Narcotics Flashcards
What are narcotics are type of?
Analgesic
What is an analgesic?
A pain reliever
In what 2 systems does a human perceive pain?
- PNS - periphery sensory nerves
2. CNS - transmission of periphery sensory to brain
What is the name of the body’s natural analgesics?
Endorphins
What narcotic do endorphins mimic?
Morphine
What receptors in the body do endorphins and opioids work on?
Opioid Receptors
What 2 things do endorphins regulate?
- transmission of pain from PNS to CNS
2. other bodily functions
Where are endorphins located?
In CNS - brain and spinal cord
Are endorphins more potent than morphine?
Yes, 3-4x more potent
How many types of opioid receptors are there?
4
What are the names of the 4 opioid receptors?
- Mu
- Kappa
- Sigma
- Delta
What do Mu opioid receptors regulate?
- “morphine-like” effects - analgesia
- euphoria
- respiratory depression
What do Kappa opioid receptors regulated?
- “pentazocine-like” effects - analgesia
- sedation
- mild respiratory depression
What do Sigma opioid receptors regulated?
Withdrawal
- dysphoria
- hallucinations
- respiratory and vasomotor stimulationat
What are the 7 narcotic analgesics to know?
CHOP MMM
- Codeine
- Hydromorphone/Dilaudid
- Oxycodone/Roxicodone
- Pentazocine
- Morphine
- Meperidine/Demerol
- Methadone
What are narcotic analgesics derived from?
- opium
2. synthetic chemicals similar to opium
What can all narcotics produce with chronic use?
- tolerance
2. dependency
What list are narcotic analgesics typically on?
2 and 3 - highly addictive BUT medically useful
What is an appropriate use for narcotic analgesics?
Moderate to severe pain
How do narcotic analgesics relieve severe pain?
by acting on the CNS to:
- reduce anxiety
- reduce reaction/response to pain
What do narcotic analgesics NOT interfere with?
PNS periphery sensory nerves
To obtain full effect, when should narcotics be given?
before onset of pain
How do narcotic analgesics control different degrees of pain?
By stimulating different opioid receptors
What are the pharmacological effects of narcotics on the CNS?
- euphoria
2. dysphoria
What do narcotic analgesics do to the CNS?
- alter mental mood/behavior
2. alter mental alertness
What can low doses of narcotic analgesics cause?
stimulation of the CTZ making you naseous
note high doses do not
What are some other SE of narcotic analgesics?
Respiratory Depression Anti-tussive Properties Toxicity Produces mostly miosis *exception = Meperidine = mydriasis Increase smooth muscle tone/GI spasm Inhibit parasympathetic *constipation Decrease urinary formation/frequency
What are the 2 clinical indications for the use of narcotic analgesics?
- moderate to severe acute or chronic pain
2. before surgery to help induce anesthesia
What is a narcotic antagonist?
A drug that blocks or competes for the same opioid receptor as a narcotic agonist
What are narcotic antagonist drugs reserved for?
- life threatening respiratory depression
2. narcotic poisoning
What are the 2 types of narcotic antagonist?
- Pure Narcotic Antagonist
2. Partial Narcotic Antagonist
How does the Pure Narcotic Antagonist work?
It competes for the opioid receptor site and completely blocks WITHOUT any agonist interaction - hence NO respiratory depression
How does the Partial Narcotic Antagonist work?
It competes for the opioid receptor site and partially blocks with minor agonist effects and can reverse respiratory depression since it has little effect
What is a Pure Narcotic Antagonist?
Naxolone/Narcan
What is a Partial Narcotic Antagonist?
Pentazocine
Which drug is the “prototype” drug for all narcotics?
Morphine
Which drug is typically used as an anti-tussive?
Codeine
Which drugs is used to wean patients off heroin?
Methadone
What is pentazocine?
a narcotic and a narcotic ant agonist used to wean people off addiction to narcotics with milder withdrawal symptoms than straight cold
What are SE and ADVERSE effects of narcotics?
- N/V
- Mental Confusion
- Constipation
- Urinary Retention
- Tolerance/Dependency
- Dysphoria
- Respiratory Depression