Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

1390-59 Intro to Pharmacology > Chapter 19 > Flashcards

Chapter 19 Flashcards

1
Q

addiction

A

a chronic neurobiological disease in which genetic, psychosocial and environmental factor induce changes in the individuals behavior to compulsively use drugs despite the harm that may result

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Opioid agonists

A

-drug that attaches to a receptor and initiates an action

Opioid receptor agonists
-Bind to opioid receptors and mimic the effects of the endogenous analgesic peptides

  • Interact with mu and kappa receptors
  • Inhibit neurotransmitter release and nociceptor signals
  • Reduce nerve excitability and alter pain perception
  • Pure (mu) agonists - Bind to receptors and produce a response
  • Partial agonists - Initiate kappa receptors and partially block mu receptors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

analgesics

A

substance (synthetic or naturally occurring) that inhibits the body’s reaction to painful stimuli or perception of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

analgesia

A

relief from pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Opioid antagonist

A
  • drug that attaches to a receptor, does not initiate an action, but blocks an agonist from producing an effect
  • Bind to receptors to prevent agonist from binding - naloxone
  • Reverse the mu effects of opioids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

antidiuretic hormone (ADH)

A

substance produced in the hypothalamus and secreted by the pituitary gland that modulates urine production and allows the kidneys to reabsorb water in order to conserve body water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

antitussive

A

a drug that suppressed coughing at a therapeutic dose

examples-Codeine
Hydrocodone
Dextromethorphan

Combined with agents in order to relieve other cold symptoms - may counteract the potential for abuse

Expectorants alter the volume and viscosity of mucus.

Sympathomimetic amines produce nasal decongestion.

Antihistamines decrease mucus secretion.

Alcohol acts as a CNS depressant.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

anuria

A

condition in which no urine is produced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

dysphoria

A

feeling of discomfort or unpleasantness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

emesis

A

vomiting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

endogenous

A

naturally occurring within the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

endorphins

A

neuropeptides produced within the CNS that interact with opioid receptors to produce analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

expectorant

A

substance that causes the removal (expulsion) of mucous secretions from the respiratory system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

hyperalgesia

A

an abnormally painful response to a stimulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

neuropathic pain

A
  • pain resulting from a damaged nervous system or damaged nerve cells
  • abnormal signals or nerves damaged by entrapment, infection, amputation, or diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

nociceptor

A
  • specialized peripheral nerve cells sensitive to tissue injury that transmit pain signals to the brain for interpretation of pain
  • or free nerve endings, respond to tissue injury and painful stimuli. Nociceptors are located in the skin, muscle, joints, bones, and viscera, and transmit pain signals to the brain for interpretation of pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

nonopioid analgesic

A

formerly known as nonnarcotic analgesics, such as NSAIDs and COX-2 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

NSAIDs

A

nonsteroidal anti-inflammatory drugs’ nonopioid analgesics that relieve pain without producing physical dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

oliguria

A

condition in which very small amounts of urine are produced

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

opiate

A

drug derived from opium and producing the same pharmacological effects as opium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

opioid

A
  • drug that produces the same pharmacological effects as opium and its family of drugs or neuropeptides (enkephalin, endorphin) produced by the body
  • Any molecule that acts on the opioid receptors - Drugs that were extracted from opium (opiates) or synthetic chemicals that produced the same pharmacological effects as opium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

opioid analgesic

A
  • chemically related to morphine or opium and sued to relieve pain
  • Centrally acting analgesics - affect the CNS at any dose
  • Tolerance develops to all opioids.
  • Physical dependence results from long-term daily use.
  • Federally restricted (controlled) substances because of the high potential for abuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

opioid antagonist

A

a drug that attaches to opioid receptors and displaces the opioid analgesic or opioid neuropeptide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

peripheral nerve

A

part of the nervous system that is outside the central nervous system (the brain or spinal cord) usually near the surface of the tissue fivers or skin

25
Q

phlem

A

secretion from the respiratory tract’ usually called mucus

26
Q

physical dependence

A

condition in which the body requires a substance (drug) not normally found in the body in order to avoid symptoms associated with withdrawal, or the abstinence syndrome

27
Q

referred pain

A

origin of the pain is in a different location than where the individual feels pain

28
Q

spasmogenic

A

causing a muscle to contract intermittently, resulting in a state of spasms

29
Q

synthetic drug

A

drug produced by a chemical process outside the body

30
Q

tolerance

A

ability of the body to alter its response (to adapt) to drug effects so the the effects are minimized over time

31
Q

Pain

A

Protective signal
Warn of imminent danger or presence of internal disease
Part of the normal healing process (inflammation)

32
Q

What are 2 major classes of Analgesic’s?

A

Opioid analgesics

Non-opioid analgesics

33
Q

Nociceptive Pain

A

-Occurs due to the proper functioning of neural equipment (nerve cells, nerve endings, spinal cord, and brain)

  • Elements that cause the sensation of pain
    • Local irritation that stimulates the peripheral nerves
    • Recognition of pain within the CNS
34
Q

Pathways for Pain Recognition

A

If the originating signal is transmitted through :

A-delta fibers - pain is sharp

C fibers - pain is dull and achy

35
Q

Characteristics of Pain

A
  • Pain duration can either be acute or chronic.
    • Acute – usually associated with an injury and goes away when healed
    • Chronic - persists for weeks, months, or years even with analgesic therapy
  • Peripheral sensitization can lead patients to perceive normal stimuli as painful
  • Inadequate control of pain can delay the healing process
36
Q

Types of Pain managment

A
  • Opioid analgesics

- Nonopioid analgesics – NSAIDS, acetaminophen, and COX-2 inhibitors

37
Q

Clinical Indications of Opioids

A

-Analgesia, sedation, cough, and diarrhea suppression

  • Opioids are considered first-line therapy for:
    • Pain associated with procedures (bone marrow transplant)
    • Pain due to trauma or cancer (burns)
    • Visceral pain (appendicitis)
  • Opioids are drug of choice in treating acute postoperative pain due to no increased risk of bleeding (as with NSAIDS)
  • Used to relieve acute or chronic pain
  • Also used pre-operatively to decrease apprehension to aid in induction of anesthesia
  • Suppress cough and treat diarrhea
38
Q

Sources of Opioids

A

-Naturally occurring opiates
Morphine and codeine
Hydrocodone, hydromorphone, oxycodone, and oxymorphone

-Synthetic chemicals
Fentanyl

39
Q

Sites and Mechanism of Opioid Action

A
  • Endogenous analgetic peptides
    • Opioid analgesics act selectively within the CNS to reduce the reaction to pain.
      • Do not impair the functions of the peripheral nerves; patients respond as though they can tolerate the pain
    • Include endorphin, enkephlin, dynorphin, nociceptin, and nocistatin – our body’s built in pain relief

-Opioid receptors (G-protein receptors)
Mu - Mu1 and mu2
Kappa
Delta

  • Each of the endogenous opioid peptides have a preference for one of the opioid receptors.
    • May interact with multiple receptors
40
Q

How do opioids work?

A

Opioids bind to their G-protein (mu) receptors, resulting in the closure of presynaptic neurons. This prevents the flow of calcium ions into the cell and facilitates the release of neurotransmitters such as acetylcholine, Substance P, catecholamines, and glutamate. Glutamate is an excitatory neurotransmitter that sends the pain signal along the nerve. So pain transmission is prevented by opioids by inhibiting the release of glutamate.

Opioids bind to the postsynaptic mu receptors and open potassium ion channels resulting in the movement of potassium ions out of the cell, which produces a hyperpolarized state. The nerve cannot respond to pain signals, further interrupting the transmission to the brain. Opioids interact with their receptors at different CNS levels

41
Q

Nonanalgesic opioid effects on the cardiovascular system

A
  • Opioids do not depress cardiac function.
  • Help relieve pain during myocardial infarction
  • Bradycardia and hypotension may occur
42
Q

Nonanalgesic opioid effects on the CNS system

A
  • Mood – decrease mental alertness
  • Nausea and vomiting
  • Respiratory depression
  • Miosis
43
Q

Distribution of Opioid Receptors/side effects

A
  • Widely distributed outside the CNS
    • Endogenous peptides
    • Modify pain perception and mood
    • Regulate cardiovascular, respiratory, and endocrine function

-Side effects
Sedation, euphoria, dysphoria, miosis, constipation, urinary retention, and respiratory depression

44
Q

Gastrointestinal Tract

Nonanalgesic Opioid effects On smooth muscles

A

Intermittent muscle contractions or spasms – peristalsis is inhibited

Constipation – parasympathetic stimulation is inhibited by analgesics

45
Q

Bile Duct

Nonanalgesic Opioid effects On smooth muscles

A

Spasms in common bile duct, causing increased pressure in the gall bladder which usually leads to intense pain, but the opioid will eliminate the pain

46
Q

Bronchial tissue

Nonanalgesic Opioid effects On smooth muscles

A

Spasmogenic action on bronchial smooth muscle

Constriction of bronchioles by release of histamine – making it more difficult to breathe

47
Q

Antidiuretic effect

Nonanalgesic Opioid effects On smooth muscles

A

Decreased urination and urine formation by stimulating secretion of antidiuretic hormone

Spasmogenic activity of ureters and sphincter muscles inhibits urine from passing from bladder

48
Q

Routes and Schedule of Opioid administration

A

Opioids are available in oral and parenteral preparations.

Administered on a repeated schedule to avoid intense pain

Oral formulations should never be chewed

-If unable to swallow, capsules can be prescribed and opened up and placed on applesauce and swallowed

Factors determining selection and dosage levels

  • Intensity and type of pain
  • Acute or chronic
  • Cancer, MI,postsurgery

Tolerance and physical dependence levels

49
Q

Opioid Delivery system

A

Patient controlled analgesia (PCA)

  • Dosing is often under patient control.
  • Allows the use of the lowest effective dose of opioid before the intensity becomes unbearable – patient feels they have control over the pain

-Nasal spray, lozenges, and patches

50
Q

Opioid Disposition

A

Drugs are absorbed in the intestines

Metabolized by the hepatic drug microsomal metabolizing system to produce analgesia

Several opioids are metabolized to products that produce analgesia -duration of analgesic activity

Excreted through the kidneys

Tubular reabsorption of opioids increases:

  • Concentration of drug in the blood
  • Risk of developing drug toxicity
51
Q

Adverse Effects of Opioids

A 
Mental confusion
Somnolence
Nausea and vomiting
Dry mouth
Constipation
Urinary retention
Respiratory or cardiovascular depression
Opioid-induced histamine release produces hypotension and allergic reactions
52
Q

What is a black box warning?

A

Special cautionary warnings that emphasize the level of abuse liability is highest among the opioids

53
Q

What are some cautions and contraindications when it comes to opioids?

A

Opioids should not be given in place of nonopioid analgesics.

Opioids should not be used in patients with:

  • Acute bronchial asthma, heavy pulmonary secretions, or respiratory depression
  • Convulsive disorders, biliary obstruction, or head injuries

Use of opioids during pregnancy should be minimized. Pregnancy Category C or NR

54
Q

Opioid specific drug interactions

A

Opioid analgesics potentiate the effects of CNS depressants.

Meperidine and dextromethorphan should not be given with MAO inhibitors.

Rifampin and phenytoin cause withdrawal symptoms when administered with methadone.

Mixing parenteral solutions may result in drug inactivation.

55
Q

Opioid Tolerance

A

Develops due to changes in the opioid receptors (desensitization and/or fewer opioid receptors available)

Tolerance to sedation, drowsiness, or respiratory depression is a beneficial response.

Analgesic tolerance is not beneficial to the patient.

Cross-tolerance is relative to the patient’s condition and the specific opioid.

56
Q

Opioid Physical Dependence

A

Develops with the chronic use of opioids

Treatment - Controlled gradual tapering of the medication

57
Q

Opioid Addiction

A

Complex interaction of factors that leads to lack of control over drug use

Onset of withdrawal should be avoided.

58
Q

Opioid Treatment

A

Methadone - Does not produce severe withdrawal symptoms

Levomethadyl acetate - Used to manage opiate addiction

Buprenorphine - Blocks the attachment of opioids to receptors

59
Q

Drugs that attach to Opioid receptors

A

Displace the analgesic and rapidly reverse respiratory depression

Pure - Competitive blocking drugs (naloxone)

  • Occupy the mu, delta, and kappa opioid receptors but has no agonist activity (stimulation)
  • Inhibits the analgesic from attaching to the receptors but does not produce any pharmacological action of its own

Partial

  • Produce respiratory depression in normal individuals
  • Reverse respiratory depression in case of acute opioid poisoning

Naloxone - Preferred drug for the treatment of acute opioid poisoning

Antagonist treatment of constipation
-Methylnaltrexone bromide

1390-59 Intro to Pharmacology (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions