19 Opioids 1 Flashcards
T/F endogenous opioid peptides exist?
True.
List the opioid receptors? What is their mechanism of action?
- mu, delta, kappa
- G-protein
How do opioids relieve pain?
Reduce sensitization due to injury
What are classic opioid side effects? (5) and less classic ones? (9) (just get familiar w/ them, not memorize)
- sedation
- constipation
- respiratory depression
- nausea
- vomiting
-euphoria, antitussive, inhibit sex hormone, miosis, itch, bradycardia, vasodilation, GI spasm, seizures
[generally: depresses pain, wakefulness, heart, lungs, & GI]
What is tolerance? Dependence?
- need greater dose
- physical:need dose or go into withdrawal. psych: “need” it
3 cardinal signs of opioid intoxication? (relate to the side effects)
respiratory depression, stupor/coma, miosis (constriction)
What does he want you to know about pain not managed by opioids?
we prescribe enough opioids but don’t manage the psychological aspect of pain. Also opioids don’t help much during physical activity
Analgesia definition?
absence pain w/o loss of consciousness
Narcotics defined legally? medically?
- Illegal
- opioid
Pain is due to?
tissue damage, directly related in intensity
what kind of pain med is most effective against motivation-affective pain?
Opioids!
What are the most efficacious pain meds?
Opioids!
What happens as opioid dose increases?
side effects exceed pain relief
T/F endogenous opioids are generally specific for 1 type of receptor (mu, delta, kappa)?
False. (he said “don’t need to know which goes to which receptor for the test”)
Mu receptors produce what functions? (integration “global” card, don’t mem. list 8)
sedation, analgesia, dependence, respiratory depression, miosis, drops GI motility, vasodilation, euphoria
Kappa receptors produce what functions? (integration “global” card, don’t mem. list 7)
analgesia, anticonvulsant, delirium, diuresis, dysphoria, miosis, sedation
Delta receptors produce what function? (global card don’t mem. list 4)
analgesia, antidepressant, convulsant, physical dependence
What unique effect do delta receptors have? (2)
convulsant & antidepressant
What unique effect do kappa receptors have? (3)
anticonvulsant, delirium, dysphoria
What unique effect do mu receptors have? (4)
respiratory depression, euphoria, drops GI motility, vasodilation
T/F all 3 opioid receptors produce analgesia?
T
[note that mu and kappa receptors share similar effects like miosis, sedation, etc while the ONLY effect delta receptors have in common with the others is analgesia]
what kind of nociceptor do prostaglandins act on?
silent nociceptor
what kind of nociceptor does acid work on?
chemical nociceptor
Once opioid G-protein is triggered what does it do?
On excitatory neurons: Inhibit neurotransmission by blocking Ca influx presynaptically and increasing K efflux postsynaptically
What prevents respiratory depression?
intense pain
How are opioid side effects prevented?
anti-emetics & laxatives
What drug reverses opioid overdose?
Naloxone
What side effects do not become tolerant to opioids?
GI, ocular
Why is there no max dose of opioids?
tolerance to respiratory depression
Can a non-addicted person go thru withdrawal?
yes (they had physical but not psych dependence)
what does withdrawal look like?
sweaty, fast heart/BP, pain & can’t sleep, squirting out both ends of GI tract
physical dependence is defined how?
withdrawal symptoms
[note: develops along w/ tolerance!!]
psych dependence is related to what neuro circuit?
mesolimbic dopamine
T/F addiction to acutely used opiods is rare?
True
