Opiates

Question 1

What are the uses of opiates?

Answer 1

Acute: trauma, burns, perioperative, MI
Chronic: refractory pain, malignancy
Non-analgesic: cough suppression, manage diarrhoea and breathlessness

Question 2

What is the action of opiates?

Answer 2

Bind to opiate receptor (Gi coupled)
Inhibition of adenylyl cyclase
Decreases cAMP
Less influx of Ca2+
Reduced neurotransmitter release
Reduced transmission of nociceptive impulses

Question 3

What are the different types of opiates?

Answer 3

Oral codeine (metabolised to morphine)
Oral tramadol
Morphine 
Fentanyl patch 
Oxycodone (cancer pain/renal failure)

Question 4

List some ADRs for opiates

Answer 4

GI disturbances: Constipation, NV
Respiratory depression
Confusion and reduced conscious level
Constricted pupils