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therapeutics 2 > non-malignant pain Opioids > Flashcards

non-malignant pain Opioids Flashcards

1
Q

opioid antagonist

A

nalaxone

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2
Q

opioid weak agonists

A

codeine
tramadol

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3
Q

opioid full agonist

A

morphine
hydrocodone
hydromorphone
oxycodone
merperidine
fentanyl
methadone

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4
Q

s/sxs of opioid overdose

A

sedation
loss of consciousness
pinpoint pupils
decreased respiratory rate
bradycardia
hypotension
pale/clammy skin

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5
Q

s/sxs of opioid withdrawal

A

insomnia/agitation
dilated pupils
increased respiratory rate
tachycardia
hypertension
sweating

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6
Q

when does opioid withdrawal onset and how long

A

short acting: 8-24 hours and lasts 4-10 days
long acting: 12-48 hours and lasts 10-20 days

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7
Q

withdrawal treatment

A

clonidine
buprenorphine
methadone

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8
Q

opioid side effects

A

antitussive
constipation
N/V
itching
hypotension
urinary retention
sedation
respiratory depression

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9
Q

opioid clinical pearls

A

consider laxative/stool softener
potential for tolerance/addiction
schedule II

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10
Q

codeine schedule

A

V, III, or II depending on strength

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11
Q

codeine metabolism

A

metabolized to morphine via CYP2D6
poor metabolizers will get no effect from codeine

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12
Q

who should avoid codeine

A

breastfeeding mothers
under 12
Ultra rapid metabolizers

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13
Q

tramadol risks

A

serotonin syndrome

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14
Q

when should tramadol be adjusted

A

renal

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15
Q

tramadol boxed warning

A

CYP3A4 inducers, inhibitors, and 2D6 inhibitors should be used cautiously with tramadol

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16
Q

tramadol scheduling

A

IV

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17
Q

tramadol brand

A

ultram

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18
Q

morphine formulations

A

Capsule ER
tablet IR and ER
oral solution
injection
suppository

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19
Q

morphine major side effect

A

itching

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20
Q

How is morphine excreted?
When to avoid morphine?

A

renally excreted
avoid in CKD or AKI

21
Q

morphine boxed warning

A

avoid alcohol while taking ER capsules

22
Q

Hydromorphone brand

A

dilaudid

23
Q

hydromorphone formulations

A

IR and ER tablets
oral solution
injection
suppository

24
Q

hydromorphone boxed warning

A

dosing errors with different formulations

25
Q

hydrocodone + APAP brand

A

norco, lortab, vicodin

26
Q

hydrocodone + APAP formulation

A

oral solution
er tab
tablet

27
Q

hydrocodone + apap counseling

A

APAP use and max dose

28
Q

hydrocodone + apap boxed warning

A

use with cyp 3A4 inhibitors may increase plasma concentrations

29
Q

oxycodone brand

A

oxycontin, xtampza, percocet (+APAP)

30
Q

oxycodone formulations

A

tablet
capsule
solution
NO IV

31
Q

oxycodone boxed warning

A

use with cyp3A4 inhibitors may increase oxycodone concentrations

32
Q

fentanyl brand

A

duragesic

33
Q

fentanyl formulations

A

buccal tablet
SL liquid
lozenge
solution
patch

34
Q

what is the fentanyl patch most preferred for

A

chronic pain

35
Q

boxed warning fentanyl

A

CYP3A4 inhibitors or inducers

36
Q

when should fentanyl patch dosing table not be used

A

conversion from transdermal fentanyl to other opioids

37
Q

fentanyl patch counseling

A

apply 1 patch every 72 hours
apply to chest, back, flank, or upper arm
do not cut patch
do not let patch get too warm

38
Q

methadone uses

A

last line for chronic pain
opioid detoxification

39
Q

methadone boxed warning

A

QTc prolongation
cyp3A4 inhibitor or inducer

40
Q

methadone half life

A

8-59 hours

41
Q

who should avoid meriperidine

A

elderly
renal impairment
hepatic impairment

42
Q

what are the natural opioids

A

morphine
codeine

43
Q

what are the semi synthetic opioids

A

hydromorphone
oxycodone
oxymorphone
hydrocodone
buprenorphine

44
Q

what are the synthetic opioids

A

fentanyl
methadone
meperidine
tramadol

45
Q

cross reactivity with natural opiates

A

yes

46
Q

cross reactivity with semi synthetic opiates

A

yes

47
Q

cross reactivity with synthetic opiates

A

no

48
Q
A

therapeutics 2 (24 decks)

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