Negative Consequences of Opioid use

Question 1

Range of effects of opioids

Answer 1

> pain to sedatio/respiratory depression/depression/death

Question 2

Side effects of Senna

Answer 2

> irritates the colon

> fluid secretions and colonic contractions

Question 3

Function of Polyethylene glycol(Miralax)

Answer 3

> osmotic increase in GI water content

> stool softener

Question 4

Function of Dioctyl sodium sulfosuccinate

Answer 4

> stool softener

> peristalsis > 400mg/day

Question 5

Peripherally restricted mu opioid antagonist

Answer 5

> methylnaltrexone(Relistor)
alvimopan(entereg)
naloxegol(movantik)
naldemedine

Question 6

Opioid induced pruritis

Answer 6

> opioids release histamine from mast cells
requires MOR1D splice variant
heteromer with gastrin releasing peptide receptor

Question 7

Therapeutic tolerance and side effect tolerance

Answer 7

Analgesic effects
Nausea
Urinary retention
Respiratory depression
Euphoria

Constipation/Itch/Miosis with limited to no tolerance

Question 8

Opioid induced hyperalgesia

Answer 8

> increased dose required
receptor adaptation
decreased receptor number
decreased coupling to effector

Question 9

Hyperalgesia conditions

Answer 9

> compensatory changes
altered excitability of target neurons
NMDA, Cholecystokinin, dynorphin, sub P