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Clinical prep > meds; opioids > Flashcards

meds; opioids Flashcards

1
Q

Morphine intraop dose

A

1-10 mg

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2
Q

Mu 1 receptor effects

A

analgesia
euphoria
no dependence
hypothermia
bradycardia
miosis
urinary retention

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3
Q

Morphine Postop dose

A

5-20 mg

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4
Q

Mu2 receptor effects

A

analgesia
physical dependence
constipation
depression of ventilation

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5
Q

Onset for morphine

A

10-20 min

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6
Q

Kappa receptor effect

A

anaglesia
dysphoria/sedation
no dependence
miosis
diuresis
antishivering

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7
Q

duration of morphine

A

4-5 hr

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8
Q

Delta receptor effect

A

anaglesia
depression of ventilation
physical dependence
constipation
urinary retention
pruritis

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9
Q

Morphine MOA

A

receptors; Mu1 and Mu 2

dull> sharp pain

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10
Q

General opioid side effects

A

chest wall and abd rigidity
cardiac protective
sphincter of opioid spasm (fent>morphine> meperidine)
x placenta

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11
Q

Morphine side effects

A

hydrophilic = slow cephalad spread w/ blocks

MU 1 and 2 effects

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12
Q

Morphine metabolism

A

glucuronic acid conjugation -> active metabolites (morphine - 6)

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13
Q

Fentanyl intraop dose

A

1-3 mcg/ kg

IBW

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14
Q

onset of fent

A

30-60 seconds

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15
Q

duration of fent

A

1-1.5 hr

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16
Q

Fent potency

A

75-125 x more pot than morphine

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17
Q

Side Effects of fent

A

increase ICP
depression of carotid sinus baro r
potentiates benzos

(lipophilic)

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18
Q

Fent metabolism

A

lung first pass effect; 75%

cyp3A -> norfentanyl

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19
Q

Fent MOA

A

Mu 1 and 2 > kappa and delta

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20
Q

Sufent intraop dose

A

0.3-1mcg/kg

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21
Q

Sufent MOA

A

› Highly selective mu opioid receptor agonist

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22
Q

sufent onset

A

30-60 seconds

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23
Q

Sufent concentration

A

50mcg/ml

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24
Q

Sufent duration

A

1-1.5 hr

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25
Q

sufent gtt dose

A

0.5-1 mcg/kg/ hr

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26
Q

Sufent potency

A

Fent < sufent
1000 x more potent than morphine

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27
Q

sufent side effect

A

bradycardia

(lipophilic)

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28
Q

sufent metabolism

A

alpha 1 acid glycoprotein binding (92.3%)

60% lung first pass

hepatic metabolism

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29
Q

remifent intraop dose

A

load; 0.5-1 mcg/kg over 1 min

**IBW

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30
Q

Remifent trade name

A

Ultiva

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31
Q

remifent onset

A

30-60 sec

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32
Q

remifent duration

33
Q

remifent gtt dose

A

0.125-0.375 mcg/kg/min

IBW**

34
Q

Remifent moa

A

selective mu

35
Q

remifent side effects

A

hyperalgesia/tolerance
bradycardia

36
Q

Remifent metabolism

A

tissue esterase metabolism

37
Q

Remifent is used for what cases?

A

neuro, carotid endarterectomy, eye blocks, TIVA

38
Q

What should be given prior to stopping remifent gtt?

A

a longer acting analgesic

39
Q

remifent potency

A

fent < remi

100-300 x more potent than morphine

40
Q

Meperidine postop dose and whats it given for?

A

12.5 mg
given for shivering

41
Q

Meperidine onset

42
Q

meperidine duration

43
Q

Meperidine potency

A

1/10th as potent as morphine

44
Q

meperidine MOA

A

mu, Kappa and alpha 2 agonist
structurally similar to atropine and LA

45
Q

Meperidine side effects

A

tachycardia, mydriasis, dry mouth
serotonin syndrome
negative inotrope
x placenta
w/d symptoms faster than morphine
decrease sz threshold -> sz/ myoclonus (active metabolite causes)

46
Q

Brand name for meperidine

A

pethidine/ demerol

47
Q

Hydromorphone intraop dose

48
Q

hydromorphone postop dose

49
Q

hydromorphone onset

50
Q

hydromorphone duration

51
Q

hydromorphone potency

A

7x more pot than morphine

52
Q

hydromorphone metabolism

A

CYP3A4; active metabolite hydromorphone- 3 glucuronide (neurotoxic, sz, allodynia, myoclonus)

53
Q

Naloxone intraop dose

54
Q

Naloxone post op dose

55
Q

Naloxone onset

56
Q

Naloxone duration

57
Q

Naloxone moa

A

competitive antagonist for Mu, kappa, and delta
opioid Rectors

Reduces/reverses mu related SE’s: pruritis, urinary retention, muscle rigidity, biliary spasm

58
Q

Naloxone side effects

A

N/V, - analgesia, increased SNS

flash pulmonary edema

59
Q

Naloxone concentration

A

400mcg/ml (must dilute)

60
Q

Opioids are usually weak acids or bases?

61
Q

Tramadol dose PO

A

3 mg/kg PO
50-100 mg

62
Q

Tramadol MOA

A

mu, weak kappa and delta

63
Q

Tramadol potency

A

5-10x less potent than morphine

64
Q

Tramadol SE

A

Interactions with coumadin

65
Q

Codeine dose PO

66
Q

Hydrocodone dosage PO

67
Q

Oxycodone PO dose

68
Q

Methadone PO dose

A

2.5-10 mg

NMDA antagonist

69
Q

Hydrocodone trade name

70
Q

Methadone potency

A

4x more pot than morphine

71
Q

What is Percocet

A

oxycodone + acetaminophen

72
Q

Methadone IV dose

A

0.2-0.3mg/kg

73
Q

What is percodone

A

Oxycodone + aspirin

74
Q

Methadone uses

A

opioid w/drawal and chronic pain

T1/2 = 1-2 days

inc QTC

NMDA antag

75
Q

Fentanyl trade name

76
Q

fentanyl gtt dose

A

3-6mcg/kg/hour (off 60 minutes before breathing)

77
Q

fentanyl concentration

78
Q

Meperidine contraidicated

A

with MAOI’s

Clinical prep (21 decks)

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