Opiates Flashcards
Pure Opioid Antaganists
Naloxone
Naltrexene
Nalmefene
Mixed Opioid Agonist-Antagonists
Buprenorphrine - mu agonist, kappa antagonist
Nalbuphine - kappa agonist, mu antagonist
- bumuka
- nakama
Opioid Agonists
Morphine
Methadone
Fentanyl
Meperidine
Hydromorphone
Oxycodone
Sufentanil, alfentanil, remifentanil
Antitussives
Dextromethorphan
Codeine, Levopropoxyphene
Other Analgesics Used in Moderate Pain
Tepentadol
Tramadol
Endogenous opioid peptides
Dynorphin
Enkephalin
Endorphin
Natural opium alkaloid
Morphine
- prototype opioid agonist, comes from opium which is obtained from the poppy of Papaver somniferous and P.album.
- other naturally occurring alkaloids include:
Codeine, Thebaine, and papaverine
Oldest opioid with mixed receptor actions.
Pentazocine
The major analgesic opioid receptr
mu receptor
Adverse Effects of opioid analgesics as seen in addicts can lead to:
hyperalgesia
Adverse effects with chronic use of opioid analgesics
hypogonadism, immunosuppression, increased feeding, increased growth hormone secretion, withdrawal effets, tolerance, dependence, abuse, addistion, hyperalgesia, impairment while driving
Adverse effects with acute use of opioid analgesics
respi depression, N/V, pruritus, urticarial, constripation, urinary retention, delirium, sedation, seizure, myoclonis
Tramadol Toxicity
Serotonin Syndrome
inc. seizures, devt serotonin syndrome, nausea, dizziness
This occurs when repeated doses of opioids have a diminishing analgesic effect
tolerance
Strong agonist opioid assoc with QT- based cardia arrhythmias
methadone
Effect of heroin intake by the mother during pregnancy to her baby include
shrill crying, irritability, diarrhea, seizures
This over-the-counter opioid containing cold/cough medicine was banned in children below 6 yo because of reports of death
dextromethorphan
used in sedating mammals like elephants
Carfentanil (extremely potent analog used in veterinary esp in malalaking animals)
tx for post operative ileus ff bowel rsection surgery
alvimopan
maintenance drugs for addics in treatment programs
naltrexone
tx for constipation in pt with late stage advanced illness
Methylnaltrexone bromide
tx for acute opioid overdose
naloxone
phenylpiperidine derivative opioid used to control diarrhea due to action on peripheral mu-opioid receptpr and lack of effect on the CNS receptors
loperamide
diphenoxylate also indicated for diarrhea
detox of heroin dependent addict
methadone
maintenance drugs for addics in treatment programs
naltrexone
contraindicated for opiates
increased ICP
pregnancy,
impaired pumo/hepatic/renal function, endocrine dse,
combi use of pure agonist with weak partial agonist
opioids inhibit the release of
luteinizing hormone
opioid with most pronounced anti-shivering properties
thru alpha-2 adrenoreceptors
meperidine
drug group that is relative contraindication to al opioid analgesics because of high incidence of hyperpyrexic coma
monoamine oxidase inhibitors
this long acting phenanthrene derivative opioid available in transdermal patch preparations is both a partial mu receptor agonist and an antagonist at the kappa and delta receptors
buprenorphine
when starting an opiod therapy…
a. start with the highest dose of opioid
b. establish a therapeutic goal before starting
c. multiple prescribing physicians are recommended
d. early refills are beneficial
b
tx for pt with dyspnea from pulmonary edema assoc with left ventricular HF
morphine
opioid available in nasal formulation
butorphanol
