which stimulates K+ efflux the same way that opioids do

3

How are opioids metabolized?

- Hepatically (has implications for liver failure – prolonged half life)

4

How are opioids eliminated?

renally

5

What opioids are associated with seizures?

- Meperidine (its metabolitem: normeperidine)
Propoxyphene

6

What are the half-lives of heroin and methadone? How does this affect the onset of withdrawal symptoms after cessation?

Heroin: T1/2= 30 min WD after 4-6 hrs

Methadone: T1/2 15-40hr

7

What route of opioid abuse is associated with spongiform leukoencephalopathy?

“Chasing the dragon” – Inhalation of heated heroin

8

List symptoms of spongiform leukoencephalopthy

- Psychomotor retardation
- Dysarthria
- Ataxia
- Tremor
- Other neurologic abnormalities

9

What opioids can precipitate the serotonin syndrome?

Meperidine

10

What opioid does not cause meiosis

meperidine (demerol)

11

What mechanisms contribute to nausea and vomiting caused by opioids?

- Delayed gastric emptying
- Direct stimulation of chemoreceptor trigger zone
Vestibular stimulation

12

What is the differential for opiate intoxication?

- Clonidine
- Tramadol
- VPA
- GHB
- Sedative hypnotics
- Brainstem or pontine infarct

13

What is the IV dose of naloxone?
What is the dose of an infusion

- Start at 0.04mg and titrate to respirations, fentanyl long acting oxycontin may require doses up to 10mg

2/3 the initial effective dose/hr

need to monitor for 2+ hrs after naloxone b/c of its short half life (30-80 min avg 60 min)