Opiates

Question 1

Opiate receptors

Answer 1

mu, kappa, delta

Question 2

Behavioral effects of opioids

Answer 2

euphoria, dysphoria, sedation/lethargy/confusion, behavioral excitation

Question 3

Most dangerous side effect of opiates

Answer 3

respiratory depression
- primary cause of opioid-induced death, respiratory function depressed at analgesic doses, due to decrease in sensitivity to CO2 in brain stem respiratory centers
(increase blood CO2–>central vasodilaiton, vasodilation can exacerbate head injury, opioid drugs contraindicated in case of suspected head injury, use them with caution in any compromised respiratory function)

Question 4

Opioid actions in brainstem

Answer 4

respiratory depression, nausea/vomiting, cough suppression, pupillary constriction

Question 5

opioid effects on smooth muscle

Answer 5

GI - constipation, increased billiarypressure – constriction of sphincter of oddi, increased tonus/contraction in ureter/bladder (retention of urine)

Question 6

opioid allergy

Answer 6

rare; usually symptoms resembling mild allergy, can sometimes exacerbate asthmatic symptoms, peripheral vasodilation and decreased BP

Question 7

opioid CV effects

Answer 7

Minimal at therapeutic doses

• some therapeutic uses of opioids in CV therapy (MI)
• therapeutic use of opioids in pulmonary edema associated with cardiac dysfunction

Question 8

contraindications of opioid use

Answer 8

Respiratory dysfunction (emphysema, asthma, sleep apnea, severe obesity), pathological (head injury, hypotensive, shock, histamine release) impaired hepatic function, hypothyroidism

Question 9

Important drug interactions

Answer 9

Barbituates( additive/synergistic CNS depression)

• Phenothiazines (antipsychotics)
• MAO inhibitors/Tricyclic antidepressants