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RUSVM Pharmacology > Analgesics- Opioids > Flashcards

Analgesics- Opioids Flashcards

1
Q

_______________ are a group of mainly synthetic agents that act at opioid receptors to proceed analgesic and other effects

A

Opioid drugs

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2
Q

Naturally occurring drugs extracted from opium

A

Opiates

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3
Q

Analgesia and stupor bordering on general anesthesia

A

Narcosis

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4
Q

Analgesia and amnesic state produced by admin of a neuroleptic and narcotic

A

Neurleptanalgesia

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5
Q

What parts of the pain pathways do opioids have an effect on

A

Transduction
Modulation
Perception

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6
Q

What are the 3 types of opioid receptors

A

Mu (u)
Kappa (k)
Delta

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7
Q

What are the most common opioid receptors

A

Mu

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8
Q

What is the MOA of opioid agonists

A

Activation of Mu
Couples with G protein
Reduces neurotransmitter release by decreasing Ca influx

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9
Q

What are the main sites where opioid agonists inhibit neurotransmitter

A

Dorsal horn of spinal cord

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10
Q

What is the distribution of opioids?

A

Widely distributed

Can cross BBB and placenta

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11
Q

How are opioids metabolized?

A

Conjugation to glucuronic acid

Cats are deficient –> metabolize more slowly

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12
Q

What are the full opioid Mu receptor agonists?

A 
Morphine 
Hydromorphone 
Oxymorphone 
Fentanyl 
Carfentanil/Etorphine
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13
Q

What is a risk of using opioids especially in dogs with IV use

A

Histamine release

Morphine > hydromorphone

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14
Q

What full Mu receptor agonsit is very potent and used in wildlife

A

Carfentanil/Etorphine

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15
Q

What is the partial opioid Mu receptor

A

Buprenorphine

-> semisynthetic partial u agonist
‘Ceiling effect’

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16
Q

How does the onset and duration of buprenorphine compare to morphine

A

Buprenorphine has slower onset and longer duration than morphine

17
Q

What is a mixed opioid receptor agonist-antagonist

A

Butorphanol

K agonist and u antagonist
=> sedation with less analgesic effects

18
Q

What drug can be used to partially reverse the dysphroic effects from a pure Mu agonist

A

Butorphanol

19
Q

Butorphanol is better for use against (visceral/Somatic) pain?

A

Visceral

20
Q

What effects do opioids have in the CNS?

A

Behavioral changes

  • CNS depression in dog, monkey, and humans
  • CNS stimulation in cat, horse, ruminant, and pig

Motor activity

  • depressed in dog
  • increased in horse

Thermoregulation

  • hypothermia in dog, rabbit and monkey
  • hyperthermia in CAT, ruminant and horse

*** hyperthermia in cat-> not due to fever; can become intolerant to opioid

21
Q

What is the main effect of opioids on the respiratory system

A

Dose dependent respiratory depression -> hypoventilation

22
Q

What is the main effect of opioids on the cardiovascular system?

A

Minimal CV effects

Centrally medicated bradycardia and hypotension due to vasodilation ** most important in dogs

23
Q

What are the main GI effects of opioids

A

Nausea, salivation, vomiting, and regurgitation
-Apomorphine ->emetic of choice in dog, TOXIC to cat

Ileum and Constipation
-increased intestinal wall tone, decreased propulsive motility

24
Q

What are the clinical uses of opioid agonists

A

Analgesia

Sedation

Pre-anesthetic

Antitussive (anti cough)- non full u agonist (butorphanol)

Emetic (apomorphine)

Antidiarrheal

25
Q

When should a full/pure opioid antagonists be used?

A 
Overdose
Toxicity 
Severe opioid-induced respiratory depression 
Prolonged anesthetic recover 
Cardiac arrest 
Cardiorespiratory arrest
26
Q

What is a full u receptor antagonist

A

Naloxone

Naltrexone and diprenorphine
Methylanltrexone

Reverse opioid adverse effects and analgesic

27
Q

What weak opioid u agonist also inhibits serotonin and NE reuptake

A

Tramadol

Generally used for short term post-op pain management

28
Q

What semisynthetic opioid is used orally and an antitussive?

A

Hydrocodone

29
Q

What is the emetic of choice in dogs but is toxic to cats

A

Apomorphine

30
Q

What opioid has the most potent anti-diarrheal effects

A

Loperamide

31
Q

What are precautions for opioid use?

A

Pre-existing ileus
Conditions causing increase ICP
Advanced or severe cardiac or hypoventilation
Acute renal failure/injury
History of opioid intolerance/hypersensitivity

32
Q 
Which of the following drugs MOA is described as having a 'ceiling effect'
A. Morphine
B. Naloxone 
C. Buprenorphine 
D. Butorphanol
A

C. Buprenorphine

33
Q

T/F: hyperthermia can be induced by opioids in cats?

A

T

34
Q

_____________ release is an important adverse effect to using morphine

A

Histamine

35
Q

T/F: Butorphanol has stronger antitussive effects than buprenorphine

A

T

36
Q

T/F: ileus is caused by decreased segmental intestinal motility

A

F
Increased GI segmental motility
Decreased GI propulsive motility

37
Q

What is the drug of choice to completely reverse /antagonized the effects of fentanyl

A

Naloxone

RUSVM Pharmacology (18 decks)

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