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Pharm 3 > Opiates > Flashcards

Opiates Flashcards

1
Q

Define acute pain

A

short term with easily identifiable cause- warning of damage or disease by body, has physio purpose

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2
Q

Define chronic pain

A

persists longer than should, constant or intermittent but outlives purpose

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3
Q

Name 5 types of pain

A

Acute, chronic, neuropathic, visceral, somatic

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4
Q

Nociception

A

ability to perceive pain

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5
Q

Analgesia

A

loss of sensitivity to pain without loss of consciousness

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6
Q

Hyperalgesia

A

Increased response to painful stimuli when tissue already damaged

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7
Q

Allodynia

A

Pain caused by stim that wouldnt normally cause

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8
Q

Physio changes in pain (5)

A

CV (increased symp), HPA stress response, hyperglycemia (increased glycogenolysis), ileus (reduced GI), reduced immune function (wound healing)

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9
Q

What drugs are antitussive

A

Codeine and butorphanol

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10
Q

What drug is an emetic

A

hydromorphone

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11
Q

Three types of analgesics

A

Block transduction, block trasmission in sensory nerves, block/change transmission in spinal pathways (perception)

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12
Q

Which analgesic drugs block transduction

A

NSAIDs

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13
Q

Which analgesic drugs block transmission

A

Locals

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14
Q

Which analgesic drugs block spinal transmission/alter perception

A

Opioids, A2Agonsits, NMDAs, NSAIDs, locals

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15
Q

A2Agonists, NMDAs and opioids all work on ____ sites of action

A

CNS and spinal

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16
Q

Cannabinoids work at what site of action

A

CNS

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17
Q

NSAIDS work at what sites of action

A

Spinal cord and peripheral

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18
Q

What are the three receptors

A

delta, kappa, mu (OP1,2,3)

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19
Q

What is the ceiling effect

A

Dose at which no effects can be produced anymore

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20
Q

Receptors, which do dogs have many of? which do horses have many of?

A

Dogs- mu, horses- K

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21
Q

What systems are effected by the pharmacological actions of opioids

A

CNS (analgesia, mood, sedation, RR, nausea/vomiting), GI- constipation; CV- bradycardia, hypotension

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22
Q

Describe the effect of opioid analgesia at teh spinal cord

A

Hyperpolarization of neural cells via increased K activity

23
Q

What are the two levels of action of CNS analgesia

A

Spinal cord- modulation of substance P and supraspinal decreased affective pain response (fear/anxiety)

24
Q

Which receptor provides the most analgesia

A

mu

25
Q

Which species experience myosis

A

dogs, primates

26
Q

Which species experience mydriasis

A

small ruminants, cows, horses

27
Q

How is ventilation depressed in opioid analgesia

A

Depressed PCO2 sensitivity in brainstem

28
Q

How can ventilatory depression be reversed

A

Naloxone

29
Q

What can reverse CV effects of opioids

A

Anti-cholinergic agents (to increase HR and BP)

30
Q

What receptors does morphine act on

A

Mu- full agonist

31
Q

Describe solubility and BBB of morphine

A

Low lipid solubility, low BBB

32
Q

Morphine- metabolism

A

Glucuronic conjugation into M6G and M3G

33
Q

Why is morphine less effective in cats

A

Less glucuronidation

34
Q

What is the potency 1 prototype for all opioid receptor classes

A

Morphine

35
Q

Side effects- morphine

A

Vomiting

36
Q

Butorphanol- type

A

Agonist-antagonist (K, mu)

37
Q

What drug can preserve analgesia and still reverse mu agonists

A

Butorphanol (k-ag, mu-antag)

38
Q

What drug is best for patients with cardiac or respiratory issues

A

Butorphanol - less CV and respiratory depression

39
Q

What drug is best in horses and ruminants

A

Butorphanol

40
Q

What type of drug is buprenorphine

A

Partial mu agonist

41
Q

Level of analgesia- morphine

A

moderate to high

42
Q

Level of analgesia- butorphanol

A

mild

43
Q

Level of analgesia- buprenorphine

A

mild to moderate

44
Q

Advantages of buprenorphine

A

High bioavailability

45
Q

What type of drug is naloxone

A

Full antagonist

46
Q

Fentanyl - type

A

Opioid agonist

47
Q

Fentanyl- potency

A

100x more than morphine (dosing 100x less)

48
Q

Better CV drug - morphine or fentanyl - why

A

Fentanyl bc less histamine release

49
Q

Meperidine- type

A

mu agonist

50
Q

What drug is best in geriatric and young patients

A

Meperidine

51
Q

What drug is the only opioid to cause increased HR

A

Meperidine ( like atropine)

52
Q

Describe neuroleptanalgesia

A

Combination of analgesic with sedative (ex. alpha-2 agonist with phenothiazines)

53
Q

Which drug has a short half life compared to others

A

Naloxone

Pharm 3 (8 decks)

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