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