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Pharmacology > Opioid 2 > Flashcards

Opioid 2 Flashcards

1
Q

List the agonist model drugs (5)

A
  • morphine
  • methadone
  • hydromorphone
  • fentanyl
  • tramadol
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2
Q

List the 2 agonist-antagonist opioids

A
  • butorphanol
  • buprenorphine
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3
Q

List the only full opioid antagonist

A

Naloxone2

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4
Q

Morphine MOA

A

Mu receptor agonist (new agonist)

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5
Q

PK of morphine

A

Liver metabolism & crosses placenta

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6
Q

Physical effects of morphine

A

Analgesia (primary use), emesis, miosis, decrease GI motility

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7
Q

Therapeutic Indications of Morphine

A

Tx acute pain, anesth. pre-med, antitussive

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8
Q

Adverse effects of morphine

A

Hyperexcitability, hypotension, cerebral hemorrhage, edema

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9
Q

What type of opioid is methdone

A

Synthetic

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10
Q

MOA of methadone

A
  • Mu receptor agonist
  • NMDA antagonist (good for deep nerve pain)
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11
Q

Physical effects of methadone

A
  • slower elimination rate compared to morphine
  • similar analgesic effect as morphine
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12
Q

Therapeutic indications

A
  • pre-med
  • analgesia
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13
Q

Adverse effect

A
  • sedation
  • vomit
  • constipation
  • resp. Depression
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14
Q

Hydromorphone MOA

A

Mu receptor agonist

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15
Q

Hydromorphone potency comparison to morphine

A

5x analgesic potency

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16
Q

Therapeutic indicators for hydromorphone

A

Analgesia, pre-med, anesthetic

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17
Q

Adverse effects of hydromorphone

A

Panting*, bradycard., dose-dependent excitement, cerebral hemorrhage, edema

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18
Q

Why is hydromorphone being increasingly used in vet med? What is it replacing?

A
  • replacing oxymorphone
  • being used b/c oxymorphone is expensive & has availability issues
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19
Q

T or F: Fentanyl is a synthetic opioid

A

True

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20
Q

What are the units used in fentanyl dosing?

A

Mcg

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21
Q

MOA of fentanyl

A

Mu receptor agonist

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22
Q

Pharmacokinetics of fentanyl

A
  • faster onset than morphine
  • shorter duration of action
  • more potent (75-125x)
23
Q

Therapeutic indications of fentanyl (3)

A

Continuous infusion analgesia, K9 inductor, neuropetanalgesia

24
Q

Adverse effects of fentanyl

A

Motor response, panting, pooping, farts, bradycardia, salivation

25
Q

Tramadol is a synthetic analog of…

A

Codeine

26
Q

MOA of tramadol

A

Mu receptor agonist (WEAK), inhibits serotonin & NE uptake

27
Q

Pharmacokinetics for tramadol

A
  • active metabolite: desmethyltramadol
  • exaggerated opiate effects may be seen in cats b/c they can’t glucuronidate
28
Q

Therapeutic indications

A
  • analgesic
  • antitussive in small animals
29
Q

Can tramadol be reversed?

A

Yes, only partially by nalaxone

30
Q

MOA of butorphanol

A
  • high affinity for mu receptors, but no activity
  • high affinity for kappa receptors, moderate agonist activity
  • 4-7x stronger than morphine
31
Q

Is butorphanol an agonist or antagonist?

A

Neither, its an agonist-antagonist

(Both properties)

32
Q

Pharm. effects of butorphanol

A

Analgesia

33
Q

Therapeutic indicators

A

Opioid reversal, analgesic, antitussive

34
Q

What effect does butorphanol’s short duration of activity have on its usage?

A

Limits it (b/c 0.5-6 hrs)

35
Q

Can butorphanol be reversed?

A
  • yes, but it is difficult b/c of its high receptor affinity
36
Q

The most generally useful anlagesic in K9 & cats is

A

Buprenorphine

(30x stronger than morphine)

37
Q

MOA of buprenorphine

A
  • high affinity for mu receptors, but partial agonist
  • kappa receptor antagonist
38
Q

Pharmacokinetics for butorphanol

A

Longer duration of action than other opioids

39
Q

Therapeutic indications for buprenorphine

A
  • analgesia for mild-mod. Pain in small animals
  • cats can have buccal or transmucosal admin.
40
Q

Simbadol

A
  • long acting, SQ buprenorphine
  • cats only
  • lasts 24 hrs; admin SID
  • for surgical pain
41
Q

Zorbium

A
  • transdermal solution
  • for cats
  • lasts for 4 days
  • single, in clinic dose
42
Q

Opiate antagonists are…

A

Pure antagonists; no agonist activity

43
Q

MOA naloxone

A
  • high affinity for mu receptors

(Higher doses reverse DOP and KOP)

44
Q

Pharmacokinetics of naloxone

A
  • short duration of action, so may need repeated admin
45
Q

Therapeutic indications of naloxone

A
  • Reverse opioid induced respiratory depression & shock Tx
  • given IV, IM, IN (if no IN response after 5 mins, repeat)
  • extralabel use in K9 & cats
  • not regulated by CSA
46
Q

Adverse effects of naloxone

A
  • CNS sedation
  • excitement in horses and cats
  • resp. Depression
  • bradycardia
  • sedation
  • contraindicated shock, severe cranial trauma and diseases assc. w/ resp. Compromise
47
Q

Tolerance and dependence of naloxone

A
  • aren’t used long enough in vet med to cause tolerance/depend.
  • if P is on opiates > 5-7 days, then withdrawal signs may be seen after stopping meds
  • DON’T CUT OFF COLD TURKEY, WEAN P OFF OPIOID
48
Q

Schedule I drugs

A

No medical benefit/use

49
Q

Schedule II-IV drugs

A

High to low abuse potential

50
Q

Schedule V drugs

A

Lower potential for abuse compared to schedule IV

51
Q

Most pure opioid agonists (i.e. morphine) are classified as

A

Schedule II

52
Q

Buprenorphine is a Schedule….

A

Schedule III

53
Q

Butorphanol is Schedule…

A

IV

Pharmacology (20 decks)

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