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MD4001 Drugs > Opiods > Flashcards

Opiods Flashcards

1
Q

what is an opiod?

A

any substance (natural or synthetic) that
produces morphine like effects which are
blocked by a morphine antagonist
(e.g. naloxone)

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2
Q

name some strong opiods

A 
morphine 
diamorphine 
oxycodone
fentanyl 
pethidine
remifentanil 
methadone
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3
Q

name some weak opiods

A

codeine
dihydrocodein
tramadol
loperamide

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4
Q

what is the oral bioavailability of morphine

A

30%

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5
Q

what is the oral bioavailability of oxycodone

A

70%

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6
Q

what are the sites of action of opiod receptors

A

Mu
kappa
delta
nociception opiod receptor

the most important one for analgesia is Mu

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7
Q

what is the antagonist of opioids

A

naloxone

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8
Q

what is the parenteral dose of morphine

A

10mg

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9
Q

what is the standard oral dose of morphine

A

30 mg

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10
Q

what is step 1 of the analgaesic ladder

A

NSAIDS

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11
Q

what is step 2 of the analgaesic ladder

A

weak opiods plus NSAID

+- adjuvant

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12
Q

what is step 3 of the analgaesic ladder

A

strong opioids plus NSAID
oral/transdermal patch

e.g. methadone

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13
Q

what is step 4 of the analgaesic ladder

A

nerve block, epidural, PCA pump, spinal stimulators

plus NSAID

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14
Q

what are the principles of pain medication administration

A

drug by mouth if possible

give the drug ‘by the clock’ i.e. give it regularly

have a dose ready for breakthrough pain

go up the ladder in a stepwise fashion (adding in on top)

personalize to the patient

anticipate side effects of the drug

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15
Q

what is opium

A

extract from poppy

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16
Q

what is an opiate

A

naturally occurring opioid

17
Q

what should you consider when thinking about drugs

A 
what class is it
how is it given 
what is the MOA
what are its uses
how is it metabolized
what are the effects on body systems
is there anything else to know 
what is the duration of action 
what is the potency
18
Q

what is the ceiling effect of weak opioids

A

increasing the dose does not improve analgesic effect

19
Q

what is a problem with using morphine

A

low bioavailability so usually not given orally

20
Q

what is diamorphine

A

heroin

crosses the BBB so open to abuse

21
Q

what are effects of loperamide (immodium)

A

very low oral bioavailability
used as a constipator
is an opioid

22
Q

what is PCA

A

patient controlled analgaesia

23
Q

what are the endogenous opioids

A

endorphins, encephalins and dynorphins

24
Q

how do opioids affect the pupils

A

pinpoint pupils

25
Q

what are some side effects of opioids

A 
euphoria
sedation 
decreases respiratory rate
(should not fall below 8 per minute)
stops people coughing (anti tussive) 
morphine: release of histamine (bronchoconstriction and vasodilation) be careful in asthmatics 
decreases heart rate 
affects SAN and sympathetic drive 
constipation- so prescribe a laxative/ stool softener (myenteric plexus) 
nausea and vomiting (CTZ, vestibular apparatus, slow gut motility) 
urticaria, itch 
urinary retention 
may impact kidneys 
increased ADH
decreases immunity
26
Q

why might morphine cause a decrease in blood pressure

A

histamine combined with decrease sympathetic innervation to the heart

27
Q

what is naltrexone

A

reverses the effects of opioids and used in opioid dependence

28
Q

what is methadone

A

long acting opioid

29
Q

what is a common side effect of methadone

A

tooth decay

dries up secretions, gives munchies and is administered in a thick glucose syrup

30
Q

what are the features of a controlled drug prescription

A 
specify the form of  the preparation 
(tabs or caps)
specify the dose to be taken 
give the strength of the preparation 
enter the total quantity in both words and figures 
signed and dated by prescriber

MD4001 Drugs (10 decks)

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