Opioid Analgesics Flashcards

0
Q

How do opiates and opioids differ?

A

And opiate is derived from the poppy while an opioid is a general term that refers to things that bind opioid receptors

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1
Q

Where is the periaqueductal gray?

A

The midbrain

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2
Q

What is a Narcotic?

A

A legal term
Technically means sleep inducing
Opioids

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3
Q

What is the primary receptor for analgesia?

A

Mu (u)

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4
Q

What are some effects of Mu stimulation?

A

Analgesia
Respiratory depression
Constipation
Physical dependance

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5
Q

What is the kappa receptor?

A

Another opioid receptor
Analgesia
Sedation
Constipation

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6
Q

What receptor is responsible for modulating Mu activity?

A

Delta receptor

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7
Q

What triggers Mu receptors?

A

Endorphins

Endomorphins

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8
Q

What receptor do enkephalins trigger?

A

Delta receptors

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9
Q

What do dynorphins trigger?

A

Kappa receptors

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10
Q

What are opioid receptors coupled to?

A

G coupled receptors

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11
Q

What are two important outcomes of opioid receptor activation?

A

Inhibited calcium channels

Increased K channels efflux

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12
Q

What do opioids eventually do?

A

Inhibits presynaptic and post synaptic transmission

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13
Q

What is inhibited by opioids in the presynaptic neuron?

A

Calcium channels thereby blocking release of glutamate and substance p

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14
Q

What other pain meds act at calcium channels?

A

Gabapentin - blocks calcium channels

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15
Q

How do opioids inhibit the postsynaptic neuron?

A

By increase K concentration causing hyperpolarization

16
Q

Where is the primary area for opioid action?

A

Spinal cord but also in the thalamus and periphery

17
Q

What is main area of inhibition by opioids in the descending pathway?

A

The interneuron

18
Q

What does opioid receptor activation do to the interneuron in the descending pathway?

A

Opioid activation blocks release of GABA

Indirect activation of the descending pathway

19
Q

What does GABA do?

A

Inhibits the descending pathway

20
Q

What are some examples of opioid receptor agonists?

A

Morphine (Mu and Kappa)
Methadone
Oxycodone
Heroin

21
Q

What are some opioid receptor antagonists by competition?

A

Naloxone

Naltrexone

22
Q

What are some examples of opioid r partial agonist?

A

Codeine

By Mu

23
Q

What does Pentazocine do?

A

Agonist at kappa

Antagonist at Mu

24
Q

What does Buprenophine do?

A

Partial Mu agonist and antagonist of the others

Often used with naloxone

25
Q

What is the bad part of oral opioids?

A

First pass metabolism

26
Q

What is a common buccal drug?

A

Fentanyl lollipop

27
Q

What oral opioid is not affect much by first pass metabolism?

A

Methadone

28
Q

What is most lipid soluble opioid?

A

Heroin

29
Q

What area is associated with opioid euphoria?

A

Cortex

30
Q

What area of the brain is associated with opioid respiratory depression, nusea, and bad thermoregulation?

A

The medulla

31
Q

What do opioids affect when they give bradycardia and increased GI tone?

A

The vagus nerve

32
Q

What does Imodium do?

A

Does not cross the BBB so it just relieves diarrhea

33
Q

What are some side effects of opioids?

A
Prolongs labor
Constipation
Bronchial constriction
Histamine release
Difficult urinating
34
Q

What can be used for opioid overdose?

A

Naloxone
Short duration
Can relapse
Injection to avoid first pass

35
Q

What is used for opioid addiction?

A

Naltrexone

Also alcohol addiction

36
Q

Why can’t you give a patient more opioids when there is a tolerance?

A

Risk of respiratory depression

37
Q

What is a treatment for addiction?

A

Methadone

Buprenophine + naloxone = suboxone

38
Q

Is withdrawal life threatening?

A

No