Pharm Pain, Martin II Flashcards Preview

Year 2 neuro exam 2 > Pharm Pain, Martin II > Flashcards

Flashcards in Pharm Pain, Martin II Deck (28):
1

codeine affects what R

mu at low dose
at high dose starts to work on kappa

2

hydrocodone works on what R

mu

3

oxycodone works on what R

mu

4

what are the most widely prescribed outpatient analgesics

tylenol with codeine
codeine/aspirin
hydrocodone/acetaminophen
oxycodone/acetaminophen
oxycodone/aspirin

5

what is a common mixed opioid agonist-antagonist

buprenorphine

6

what occurs when partial agonist given with full agonist

act as antagonist!!
important concept

7

buprenorphine action on mu R

partial agonist

8

major use beuprenorphine

opioid detoxification

9

what R activated by high dose codeine cause psychotomimetic effects

kappa

10

what occurs with the antagonist side of opioid agonist/antagonist drugs

precipitate withdrawal Sx in physically dependent individuals since block effects of full agonists

11

what are the opioid antagonist

naloxone(narcan)
short acting, injected

12

what is naloxone used for

treat opioid overdose

13

what occurs if give naloxone to patient dependent on opioids

precipitate withdrawal syndrome

14

reward pathway

reduce excitability and transmitter release
inhibits VTA on GABA interneurons and increase ventral pallidum outflow which correlates to positive reinforcing state

15

which way does dose response curve shift in tolerance

to the right

16

what occurs in tolerance

R down regulated and signal transduction pathways desensitized

17

what effects of opioids develop tolerance

analgesia
respiratory depression
euphoria
sedation

18

what effects of opioids do not develop tolerance

miosis
constipation

19

tolerance can be how high

35x fold

20

opioid withdrawal Sx

rhinorrhea
lacrimation
yawning
chills
piloerection
hyperventilation
hyperthermia
mydriasis
vomiting
diarrhea
anxiety

21

firs 8 hours withdrawal Sx

anxiety and drug craving

22

8-24 hours withdrawal Sx

anxiety
insomnia
GI disturbance
rhinorrhea
mydriasis
diaphoresis

23

up to 3 days Sx withdrawal

tachycardia
nausea vomiting
HTN
diarrhea
fever
chills
tremors
seizure
muscle spasm

24

Tx opioid withdrawal

monitor
if need-- clonidine a2 agonist

25

effects of clonidine during withdrawal of opioids

reduce cravings
reduce anxiety
reduce sympathetic outflow

26

primary signs of opioid overdose

lethargy or coma
depressed respiration
pinpoint pupils

27

secondary signs opioid overdose

hypotension
hypothermia with cold or clammy skin
PE
conbulsions
hypoxia with dilated pupils

28

when see dilated pupils but know opioid overdose
give what

naloxone