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Pharmacology > module 4 opioid agents > Flashcards

module 4 opioid agents Flashcards

1
Q

morphine MOA

A

mu receptor agonist

- min. effect on Kappa and sigma Rc

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2
Q

morphine AE

A 
nausea
myoclonus
hallucination
pruritis d/t histamine release
supraspinal analgesia 
resp depressin
euphoria
sedation 
dec. GI motility
pupil constriction
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3
Q

Morphine Contraindication

A

renal insufficiency: Inc. AE

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4
Q

Morphine administation

A 
PO
IM
IV
SubQ
rectal
epidural
intrathecal
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5
Q

Codeine administration

A 
PO
IV
IM
SubQ
Combo with:
- APA
- guaifenesin
- promethazine
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6
Q

Codeine prodrug

A

active form: morphine

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7
Q

codeine use

A

antitussive effect without conversion

cough

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8
Q

hydrocodone administration

A 
always combined with 
- APAP
- ASA
- ibuprofen
- antihistamine
PO
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9
Q

hydrocodone use

A

analgesic

antitussive

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10
Q

oxycodone administration

A 
PO
in combination with
- APAP
- ASA 
No active metabolites: safer with renal dysfunction
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11
Q

hydromorphone administration

A 
PO
IV
IM
SubQ
rectal 
epidural 
- semi-synthetic 
- no major metabolites: safer with renal dysfunction
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12
Q

Methadone administration

A 
PO
IV
SubQ
Long half life
no active metabolites: safer with renal dysfunction
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13
Q

methadone use

A

opioid addiction treatment or maintenance
daily dosed
pain management: 2-3/day

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14
Q

Meperidine administration

A 
PO
IV
IM
rectal
epidural
intrathecal 
- synthetic
main metabolite: normeperidine 
- long half life
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15
Q

meperidine use

A

post-op for shakes/chills
epidural
spinal analgesia ST

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16
Q

meperidine AE

A

CNS excitation
anxiety
seizures

17
Q

Meperidine caution

A

elderly

renal dysfunction

18
Q

fentanyl administration

A

IV
transdermal patch (q72h)
transmucosal lozenge
buccal tablets

19
Q

fentanyl uses

A
  • transdermal for chronic pain: after titration with short acting opioid
  • transmucosal for breakthrough pain
20
Q

Fentanyl precautions

A

80-100X more potent than morphine

21
Q

buprenorphine administration

A

SL
parenteral
Has a ceiling effect

22
Q

buprenorphine MOA

A

partial agonist

- can precipitate withdrawal s/s if already on full agonist: displaces full-agonist and has less effect

23
Q

buprenorphine uses

A

sublingual tablets: opioid dependence tx.

- alone or combined with naloxone

24
Q

Heroin

A

3x more potent than morphine due to greater lipid solubility

  • metabolized to morphine
  • crosses BBB quickly
25
Q

3-methylfentanyl (china white)

A

1000x more potent than morphine

metabolites can accumulate

26
Q

opioid AE

A 
most common:
- sedation
- dizzy
- N/V
- itching
- sweating
- constipation 
Most serious: 
- resp. depression
27
Q

tolerance to AE of opioids

A

tolerance to sedative and emetic effects

no tolerance to constipation

28
Q

opioid dosage

A

no min. or max. dose except limitation by the dose of APAP or ASA
- use dose to maintain optimum pain relief with tolerable AE

29
Q

Sustained release use

A

chronic pain

30
Q

immediate release use

A

breakthrough pain

31
Q

PCA use (IV, SQ)

A

when oral route not feasible

32
Q

tramadol administration

A

PO

metabolite 200x greater affinity for mu Rc

33
Q

tramadol MOA

A

blocks reuptake of Norepi and serotonin

34
Q

tramadol use

A

moderate to severe pain

35
Q

tramadol AE

A

seizures possible w/ MAOI or antipsychotic use

only partially reversible with naloxone

Pharmacology (78 decks)

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