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Flashcards in pharmacology: opioids Deck (23):
1

effects of morphine

-analgesia (increase pain tolerance and decrease -perception/reaction to pain)
-sedation
-respiratory depression
-vasodilation
-smooth muscle (longitudinal relaxes and circular contricts)
-cough suppression
-nausea and vomiting (stimualtion of chemoreceptor trigger zone)
-increase histamine release

2

what are the effects of morphine on smooth muscle

longitudinal relaxes and circular constricts causing :
GI: decreased peristalsis, constipation, cramping
GU: urinary retention and urgency to void
Biliary: increased pressure
Pupils: miosis

3

what can be used to avoid cramping with opiods?

antimuscarinic (atropine)

4

opiod mechanism

presynaptic and postsynaptic inhibition through Gi coupling (decreased cAMP)
-endorphins effects mu receptor

5

what is the prototype for mu agonist?

morphine

6

what are the full agonists of mu?

morphine, meperidine, methadone, fentanyl, codeine (weak), heroine lol

7

meperidine use

since an antimuscarinic as well - NO MIOSIS, tachcardia, NO spasm GI/GU/gallbladder

8

side effect of meperidine

metabolized by chtochrome P450 to normeperidine which is a serotonin reuptake inhibitors - may cause serotonin syndrome and seizures

9

methadone use

maintenance of opiate addict (long long halflife)

10

codeine use

cough suppressant and analgesia

11

what is the partial opiod agonist? what does it cause?

buprenorphine - causes precipation of withdrawal

12

what are the mixed agonists/antagonist opiods? mechanism and uses?

nalbuphine and pentazocine
kappa agonist for spinal analgesia and dysphoria
mu antagonist causing precipitation of withdrawal

13

what are the opiod antagonists

naloxone, naltrexone, methylnaltrexone

14

naloxone use

IV - reversal for respiratory depression

15

naltrexone use

PO causing decreased craving for alcohol and used in opiate addiction

16

methylnatrexone use

treatment for opioid induced constipation (does not cross BBB and won't precipitate withdrawal)

17

side effects of opioids

acute toxicity: pinpoint pupils, respiratory depression, coma

18

management of acute toxicity of opioids

supportive and IV naloxone

19

tolerance of opioids

pharmacodynamic (NOT RECEPTOR - but increased cAMP signal transduction)
NO TOLERANCE TO MIOSIS AND CONSTIPATION

20

withdrawal symptoms of opioids

yawning, lacrimation, rhinorrhea, salivation, anxiety, sweating, goose bumps, muscle cramps, spasms, CNS-originating pain

21

management of opioid withdrawal

supportive, methadone, clonidine (alpha 2 agonist - taper down withdrawal symptoms by canceling sympathetic flare up)

22

what opiate-related drug is used for treatment of diarrhea?

loperamide

23

what opiate-related drug is used for treatment of cough?

dextromethorphan