Opioid Analgesics Flashcards
What are the 3 major receptor families for opioids?
mu, kappa, delta
What is the prototype u-agonist?
morphine
What are the contraindications to using opioids?
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
Why is meperidine not an opioid that is contraindicated in pregnancy?
it does not inhibit uterine contractions in delivery and causes less respiratory depression in the newborn
Seizures caused by meperidine cannot be treated with what drugs? What drugs should they be treated with?
can’t be treated with opioid antagonists
USE benzos
What is Suboxone a combination of?
buprenorphine and naloxone
Suboxone indication?
opiate addiction
Indications for use of morphine?
analgesia
sedation
cough suppression has some antitussive action
You should be careful in using morphine in patients with what dysfunction?
renal dysfunction
S/E of opioid analgesics.
CPR
coma
pinpoint pupils
respiratory depression
Management of acute toxicity of opioids should be done with what drug?
IV naloxone
Withdrawal symptoms of opioids?
yawning
lacrimation, rhinorrhea, salivation
anxiety, sweating, goose bumps
muscle cramps, spasms, CNS-originating pain
How manage the withdrawal symptoms from opiate use?
methadone, clonidine
Loperimide indication.
diarrhea
Dextromethorphan indication?
cough
Name some full agonist opioids and a few characteristics?
meperidine, methadone, codeine
antimuscarinic properties (meperidine) (no miosis)
tachycardia
used in maintenance of opiate addiction (methadone)
codeine
cough suppressant
used in combination with NSAIDs
What is an opioid that acts as a partial agonist at the opioid receptor?
buprenorphine
Buprenorphine S/E?
precipitation of withdrawal
What are the opioids that act as antagonists at the mu receptors?
naloxone, naltrexone, methynaltrexone
Indication Nalbuphine and MOA? What is a caution you should note when prescribing this drug?
k agonist and mu antagonist for spinal analgesia and dysphoria
Can precipitate withdrawal.
Indication for pentazocine and MOA? What is a caution to note when prescribing this drug?
k agonist and mu antagonist; spinal analgesia, dysphoria
can precipitate withdrawal
Naloxone indication?
reversal for Respiratory depression
Naltrexone ROA and indication?
PO, reduce craving for alcohol and used in opiate addiction
Methylnaltrexone indication.
treatment of opioid induced constipation
Does methylnaltrexone cross the BBB?
no
Does methylnaltrexone precipitate withdrawal?
no
