Opioids & Analgesics Flashcards Preview

Pharm - Clinical Neuro > Opioids & Analgesics > Flashcards

Flashcards in Opioids & Analgesics Deck (14)
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1

pain transmission: ascending pathway

- spinal and peripheral distribution
- primary afferent nociceptors
- dorsal horn cells

2

pain transmission: descending pathway (inhibitory regulation)

- originates in frontal cortex, amygdala and cingulate cortex
- synapses on PAG then RVA (rostral ventromedial medulla) and then on the dorsal horn cells
- major NTs = 5HT, norepi, glycine, GABA, opioids

3

function of mu receptors

- supraspinal and spinal analgesia
- sedation and inhibition of respiration
- slow GI transit
- modulation of hormones and NT release

4

function of delta receptors

- supraspinal and spinal analgesia
- modulation of hormones and NT release

5

function of kappa receptors

- supraspinal and spinal analgesia
- slow GI transit
- psychomimetic effects

6

all opioid receptors are ... (2 things)

- G-protein coupled receptors
- inhibitory

7

codeine

- naturally occurring
- used for mild to moderate pain
- gets metabolized to morpheine in liver
- oxycodone and hyocodone = mild analogs

8

morphine

- gets metabolized in liver to M3G OR M6G
- hydomorphone = more potent derivative

9

methadone

- long half life; used for chronic pain in terminally ill CA pts
- also used for detox
- high risk of respiratory depression and QT prolongation

10

meperidine

- similar effect as morphine but less potent
- metabolites may cause seizures
- causes mydriasis = pupil dilation = different from all other opioids which cause pinpoint pupils

11

fentanyl

- 100x more potent than morphine
- transdermal patch for slow delivery

12

opioid receptor antagonists

- naloxone = high affinity for mu v. kappa
- naltrexone = can be given orally; no preference for mu or kappa; used for alcohol w/drawal, tx of opioid dependence

13

opioid dependence

- psychological: mediated by ventral striatum; interactions b/w opioids and dopaminergic system (nucleus accumbens)
- physical: diaphoresis, insomnia, restlessness, abd cramps, N/V/D

14

opioid tolerance

- mediated in part by NMDA signaling
- mainly cosmetic; rotation therapy can be helpful