Narcotics Flashcards
Opioid used for severe analgesia, mood alteration, antitussive, sedation and has 2 major active metabolites
Morphine
What are the 2 major metabolites of morphine and which one is more potent?
M6–more potent
M3–little affinity
Opioid used for moderate analgesia and antitussive–metabolized via CYP2D6
Codeine
Which opioid is a weak Mu opioid receptor agonist and causes some NE/5HT uptake inhibition which leads to analgesia?
Tramadol
Strong Mu-opioid receptor agonist that is highly lipid soluble and is used for severe analgesia after identification of dose level via other opioid?
Fentanyl
What two drugs should the dose NOT be changed more than 1/week?
Fentanyl and methadone–due to long half life
Opioid used for chronic, severe pain and for treatment of heroin and opioid addicts
Methadone
Mu-opioid receptor agonist used for moderate to severe analgesia and has an extended release form?
Oxycodone
Oxycontin–ER
Why is meperidine not used?
Active metabolite–normeperidine causes mental status changes and causes seizures
Why is propoxyphene not used?
Active metabolite–norpropoxyphene causes CNS toxicity–has a long t 1/2
What are the two opioid drugs used for diarrhea b/c they slow peristalsis via opioid receptors in the intestine?
Loperamide
Diphenoxylate
What are the common side effects seen with all opioids?
Miosis
Constipation
Respiratory depression
ALSO: Dry mouth N/V Sedation Sweating Dreams Dysphoria Delirium myoclonus Seizures Pruritis Urticaria Urinary incontinence
What is the opioid antagonist used for acute opioid toxicity?
Naloxone
What is the mechanism of action of naloxone?
Competitive mu-, delta, and kappa- opioid receptor antagonist
What opioid antagonist is used for alcoholism and is a mu-opioid receptor antagonist?
Naltrexone
