Opioid Agonist-Antagonists & Antagonists (Exam II) Flashcards
What is the primary indication for opioid agonist-antagonists?
- Used if unable to tolerate full agonist
Name the four advantages of opioid agonist-antagonists.
- Analgesia
- Less respiratory depression
- Low dependence potential
- Ceiling effect (prevents ODing)
How potent is Pentazocine?
- 1/5 as potent as morphine
What receptors does pentazocine bind to?
What type of activity does it exhibit?
- κ & δ receptor partial agonist activity
How is pentazocine excreted?
- Glucuronide conjugates in the urine.
Which opioid agonist-antagonist crosses the placental barrier causing fetal depression?
Pentazocine
What is the chronic pain dose of Pentazocine?
What dose and route would be equivalent to morphine 10mg?
- 10 - 30mg IV or 50 mg PO
- 20-30mg IM = 10mg morphine
Where is butorphanol excreted?
Bile primarily
What receptors does butorphanol bind to?
- κ = analgesia & anti-shivering
- μ (low)
- σ (low)
Sigma (σ) receptors are associated with what side effect?
Dysphoria
2 to 3 mg of butorphanol is equivalent to _____ mg of morphine.
10 mg
By what route is butorphanol rapidly and completely absorbed?
Intramuscular
What drug is an excellent choice for cardiac catheterization patients?
Why?
- Nalbuphine
- No increase in BP, pBP, HR.
What receptors does nalbuphine bind to?
How potent is it?
- μ receptor agonist that is equipotent to morphine.
Which agonist-antagonist has 50 times greater μ receptor affinity than morphine?
Buprenorphine
What is buprenorphine’s onset?
Duration?
- 30min onset
- 8 hour duration
What is buprenorphine’s greatest use?
- Opioid use disorder (has low risk of abuse)
Which two drugs have resistance to naloxone?
- Buprenorphine and Bremazocine.
Which opioid has high incidence of dysphoria and is therefore not utilized clinically?
Nalorphine
Which drugs are pure μ-opioid receptor antagonists?
- Naloxone
- Naltrexone
- Nalmefene