Inman Pharmacology Flashcards
___ are compounds structurally related to products found in opium
opiates
__ are agents, regardless of chemical structure that have pharmacological actions of a natural opiate
opioids
morphine, codeine, and heroin are __
a. opiates
b. opioids
a. opiates
structurally related to products found in opium
enkephalins and endorphins are __
a. opiates
b. opioids
b. opioids
regardless of chemical structure have pharmacological actions of natural opiate
Which endogenous opioids bind delta receptors?
dynorphins, endorphins, enkephalins?
enkephalins
Which endogenous opioids bind mu receptors?
dynorphins, endorphins, enkephalins?
endorphins
Which endogenous opioids bind kappa receptors?
dynorphins, endorphins, enkephalins
dynorphins
Opioid receptors are what type of receptors?
GCPRs
inhibit adenylyl cyclase, activate phospholipase C, inactivate calcium channels, activate K channels, activate MAP kinase
Opioids __ potassium ion channels
a. activate
b. inactivate
a. activate
opioids __ calcium ion channels
a. activate
b. inactivate
b. inactivate
Which two opioid receptor types cause pinpoint pupils?
mu
kappa
Which two opioid receptor types cause constipation?
mu
kappa
Which two opioid receptor types cause respiratory depression?
mu
delta
Which opioid receptor type causes dysphoria?
kappa
Opioids increase pain threshold by inhibiting release of __ in the dorsal horn of the spinal cord
substance P
High doses of morphine like opiates in ___ can cause myoclonus and seizures
a. newborns
b. adults
b. adults
Opioid convulsions in newborn:
epileptiform EEG
occasional seizure
What is the primary cause of morbidity related to opioid therapy ?
respiratory depression
use with caution in pts with asthma, COPD< and other preexisting respiratory conditions
With opioids mydriasis (dilation) of pupils will occur with onset of ___
asphyxia
directly stimulate chemoreceptor trigger zone in the area postrema
All clinically useful opioid agonists produce some degree of nausea and vomiting.
a. true
b. false
a. true
Do opioids cause loss of libido?
yes
decrease testosterone, cortisol and gonadotrophin in males, decrease LH and FSH in females
Route of administration for morphine?
any route of administration
Morphine absorption?
slow and erratic, significant first pass metabolism
Morphine distribution?
rapidly enters all tissue, including fetuses
Is methadone stronger or weaker than morphine?
equipotent in analgesia
Does methadone or morphine have longer duration of action?
methadone
less euphoria
Which opioid is more likely to produce delirium?
meperidine
Is meperidine used for short or long term management of acute pain?
short term
Does tramadol raise or lower seizure threshold?
lower
can cause seizures
Does tramadol cause more or less respiratory suppression than morphine?
less
What CYP metabolizes tramadol?
2D6
3 kappa agonist/mu antagonists:
BNP
B - butorphanol
N - nalbuphine
P - pentazocine
Which mu antagonist is used to reverse coma and respiratory depression of opiate overdose?
naloxone
What is half life of naloxone?
30-80mins
What is duration of action for naltrexone?
24 hours
What is naltrexone used for?
rapid detoxification
