24. Opiates Flashcards
Most effective drug for itching after opiates
Pentazocine
Opiates receptors and function
Respiratory
Spinal
Diuresis
Sedation
Gastro
Psychomimesis
Mood
Ach release
Vomiting
Respiratory M
Spinal M+K+D
Diuresis K
Sedation +K
Gastro M+K
Psychomimesis K
Mood + M+D - K
Ach release M
Vomiting D
Receptor for fentanyl / morphine
Mu
Opioids classification
Natural Morphine /codeine /papaverine
Semi Heroin, buprenorphine
Synthetic
Methadone
Molevorphanol
–zocine
Phenylpiperidine (—anil)
Opiates metabolites
M3G mayor metabolite. Antagonize morphine. No analgesia
M6G. 10%. Mu agonist (analgesia) more potent than morphine
Hormones and opiates
Increase GH, PRIL, TSH
Decrease ACTH, LH, Estradiol, Testosterone
No changes in FSH
What causes inhibition of pupil constriction
Hypercarbia, hypoxemia, nociception
Opiates cause pupil constriction
Fentanyl metabolism and kidney function
Liver metabolism, safe in kidney failure
Methadone charac
Mu agonist. Longest 1/2L
Inhibits reuptake of noradrenaline and serotonin
Inhibition on NMDA
Intrathecal morphine and gastric motility
Increase
Opiate that causes tachycardia
Meperidine
The first line of treatment for pruritus
Ondansetron
After induction with fentanyl the patient coughs. What connection does it have?
cough during induction, more incidence of PONV after surgery
Mu and kappa nocioreceptor
Mu analgesic
Kappa variable, analgesic or anti
Evoked responses and opioids
Don’t alter evoked potentials
Exception Remifentanil (reduce auditory evoked potentials)
