Pharmacology: Analgesics Flashcards
(21 cards)
What do opioids act on?
- act on mu, delta, and kappy receptors
- receptors are located throughout the neuraxis and primaryr afferent nociceptor teminals
- Endophins: mu
- Enkephalins: delta
- Dynophins: Kappa
endorphins, enkephalins and dynophins are three families of opioids; the receptors are the ones that those specific types have the highest afinitiy for
How can opioids be administered
- orally
- oral mucosa
- injection
- transdermal patch
- rectal suppospitory
- ionotophoresis
- nasal insufflation
Metabolized in the liver
Acute effects of opioids:
CNS
- analgesia
- euphoria
- sedation
- respitory depression
- antitussive action: cough suppression
- miosis
- nausea and vomiting
- truncal rigidity
Acute effects of opioids:
Cardiovascular
- mostly bradycardia
- hypotension
- some may cause tachycardia
Acute effects of opioids:
GI tract/smooth muscle
- constipation
- contraction of biliary tract (increase)
- can cause biliary tract spasms
Acute effects of opioids:
renal
- depress renal system
- decrease glomerular filtation
- decrease systemic BP
- enhance Na reabsorption
Acute effects of opioids:
Endocine
- stimulate ADH and GH
- inhibit LH
- chronic use = decrease testosteone
Acute effects of opioids:
Integumentary
- flushing
- warming of the skin
- sweating
- itching
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What are the main clinical uses of opioids
- analgesia - severe pain
- anesthesia
- cough supession
- diarrhea
- acute pulmonay edema
Advese events with opioid use
- dependence and addiction
- overdose: triad signs = miosis, comatose, respiratory depression
Clinical uses of aspirin
- low dose = thomboembolus prevention
- intermediate dose = antipyretic and analgesic
Clinical uses of NSAIDs
- anti-inflammatory
- analgesic
- accelerate closure of patent ductus arteriosus
Adverse effects of NSAIDs
CNS
- Headache
- tinnitus
- vertigo
- aseptic meningitis (rare)
Adverse effects of NSAIDs
cardiovascular
- fluid retension
- HTN
- rare: MI/CHF
Adverse effects of NSAIDs
GI tract
- abdominal pain
- dyspepsia*
- nausea/vomitting
- ulcers/bleeding
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*refers to discomfort or pain in the upper abdomen, often after eating or drinking.
Adverse effects of NSAIDs
Hematologic
- thrombocytopenia
- neutropenia
- aplastic anemia
Adverse effects of NSAIDs
hepatic
- rare: liver failure
- abnomral liver function tests
Adverse effects of NSAIDs
pulmonary
- asthma
Adverse effects of NSAIDs
Skin
- rash
- pruritus
Adverse effects of NSAIDs
Renal
- renal insufficiency
- acute tubular necrosis
- interstitial nephritis
- renal failure
- hyperkalemia
- proteinuria
Acetaminophen
- analgesic
- antipyretic
- adverse effects: toxic to kidneys and liver in large doses
