Opiods

Question 1

four major opioid effects

Answer 1

analgesic, resp depresion, sedation or euphoria (NOT amnesia), miosis

Question 2

for which effects is there no tolerance

Answer 2

miosis and constipation (not n&v)

Question 3

describe how opioids affect gi tract

Answer 3

slow peristalsis via direct action. Nausea/vom via CNS

Question 4

what drugs make opioids more sedative

Answer 4

benzodiazapene and barbiturates

Question 5

symptoms of opioid withdrawl

Answer 5

sympathetic overdrive except diarrhea (withdrawl is not via Symp NS)

Question 6

Treatment for opiod OD

Answer 6

naloxone

Question 7

agonist/antagonist

Answer 7

nalbuphine. Agonist at kappa, mu antagonist

Question 8

two metabolites of morphine

Answer 8

M3G and M6G. M6G is the active one. Both cleared by kidney. Crosses into CNS in kidney failure.

Question 9

Dilaudid

Answer 9

hydromorphone. morphine but w/o metabolites.

Question 10

codeine

Answer 10

prodrug metabolized to morphine.

Question 11

Hydrocodone

Answer 11

weak opioids (schedule 3) so you can phone in. Only with tylenol

Question 12

oxycodone

Answer 12

like codiene but parent drug is active

Question 13

fentanyl

Answer 13

very fast onset (via IV). Very lipophilic. Can be used in patch (has to build up sub q). Pathc is NOT FOR ACUTE PAIN

Question 14

Fentanyl lollipop

Answer 14

NOT FOR chronic pain. fast on fast off.

Question 15

Meperidine

Answer 15

demorol. Lipophilic, fast onset. metabolite: normeperidine cleared by kidneys. If kidneys are compromised you get SEIZURES

Question 16

methodone

Answer 16

T1/2 of 24 hrs. Full effect not seen for 5 days

Question 17

Tramadol

Answer 17

non-scheduled. Prodrug. Metabolite is mu agonist. Blocks reuptake of serotonin and NE.

Question 18

what are the three receptors and how are they coded for. Where are they located?

Answer 18

Mu, Kappa, Delta. One gene for each. Subtypes from splice variants. Brain, spinal cord, gi tract

Question 19

on what fibers do opioids work

Answer 19

Not touch or motor, just nociceptors. Binds presynaptically on c fibers

Question 20

half lives of the drugs

Answer 20

everything is about 2-3 hrs except methadone

Question 21

When would you use agonist/antagonist

Answer 21

not for acute pain. lessens sedation/nausea without completely withdrawing euphoria