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CRNA - drugs > Opioids > Flashcards

Opioids Flashcards

1
Q

Phenantherane Alkaloids drugs

A

Morphine, Codeine (Natural) Hydromorphone, Tramadol (Semisynthetic):
Derived from opium poppy

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2
Q

Phenylpiperidines derrivtives (synthetic)

A

Meperidine, fent, sufent, alefent, remi

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3
Q

Diphenylheptane

A

Methadone

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4
Q

Most likely to cause histamine release?

A

Morphine, codeine, meperidine

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5
Q

Cross-class allergy?

A

Cross-sensitivity exists within classes, however, no cross-sensitivity between the 3 classes

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6
Q

Gold standard for potency comparison?

A

Morphine sulfate (=1) - purely serve as guideline because each patient response can vary drastically

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7
Q

Highest concentration of opioid receptors in the body?

A

Likely in the GI nervous system compared to CNS

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8
Q

High dose opioids?

A

Only provide analgesia, additional drugs needed to provide anesthesia/amnesia/unconsciousness/relaxation

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9
Q

Meperidine (Demerol)

A

Potency: 0.1
Duration: 2-4 hr
Analgesic Dose: 100 mg

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10
Q

Fentanyl

A

Potency: 100
Duration: 1-1.5 hr
Analgesic Dose: 100 mcg

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11
Q

Sufentanil

A

Potency: 500-1,000
Duration: 48-78 min
Analgesic Dose: 10-20 mcg

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12
Q

Alfentanil

A

Potency: 10-20
Duration: 15-25 min
Analgesic Dose: 500-1,000 mcg

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13
Q

Remifentanil

A

Potency: 100 (same as fentanyl)
Duration: 2-5 min
Analgesic Dose: infusion

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14
Q

Hydromorphone

A

Potency: 5
Duration: 2-4 hrs
Analgesic Dose: 2 mg

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15
Q

Morphine Sulfate

A

Potency: 1
Duration: 3-5 hrs
Analgesic Dose: 10 mg

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16
Q

Chronic effects of opioids

A

Tolerance, physical dependence, constipation

17
Q

Never develop a tolerance to (2)?

A

Miosis, constipation

18
Q

Effect on breathing?

A

Shift the CO2 response curve to the right, decreased respiratory response to elevated CO2 levels

19
Q

Stronger the opioid?

A

Higher the likelihood of physical dependence

20
Q

Mu receptor effects

A

Analgesia (supraspinal and spinal), euphoria, sedation, skeletal muscle rigidity, biliary spasm

21
Q

Kappa receptor effects

A

Analgesia (supraspinal and spinal), dysphoria, sedation, antishivering

22
Q

Opioid MOA specifics

A

Binds to G-protein coupled receptor - cAMP activation, depression of voltage gated Ca channels, activated inward rectifier K channels (K efflux)

23
Q

Opioid MOA general

A

Activate opiate receptors on pre-synaptic (1st order) sensory neurons resulting in a decreased amount of substance P (excitatory NT) to be released into synaptic cleft - blocks transmission of pain signal

24
Q

Endogenous opioid peptides

A

Enkephalins, endorphins, dynorphins

25
Q

SuRF in the AM Man - potency

A

Sufentanil, Remifentanil/Fentanyl, Alfentanil, Morphine, Meperidine

CRNA - drugs (8 decks)

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