Opioid Analgesics Flashcards
Morphine side effects
DEPRESSION OF COUGH D/T RESP. DEPRESSION
nausea d/t increased vestibular sensitivity
decreased gastric motility and some constipation
anorexia
nausea
vomiting
sweating
dizziness
sedation
may cause renal failure and acute pancreatitis
Opioid side effects
exocrine effects - release of gonadotropin releasing hormone (lowers LH, testosterone, stimulates release of ADH) miosis euphoria itchiness tonerance physical dependence
Opioid drug interactions
Sedative hypnotics -increased CNS depression (esp resp)
TCAs and Antipsychotic drugs - increase sedation, variable effects on resp depression
CI: MAOI (high incidence of hyperpyrexic coma)
Fentanyl Absorption
highly lipophilic- good abs. through nasal or buccal mucosa, transdermally and BBB
80-90% plasma protein bound
Morphine Absorprtion
extensive first pass effect
30% plasma protein bound
Fentanyl Distribution
Rapid onset
7-15 min oral
12-17 hrs transdermal
Short duration
12 hrs orally
72 hrs transdermal
Morphine Distribution
Slow onset b/c hydrophilic
15-60 min
Long duration
3-6 hrs
Fentanyl Biotransformation
90% metabolized in liver to active metabolite
Morphine Biotransformation
metabolized in liver to less polar, more active metabolite
Which is stronger, Fentanyl or Morphine?
Fentanyl is 100x stronger. It is the most effective opiate analgesic
Which is more selective for Mu receptors, Fentanyl or Morphine?
Fentanyl
Which is stronger Morphine or Codein?
Morphine, codeine is 1/6 the strength
Codeine distribution
30% plasma bound
Codeine distribution
lipid-soluble, faster onset than morphine
What are the mu opioids?
Morphine Hydromorphone (Dilaudid) Codeine Oxycodone (percocet/ oxycontin/ oxyIR) Hydrocodone (vicodin / Lortab) Meperidine (demerol)
