Opioids and Non-opioids

Question 1

5 cardinal signs of inflammation

Answer 1

dolor - pain

calor - heat

rubor - redness

tumor - swelling

functio laesa - loss of function

Question 2

what do opioids and non-opioids manage

Answer 2

manage pain but not inflammation

Question 3

define opioids vs opiates

Answer 3

opiate: natural from poppy

opioids: synthetic or lab made

Question 4

naturally occurring

Answer 4

morphine

codeine

thebaine

Question 5

semi-synthetic

Answer 5

hydrocodone

oxycodone

hydromorphone

buprenorphine

Question 6

synthetic

Answer 6

fentanyl

tramadol

nalbuphine

methadone

Question 7

discuss the opium poppy plant

Answer 7

illegal to have

MC in turkey

scarring of pods will release seeds that becomes alkaloids

Question 8

what are alkaloids

Answer 8

chemical substances that have active ingredients

morphine, codeine, thebane

Question 9

discuss morphine

Answer 9

gold standard opoid

new drugs are compared to this

longest existing and has proven efficacy

Question 10

discuss codeine

Answer 10

on cough syrups

antitussive: prevent cough

Question 11

discuss thebane

Answer 11

source of heroin - highly addictive and illegal

can reverse effect of opioids

Question 12

discuss characteristic of opioids

Answer 12

relieve mod to severe pain: 4-9

binds to receptors in CNS - inehrent

can cause physical dependence

targets brain, SC and peripheral nerves

Question 13

mechanism of action to the brain

Answer 13

binds to pain receptors and inhibits neurons for pain transmission

stims descending pathway - dorsal horn of SC

Question 14

mechanism of action to the SC

Answer 14

dec release of pain mediating substances

hyperpolarizes postsynaptic neuron: makes more negative hence di ma ddepolarize = no conduction of pain

Question 15

mechanism of action to the peripheral nerves

Answer 15

dec excitability of A delta and C fibers

Question 16

discuss Mu receptors

Answer 16

supraspinal areas: PAG, medial thalamus, hypothalamus, limbic

supraspinal analgesia
euphoria
respi depression

high abuse potential

Question 17

discuss Kappa receptors

Answer 17

dorsal horn of gray matter - SG
deep layers of cerebral cortex

spinal analgesia
sedation
pressed flexor reflexes

low abuse potential

Question 18

discuss Delta receptors

Answer 18

substantia nigra
globus pallidus
corpus striatum
other limbic structures

euphoria and sedation

low abuse potential

Question 19

discuss Sigma receptors

Answer 19

hippocampus and CV

dysphoria
hallucinations
CV stim - inc HR and BP

low abuse potential

Question 20

discuss analgesia as opioid effect

Answer 20

pain relief or absence

para makaka PT

Question 21

discuss sedation and drowsiness as opioid effect

Answer 21

mild sedated: full awake but s anxiety

mod sedated: may close eye or nap but awaken c stim and converses

heavy sedated: vigorous stim needed to awaken and converse

Question 22

discuss respi depression and apnea as opioid effect

Answer 22

should count RR in full min

Question 23

discuss OH and bradycardia as opioid effect

Answer 23

OH: dec BP in upon standing

bradycardia: < 60 bpm

Question 24

discuss constipation as opioid effect

Answer 24

dec in freq of passing stool

hard stool or dec peristaltic movements

kaya nag bibigay din laxatives pag naka opioids

Question 25

discuss nausea and vomiting as opioid effect

Answer 25

nausea: wanting to vomit vomiting: forceful expulsion of gastric contents antiemetic drugs: to control nausea and vomiting

Question 26

discuss miosis as opioid effect

Answer 26

pupillary constriction - eliminate pos opioid overdose

Question 27

discuss suppression of cough reflex as opioid effect

Answer 27

prod: give expectorant non-prod: give opioids to supress

Question 28

discuss histamine release as opioid effect

Answer 28

be careful mild: rashes. itchy, swelling of eyes severe: diff breating

Question 29

discuss euphoria as opioid effect

Answer 29

highness and extreme happiness to give better disposition in cancer pt can be abused

Question 30

discuss color coding on co-oxycodone and tramadol

Answer 30

color for diff doses easier to know esp sa geria

Question 31

discuss nalbuphine

Answer 31

injected - hospital and clinic

Question 32

discuss fentanyl

Answer 32

most recent - 100x more potent but higher side effects injectable or transdermal last 72 hrs - 75 mcg/hr

Question 33

what is tolerance

Answer 33

receptor down regulation - dec effect of drugs need to shift or inc dosage as safe range

Question 34

what is withdrawal

Answer 34

sx happens when you stop taking the drug

Question 35

abstinence syndromes

Answer 35

body aches diarrhea fever gooseflesh insomnia nausea/vomit runny nose shivering sneezing stomach cramps loss of appetite sweating tachycardia weakness fatigue uncontrollable yawning

Question 36

discuss comprehensive dangerous drugs act of 2002

Answer 36

basta bawal ang ket ano galing sa opium poppy

Question 37

discuss acetaminophen/paracetamol

Answer 37

classic non-opioids active metabolite of Phenacetate - good analgesic but bad to liver and kidney milder phenacetin sha

Question 38

effect of acetaminophen/paracetamol

Answer 38

analgesic - 1-6 pain antipyretic not anti-inflammatory - weak prostaglandin inhib - non-platelet inhib - inhib COX3

Question 39

peak blood concentration of acetaminophen/paracetamol

Answer 39

30-60 mins

Question 40

metabolism of acetaminophen/paracetamol

Answer 40

hepatic microsomal enzymes

Question 41

metabolites of acetaminophen/paracetamol

Answer 41

acetamine sulfate glucoronide N-Acetyl-P-Benzoquinone nephrotoxic or hepatotoxic

Question 42

half life of acetaminophen/paracetamol

Answer 42

2-3 hrs

Question 43

indications of acetaminophen/paracetamol

Answer 43

mild to mod pain fever allergy to aspirin

Question 44

adverse effects of acetaminophen/paracetamol

Answer 44

mild inc of hepatic enzymes central lobular necrosis dizziness excitement and disorientation acute renal tubular necrosis hemolytic anemia methemoglobinemia