Opioid Agonists-Antagonists

Question 1

if a pt has pure opioid agonist intolerance we can give them

Answer 1

opioid agonist-antagonists

Question 2

a-a’s have partial to no effect on these receptors

Answer 2

mu

Question 3

a-a’s have partial effects here causing dysphoria

Answer 3

kappa and delta

Question 4

advantages of using a-a’s

Answer 4

analgesia, decreased physical dependence, decreased RD, and ceiling effect

Question 5

pentazocine has agonist effects on _____ and ______ and has weak _______ effects

Answer 5

kappa and delta; antagonist

Question 6

due to some antagonism, pentazocine may cause

Answer 6

withdrawal symptoms

Question 7

pentazocine has extensive

Answer 7

hepatic first pass effect (80%)

Question 8

e 1/2 time of pentazocine

Answer 8

2-3 hours

Question 9

excretion of pentazocine

Answer 9

kidneys; glucoronidation

Question 10

pentazocine has a shorter duration than morphine in

Answer 10

epidurals

Question 11

common s/e of pentazocine

Answer 11

sedation, sweating, dizziness, and dysphoria; catecholamine release causing increases in hr, bp, PA bp, and LVEDP

Question 12

pentazocine crosses the _____ barrier

Answer 12

placental

Question 13

high doses of pentazocine may cause

Answer 13

feeling of impending death

Question 14

pentazocine may be used for

Answer 14

moderate chronic pain relief

Question 15

butorphanol is more potent than

Answer 15

pentazocine

Question 16

butorphanol affinities? what will this cause?

Answer 16

low mu, low sigma, moderate kappa; less dysphoria and more analgesia and anti shivering effects

Question 17

we have rapid and complete absorption when we give butorphanol

Answer 17

IM

Question 18

butorphenol e 1/2 time

Answer 18

2.5-3.5 hours

Question 19

butorphanol elimination

Answer 19

more in bile than urine

Question 20

unique s/e of butorphenol

Answer 20

sweating, still has dysphoria

Question 21

caution with butorphenol

Answer 21

difficult to use with other opioid agonists

Question 22

nalbuphine is equally potent to

Answer 22

morphine

Question 23

nalbuphine is a ___ agonist

Answer 23

mu

Question 24

e 1/2 time of nalbuphine

Answer 24

3-6 hours

Question 25

unique cv trait of nalbuphine

Answer 25

great for cardiac cath patients d/t no cv effects

Question 26

nalbuphine has ____ s/e than the other opioid agonists/antagonists

Answer 26

less

Question 27

buprenorphine has a ___x greater effect on ____ receptors than morphine

Answer 27

50; mu

Question 28

onset of buprenorphine

Answer 28

30 mins

Question 29

buprenorphine has a prolonged resistance to

Answer 29

naloxone

Question 30

duration of buprenorphine

Answer 30

8 hours

Question 31

uses of buprenorphine

Answer 31

post op, cancer, renal colic, MI; epidural

Question 32

unique s/e of buprenorphine

Answer 32

pulmonary edema

Question 33

nalorphine is not used clinically because of it’s

Answer 33

high incidence of dysphoria with sigma receptors

Question 34

naloxone may not be effective in reversing

Answer 34

bremazocine

Question 35

dezocine has no

Answer 35

cv effects

Question 36

meptazinol acts selectively on

Answer 36

mu1 receptors