37: Opioids

Question 1

How long do IR/ ER/ epidural / suppository opioids typically last?

Answer 1

1. IR: 3-5hrs
2. ER: 8-24 hrs
3. Epidural: up to 24hrs
4. suppository: 3-7 hrs

Question 2

AEs with chronic opioid use

Answer 2

physical dependence, constipation, low libido, cross tolerance, loss of appetite, brain damage, tolerance, hepatic damage

Question 3

sedatives + hypnotics AEs

Answer 3

increased CNS depression and resp depression

Question 4

opioids + anti-psychotic AEs

Answer 4

increased sedation, possible CV effects, variable resp depression

Question 5

opioids + MAOI’s

Answer 5

relative contraindication bc high incidence of hyperpyrexic coma and HTN

Question 6

three opioid receptors

Answer 6

mu, delta, kappa

Question 7

mu receptor 4 functions

Answer 7

1. spinal analgesia
2. resp inhibition
3. slow GI transit
4. modulates H and nt release

Question 8

delta receptor 2 functions

Answer 8

1. spinal analgesia

2. hormone and nt release

Question 9

kappa receptor 3 functions

Answer 9

1. spinal analgesia
2. slowed GI transit
3. psychomimetic effects

Question 10

three endogenous opioid peptides

Answer 10

1. endorphins
2. enkephalins
3. dynorphins

Question 11

what endogenous opioid peptide works best on the three opioid receptors

Answer 11

1. mu: endorphins
2. delta: enkephalins
3. kappa: dynorphins

Question 12

morphine works on which receptors

Answer 12

all three (mu, kappa, delta)

Question 13

methadone works on which receptors

Answer 13

mu

Question 14

buprenorphine works on which receptors

Answer 14

all three

Question 15

naloxone works on which receptors

Answer 15

mu, delta

Question 16

which drug is highly accessible to anesthesiologists and is sometimes abused by them?

Answer 16

meperidine

Question 17

if given naloxone, whats the game plan?

Answer 17

monitor carefully for at least 24hrs for recurrence of OD sx