B/26 Synthetic Opiates

Question 1

Hydromorphone

Answer 1

Strong my agonist

Morphine derivative

Immediate release tablets and slow release preparations (pump)

5 times more potent than morphine

Question 2

Dihydrocodeine

Answer 2

Morphine derivative

Question 3

Oxycodon

Answer 3

Morphine derivative

Question 4

Buprenorphine

Answer 4

Partial my agonist, k antagonist

More potent than morphine

Sublingual, trandermal patches. Heroin substitution. May precipitate withdrawal symptoms

Long duration of action

Low dependency capacity.

Question 5

Nalbuphine

Answer 5

Mixed my/k agonist.

Morphine derivative. Very low dependency capacity

Question 6

Meperidine

Answer 6

Full my agonist. Less side effects compared to morphine.

Emetic, resp. depr.

Question 7

Fentanyl

Answer 7

Strong my agonist.

Same effect as morphine, but higher potency.

Iv as general anesthesia, transdermal patch for chronic pain and sublingual tablet for breakthrough pain.

High dependency capacity

Question 8

Methadone

Answer 8

Strong my agonist.

High dependence capacity

Question 9

Tramadol

Answer 9

Weak my agonist.

Synthetic codein analog.

NE uptake inhibitor and serotonin releasef

Used in mild to moderate pain

Less pronounced resp. depr.

Interaction with MAO inhibitors —> serotonin syndrome

Question 10

Diphenoxylate

Answer 10

Weak my agonist

Question 11

Loperamide

Answer 11

Weak my agonist

Question 12

Naloxone

Answer 12

Pure antagonist

Morphine derivative

For opioid overdose (iv)

Question 13

Naltrexone

Answer 13

Pure antagonist

Morphine derivative

Long acting. Given orally.

Used in opioid addiction and in alcoholism

Hepatotoxic