Exam 2; Narcotic Analgesics (Opiates) Flashcards
These are the very best analgesics which were drastically changed with the invention of the hypodermic syringe
opiates
What is the analgesic effect of opioids on the CNS
decrease the perception of pain and the response to the pain
some sedation
How do opioids affect mood
they elevate mood; even induce euphoria
opioids have a direct effect on the chemoreceptor trigger zone in the CNS causing what
nausea
opioids have an effect on the brain respiration center which can lead to what
decreased respiration; typically dying of an OD is in conjunction with ethanol and they “just forget to breathe”
opioids stimulate the nucleus of the oculomotor nerve cause what
pupil constriction; “pin-point-pupils”
hyperthermia
What is the effects of opioids on the GI system
they cause random contraction leading to constipation
What are three effects of opioids
vasodilation
orthostatic hypotension
increased CSF pressure
increased release of histamine; bronchconstriction and itching
All of the opioids can pass what
the placenta
baby will be born with high levels and will go through withdrawal
opioids act on what
specific opioid receptors
opioids look a lot like what three things
endogenous opiate-like peptides
enkephalines
endorphins
dynorphins
What is the most significant opioid receptor
μ; mu
What are five symptoms of opioids on the μ receptor
pain euphoria cough respiration depression gut motility
The activation of opioid receptors leads to a decrease in this
cAMP
This is related both to the pleasure of the addictive experience and the dear of the consequence of withdrawal
addiction
This is when you need more of something to satisfy your need; continuously increase the dose to get the desired effect
tolerance
This is the adaptation to the presence of the drug therefore the effects of stopping the drug are the opposite of the drug itself
withdrawal
What are four symptoms of opioid withdrawal
skin; severe vasoconstriction “cold turkey”
GI; extremely active, cramping, diarrhea, nausea
What are the two treatment for opioid withdrawal
“cold turkey” no treatment
ultra-rapid withdrawal; ovoid blocker under general anesthesia
This is a natural analog opiate agonist usually given parentally because it undergoes first pass metabolism
morphine
This is a natural analog opiate partial agonist with low anti-nociceptive effects; great anti-tussive effect
codeine
This is a semisynthetic opiate agonist which is 5x more potent than morphine
heroin
This is a semisynthetic opiate agonist which is 10x more potent than morphine
hydromorphone
This is a semisynthetic opiate agonist that is 0.5% less potent than morphine and is available in oral form
oxycodone
This is a synthetic opiate agonist that is 80-100x more potent that morphine
fentanyl
What are five synthetic opiate agonists
sufentanil (500-600x more potent than morphine) alfentanil remifentanil oxymorphone levorphanol
This synthetic opiate agonist is 0.5 less potent than morphine but there is no pupil constriction
meperidine
This synthetic opiate agonist is orally effective due to giving in it a liquid form that is harder to abuse
methadone
These are three opiate receptor blockers used in emergencies
naloxene
naltrexone
methyltrexone
These are two agents that work as a combination of opiate activity and SSRIs
tramadol
tapentadol
When should opiates be used
in the control of PAIN in cancer, burn patines, trauma, allowing them to lead normal lives
addiction is rare in patients that need the pain control to function
Opiates analogs without CNS effects can be used to treat what
diarrhea and cough
What are the four things that opiates should never be used for
undiagnosed pain
head injury; increase intracranial pressure
convulsive disorder; may increase seizures
respiratory difficulties
