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NMSP Exam 3 > Opioids Dr. Izard > Flashcards

Opioids Dr. Izard Flashcards

1
Q

highest class of pain killers are the what opioids

A

Phenylpiperidines

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2
Q

Opioid Agonists

A 
Morphine 
Hydromorphine 
Methadone
Meperidine 
Fentanyl 
Codeine
Oxycodone
Hydrocodone
= can go all the way up to coma and death
Propoxyphene
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3
Q

Mixed Agonist/Antagonist (Partial Agonist) opioids

A 
Pentazocine
Nalbuphine
Buprenorphine 
Butorphanol
= plataus up to a certain point
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4
Q

Opioid Antagonist

A

Naloxone
Naltrexone
= no effect

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5
Q

oral and IV opioid time to effect pt

A 
ORAL = 30min 
IV = 5-10min (can shut CNS down immediatly)
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6
Q

settings where to use opioid 9

A
  1. MI
  2. Sickle cell
  3. Post op precedures
  4. Trauma
  5. cancer
  6. kidney stones
  7. Back pain
  8. Anti-diarrhea (Loperamide)
  9. with anesthesia
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7
Q

acute effects of opioid

A

sedation, euphoria, slow NS, slow HR, X cough reflex, N/V, coma/death

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8
Q

opioid interact with what 3 drug classes

A
  1. MOA
  2. Sedative/hypnotics
  3. Anti-psychotic agents
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9
Q

u (mu) opioid receptor has affinity for

A

Endorphins > Enkephalins > Dynorphins

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10
Q

Delta receptor opioid (has affinity for what)

A

Enkephalines > Endorphins > dynorphins

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11
Q

Kappa opioid receptor has affinity for

A

Dynorphins > Endorphins > Enkephalins

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12
Q

Morphine uses what opioid receptor

A

mu, delta, kappa

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13
Q

Methadone uses what opioid receptor

A

mu

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14
Q

Buprenorphine uses what opioid receptor

A

mu, delta, kappa

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15
Q

Naloxone uses what opioid receptor

A

mu, delta

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16
Q

Morphine

  1. contraindications
  2. used for
A
  1. sulfur hypersensitivity, bronchial asthma or resp problems
  2. management of pain
17
Q

Fentanyl use when

A
  1. manage persistent mod to severe chronic pain (continuous adminitsration) last resort
    (100 x more potent then morphine)
18
Q

Methadone used when

A
  1. abstinence sx management + tx opioid disorder + heroin disorder
    (not dosed high enough for pharmacologic response)
19
Q

Hydrocodone used for and is similar to what drug + usually combined with what

A
  1. mod to mod severe pain + antitussive (relieve cough)
  2. codeine
  3. usually combined with acetaminophen (hepatic problems if OD)
20
Q

Pentazocine MOA, used for, NOT used for, contraindications

A
  1. partial agonist
  2. when no other pain med is enough severe pain needing opioid + preoperative + with anesthesia
  3. not for tx addiction
  4. not take with benzodiazepines or other depressants , preg (neonatal opioid WD syndrome)
21
Q

Meperidine MOA, used for, RISK for what, interacts with

A
  1. agonist
  2. opioid needed pain
  3. misuse by anesthesiologists since they have access to it
  4. partial agonists + antagonists
22
Q

Codeine used for, special for, risk, important to know with the use of this

A
  1. antitussive (cough)**, mild pain, Diarrhea
  2. least opioid activity drug of all
  3. addiction, OD
  4. gradually taper to stop medication
23
Q

Loperamide used for, what can be given if OD, special thing about this one

A
  1. Diarrhea, OTC
  2. Naloxone
  3. taken my morphine addicts when they cant find it
24
Q

Buprenorphine MOA, used for, interacts with

A
  1. partial agonist
  2. opioid and narcotic pain reliever addiction TX, pain
  3. CYP3A4 inhibitor or inducer **
25
Q

Naloxone MOA, used for, risks

A
  1. opioid antagonist
  2. opioid overdose (inhibits receptors and takes over them) to reverse effects
  3. releases catacholamines –> lead to acute WD or pain (need to monitor)
26
Q

Naltrexone MOA, used for, risks

A
  1. opioid antagonist (mu receptors) (so even if pt takes opioid they get no effect, receptors are blocked)
  2. alcohol and opioid addiction or overdose = rehab drug
  3. pt after this can be way more sensitive to opioid in future (can die from what they thought was normal dose), can give WD and pain symptoms **

NMSP Exam 3 (13 decks)

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