6) Narcotics Flashcards
What is the class for Morphine
Opioid
What is the mechanism for Morphine
Mu-opioid receptor agonist
What are the therapeutics for Morphine
Severe analgesia, mood alteration, antitussive, sedation
What are the important side effects for Morphine
Miosis, constipation, respiratory depression
What are the other side effects for Morphine
Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
What are the miscellaneous for Morphine
2 major active metabolites: M6 (more potent/active), M3 (little affinity); intraspinal administration possible
What is the class for Codeine
Opioid
What is the mechanism for Codeine
Mu-opioid receptor agonist (low receptor affinity); demethylated to form morphine (10% of oral ingestion, via CYP2D6)
What are the therapeutics for Codeine
Moderate analgesia, antitussive (found in many cough medicines)
What are the important side effects for Codeine
Miosis, constipation, respiratory depression
What are the other side effects for Codeine
Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
What are the miscellaneous for Codeine
10% of Caucasians unable to convert codeine to morphine (can still experience side effects, though)
What is the class for Tramadol (Ultram)
Opioid
What is the mechanism for Tramadol (Ultram)
Mu opioid receptor agonist (weak); some NE/5HT uptake inhibition (leading to analgesia); synthetic codeine analog
What are the therapeutics for Tramadol (Ultram)
Moderate (not severe) analgesia
What are the important side effects for Tramadol (Ultram)
Miosis, constipation, respiratory depression
What are the other side effects for Tramadol (Ultram)
Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
What are the miscellaneous for Tramadol (Ultram)
1 metabolite: demethylated, more potent analgesic
What is the class for Fentanyl (Duragesic)
Opioid
What is the mechanism for Fentanyl (Duragesic)
Mu-opioid receptor agonist (strong); highly lipid-soluble
What are the therapeutics for Fentanyl (Duragesic)
Severe analgesia after identification of dose level via other opiod (e.g., morphine)
What are the important side effects for Fentanyl (Duragesic)
Miosis, constipation, respiratory depression
What are the other side effects for Fentanyl (Duragesic)
Dry mouth, nausea/vomiting, sedation, sweating; dreams, dysphoria, delerium, myoclonus, seizures, pruritis, urticaria, urinary incontinence
What are the miscellaneous for Fentanyl (Duragesic)
IV, transdermal; do not change dose more than 1/week (long half-life); intraspinal administration possible
What is the class for Methadone (Methadose)
Opioid
What is the mechanism for Methadone (Methadose)
Mu-opioid receptor agonist
What are the therapeutics for Methadone (Methadose)
Chronic, severe pain; treatment of heroin and opiod addicts