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Pharmacology 3 > E1- Opioids > Flashcards

E1- Opioids Flashcards

1
Q

Which opioid is most likely to cause N/V?

A

Injected Morphine

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2
Q

Which opioids are most likely to be used as antitussives?

A

Codeine and Dextromethophan

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3
Q

Which opioid does not suppress cough?

A

Meperidine

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4
Q

Do opioids cause mitosis or mydriasis?

A

Mitosis

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5
Q

What is the only opioid that causes mydriasis?

A

Meperidine

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6
Q

Which opioid is most likely to cause truncal rigidity

A

Fentanyl, IV

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7
Q

What are the cardiovascular effects of opioids?

A

Bradycardia

Decreased BP

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8
Q

What is the only opioid that may cause tachycardia?

A

Meperidine

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9
Q

What is the GI effect of opioids?

A

Constipation

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10
Q

What are the GU effects of opioids?

A

Decreased urine output
Harder to urinate
Harder to pass kidney stones

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11
Q

What is the effect of opioids on the uterus?

A

Prolong labor

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12
Q

What are the endocrine effects of opioids?

A

Increases ADH, prolactin, somatotropin

Inhibits LH

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13
Q

Why do some people claim they are allergic to opioids?

A

Opioids release histamine

Produces flushing, itching sweating

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14
Q

Which opioid is most likely to produce a histamine reaction?

A

Injected Morphine

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15
Q

What is the effect of opioids on body temperature?

A

Decreased body temperature

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16
Q

Which opioid is contraindicated in pts with a hx of seizures?

A

Meperidine

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17
Q

What are SE of opioids?

A 
N/V
Constipation
Urinary retention
Itching/hives
Respiratory depression
Postural hypotension
Restlessness
Dysphoria
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18
Q

What can occur with chronic opioid use?

A

Tolerance

Hyperalgesia

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19
Q

What can decrease tolerance dependence, and hyperalgesia?

A

NMDA receptor antagonist

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20
Q

What effects of opioids can develop tolerance?

A 
Analgesia
Sedation
Euphoria
N/V
Respiratory depression
21
Q

What effects of opioids do not develop tolerance?

A

Miosis
Constipation
Seizures

22
Q

Are pts more likely to become addicted if they are over or under prescribed?

A

UNDERprescribed

23
Q

What can be used to reduce symptoms of opioid withdrawal?

A

Clonidine
Methadone
Buprenorphine

24
Q

What can cause withdrawal if a pt if dependent on opioids?

A

Opioid antagonsit

25
Q

What are some symptoms of opioid withdrawal

A 
Dysphoria
Anxiety
Insomnia
Piloerection
Increased BP, HR, temp
Muscle aches, twitches
26
Q

What are signs of opioid OD?

A

CNS depression
Respiratory depression
Pin point pupils

27
Q

What is the treatment of opioid OD?

A 
Support respiration
Opioid antagonist (Naloxone)
28
Q

What are the clinical uses of opioids?

A 
Analgesia
Acute pulmonary edema
Antitussive
Diarrhea
Anesthesia
29
Q

What are possible drug interactions of opioids?

A

Sedative hypnotics
Antipsychotics
MAO inhibitors (Meperidine, Dextromethorphan- but best to avoid all opioids)
CYP2D6 inhibitors (Fluoxetine)

30
Q

What are contraindications to opioids?

A

Use of partial agonist with full agonist (cause withdrawal)
Pts with head injuries (increase in intracranial pressure)
Pregnancy
Impaired pulmonary function
function
Impaired hepatic or renal function

31
Q

What route of administration of Morphine most effective?

A

More effective when injected than PO due to high first-pass metabolism

32
Q

Which opioid is more potent than morphine, but less likely to cause itching, and is a good choice for pts with renal dysfunction?

A

Hydromorphone

33
Q

Which 2 opioids are Mu agonist?

A

Methadone

Meperidine

34
Q

What are the uses of Methadone?

A

Long-term control of pain (hard-to-treat cases)

Maintenance treatment of addicts

35
Q

When should Meperidine not be used?

A

For more than 48hrs, in high doses, or in renal failure due to accumulation of metabolite that can cause seizures

36
Q

Which opioid causes serotonin syndrome when used with MAOIs?

A

Meperidine

37
Q

Fluoxetine inhibits the effects of which opioids?

A

Codeine, Oxycodone, Hydrocodone (metabolized by CYP2D6)

38
Q

Is it recommended to prescribe hydrocodone with/without acetaminophen?

A

WITHOUT

39
Q

What is being added to Oxycodone and Buprenorphine to prevent their effects if injected?

A

Naloxone or Naltrexone

40
Q

What is the MOA of Pentazocine/naloxone?

A

Kappa receptor agonist, Mu receptor partial agonist

41
Q

What is the MOA of Buprenorphine?

A

Mu receptor partial agonist

42
Q

Which opioid has a ceiling effect to the euphoria leading to a low abuse potential?

A

Buprenorphine

43
Q

What is the MOA of Tramadol?

A

Weak Mu agonist, inhibits NE/5-HT reuptake

44
Q

What should you not combine Tramadol with? Why?

A

Antidepressants –> seizures

MAOIs, TCAs, SSRIs –> serotonin syndrome

45
Q

What should you not combine with Dextromethophan? Why?

A

MOAIs- –> serotonin syndrome

46
Q

What is DOC for opioid overdose?

A

Naloxone

47
Q

How is Naloxone administerted?

A

Must be injected (give until pupils dilate)

48
Q

What is the concern for Naltrexone and alcoholics?

A

May cause liver toxicity when used chronically

49
Q

What are the 2 opioid antagonist?

A

Naloxone

Naltrexone

Pharmacology 3 (10 decks)

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