Opioid Analgesics

Question 1

What are the 3 major receptor families for opioids?

Answer 1

mu, kappa, delta

Question 2

What is the prototype u-agonist?

Answer 2

morphine

Question 3

What are the contraindications to using opioids?

Answer 3

head injury (possible increased intracranial pressure)

pulmonary dysfunction (except pulmonary edema)

hepatic/ renal dysfunction (possible accumulation)

adrenal or thyroid deficiencies (exaggerated responses)

pregnancy (possible neonatal depression or dependence) except meperidine

Question 4

Why is meperidine not an opioid that is contraindicated in pregnancy?

Answer 4

it does not inhibit uterine contractions in delivery and causes less respiratory depression in the newborn

Question 5

Seizures caused by meperidine cannot be treated with what drugs? What drugs should they be treated with?

Answer 5

can’t be treated with opioid antagonists

USE benzos

Question 6

What is Suboxone a combination of?

Answer 6

buprenorphine and naloxone

Question 7

Suboxone indication?

Answer 7

opiate addiction

Question 8

Indications for use of morphine?

Answer 8

analgesia

sedation

cough suppression has some antitussive action

Question 9

You should be careful in using morphine in patients with what dysfunction?

Answer 9

renal dysfunction

Question 10

S/E of opioid analgesics.

Answer 10

CPR

coma

pinpoint pupils

respiratory depression

Question 11

Management of acute toxicity of opioids should be done with what drug?

Answer 11

IV naloxone

Question 12

Withdrawal symptoms of opioids?

Answer 12

yawning

lacrimation, rhinorrhea, salivation

anxiety, sweating, goose bumps

muscle cramps, spasms, CNS-originating pain

Question 13

How manage the withdrawal symptoms from opiate use?

Answer 13

methadone, clonidine

Question 14

Loperimide indication.

Answer 14

diarrhea

Question 15

Dextromethorphan indication?

Answer 15

cough

Question 16

Name some full agonist opioids and a few characteristics?

Answer 16

meperidine, methadone, codeine

antimuscarinic properties (meperidine) (no miosis)
tachycardia

used in maintenance of opiate addiction (methadone)

codeine
cough suppressant
used in combination with NSAIDs

Question 17

What is an opioid that acts as a partial agonist at the opioid receptor?

Answer 17

buprenorphine

Question 18

Buprenorphine S/E?

Answer 18

precipitation of withdrawal

Question 19

What are the opioids that act as antagonists at the mu receptors?

Answer 19

naloxone, naltrexone, methynaltrexone

Question 20

Indication Nalbuphine and MOA? What is a caution you should note when prescribing this drug?

Answer 20

k agonist and mu antagonist for spinal analgesia and dysphoria

Can precipitate withdrawal.

Question 21

Indication for pentazocine and MOA? What is a caution to note when prescribing this drug?

Answer 21

k agonist and mu antagonist; spinal analgesia, dysphoria

can precipitate withdrawal

Question 22

Naloxone indication?

Answer 22

reversal for Respiratory depression

Question 23

Naltrexone ROA and indication?

Answer 23

PO, reduce craving for alcohol and used in opiate addiction

Question 24

Methylnaltrexone indication.

Answer 24

treatment of opioid induced constipation

Question 25

Does methylnaltrexone cross the BBB?

Answer 25

no

Question 26

Does methylnaltrexone precipitate withdrawal?

Answer 26

no