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Pharm U3 > 6) Narcotics > Flashcards

6) Narcotics Flashcards

1
Q

What is the class for Morphine

A

Opioid

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2
Q

What is the mechanism for Morphine

A

Mu-opioid receptor agonist

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3
Q

What are the therapeutics for Morphine

A

Severe analgesia, mood alteration, antitussive, sedation

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4
Q

What are the important side effects for Morphine

A

Miosis, constipation, respiratory depression

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5
Q

What are the other side effects for Morphine

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

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6
Q

What are the miscellaneous for Morphine

A

2 major active metabolites: M6 (more potent/active), M3 (little affinity); intraspinal administration possible

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7
Q

What is the class for Codeine

A

Opioid

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8
Q

What is the mechanism for Codeine

A

Mu-opioid receptor agonist (low receptor affinity); demethylated to form morphine (10% of oral ingestion, via CYP2D6)

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9
Q

What are the therapeutics for Codeine

A

Moderate analgesia, antitussive (found in many cough medicines)

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10
Q

What are the important side effects for Codeine

A

Miosis, constipation, respiratory depression

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11
Q

What are the other side effects for Codeine

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

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12
Q

What are the miscellaneous for Codeine

A

10% of Caucasians unable to convert codeine to morphine (can still experience side effects, though)

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13
Q

What is the class for Tramadol (Ultram)

A

Opioid

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14
Q

What is the mechanism for Tramadol (Ultram)

A

Mu opioid receptor agonist (weak); some NE/5HT uptake inhibition (leading to analgesia); synthetic codeine analog

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15
Q

What are the therapeutics for Tramadol (Ultram)

A

Moderate (not severe) analgesia

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16
Q

What are the important side effects for Tramadol (Ultram)

A

Miosis, constipation, respiratory depression

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17
Q

What are the other side effects for Tramadol (Ultram)

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

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18
Q

What are the miscellaneous for Tramadol (Ultram)

A

1 metabolite: demethylated, more potent analgesic

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19
Q

What is the class for Fentanyl (Duragesic)

A

Opioid

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20
Q

What is the mechanism for Fentanyl (Duragesic)

A

Mu-opioid receptor agonist (strong); highly lipid-soluble

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21
Q

What are the therapeutics for Fentanyl (Duragesic)

A

Severe analgesia after identification of dose level via other opiod (e.g., morphine)

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22
Q

What are the important side effects for Fentanyl (Duragesic)

A

Miosis, constipation, respiratory depression

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23
Q

What are the other side effects for Fentanyl (Duragesic)

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

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24
Q

What are the miscellaneous for Fentanyl (Duragesic)

A

IV, transdermal; do not change dose more than 1/week (long half-life); intraspinal administration possible

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25
Q

What is the class for Methadone (Methadose)

A

Opioid

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26
Q

What is the mechanism for Methadone (Methadose)

A

Mu-opioid receptor agonist

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27
Q

What are the therapeutics for Methadone (Methadose)

A

Chronic, severe pain; treatment of heroin and opiod addicts

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28
Q

What are the important side effects for Methadone (Methadose)

A

Miosis, constipation, respiratory depression

29
Q

What are the other side effects for Methadone (Methadose)

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

30
Q

What are the miscellaneous for Methadone (Methadose)

A

90% bound to plasma protein, accumulates in tissues (thus, extended duration of action); do not change dose more than 1/week (long half-life)

31
Q

What is the class for Oxycodone

32
Q

What is the mechanism for Oxycodone

A

Mu-opioid receptor agonist

33
Q

What are the therapeutics for Oxycodone

A

Moderate to severe analgesia

34
Q

What are the important side effects for Oxycodone

A

Miosis, constipation, respiratory depression

35
Q

What are the other side effects for Oxycodone

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

36
Q

What are the miscellaneous for Oxycodone

A

Oxycontin is extended release

37
Q

What is the class for Meperidine (Demerol)

38
Q

What is the mechanism for Meperidine (Demerol)

A

Mu-opioid receptor agonist

39
Q

What are the therapeutics for Meperidine (Demerol)

A

Don’t use this

40
Q

What are the important side effects for Meperidine (Demerol)

A

Miosis, constipation, respiratory depression; mental status changes and seizures (normeperidine)

41
Q

What are the other side effects for Meperidine (Demerol)

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

42
Q

What are the miscellaneous for Meperidine (Demerol)

A

1 metabolite: normeperidine

43
Q

What is the class for Propoxyphene (Darvon)

44
Q

What is the mechanism for Propoxyphene (Darvon)

A

Mu-opioid receptor agonist (weak)

45
Q

What are the therapeutics for Propoxyphene (Darvon)

A

Don’t use this

46
Q

What are the important side effects for Propoxyphene (Darvon)

A

Miosis, constipation, respiratory depression; CNS toxicity (norpropoxyphene)

47
Q

What are the other side effects for Propoxyphene (Darvon)

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

48
Q

What are the miscellaneous for Propoxyphene (Darvon)

A

1 metabolite: norpropoxyphene (has long half-life)

49
Q

What is the class for Loperamide (Imodium)

50
Q

What is the mechanism for Loperamide (Imodium)

A

Slows peristalsis via opioid receptors in intestine, and possibly decreased GI secretion

51
Q

What are the therapeutics for Loperamide (Imodium)

52
Q

What are the important side effects for Loperamide (Imodium)

A

Miosis, constipation, respiratory depression

53
Q

What are the other side effects for Loperamide (Imodium)

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

54
Q

What are the miscellaneous for Loperamide (Imodium)

A

Meperidine congener

55
Q

What is the class for Diphenoxylate (Lomotil)

56
Q

What is the mechanism for Diphenoxylate (Lomotil)

A

Slows peristalsis via opioid receptors in intestine, and possibly decreased GI secretion

57
Q

What are the therapeutics for Diphenoxylate (Lomotil)

58
Q

What are the important side effects for Diphenoxylate (Lomotil)

A

Miosis, constipation, respiratory depression

59
Q

What are the other side effects for Diphenoxylate (Lomotil)

A

Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence

60
Q

What are the miscellaneous for Diphenoxylate (Lomotil)

A

Meperidine congener

61
Q

What is the class for Naloxone (Narcan)

A

Opioid antagonist

62
Q

What is the mechanism for Naloxone (Narcan)

A

Competitive mu-, delta-, and kappa-opioid receptor antagonist

63
Q

What are the therapeutics for Naloxone (Narcan)

A

Acute opioid toxicity (depressed RR best predicts reponse)

64
Q

What are the important side effects for Naloxone (Narcan)

A

Can precipitate withdrawal (flu-like symptoms of nausea, vomiting, diarrhea; piloerection, yawning, irritability)

65
Q

What are the miscellaneous for Naloxone (Narcan)

A

Continuous parenteral infusion, as lasts only 15-30 minutes (oral almost completely metabolized by liver); patient has normal mental status

66
Q

What is the class for Naltrexone (Revia)

A

Opioid antagonist

67
Q

What is the mechanism for Naltrexone (Revia)

A

Mu-opioid receptor antagonist

68
Q

What are the therapeutics for Naltrexone (Revia)

A

Alcoholism

69
Q

What are the important side effects for Naltrexone (Revia)

A

May produce a prolonged withdrawal state (nausea, vomiting, piloerection, yawning)

Pharm U3 (13 decks)

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