Opioid antagonists Flashcards
Opioid antagonists
Naloxone
Naltrexone
Naloxone, naltrexone - MOA
Competitive opioid receptor antagonists. Reverse effects of opioid agonists.
Naloxone, naltrexone - indications
Opioid overdose.
Opioid and alcohol dependence.
Treatment of mild pain
NSAID
Treatment of moderate pain
Codeine, hydrocodone, oxycodone.
may be used with nonopioid analgesic
Treatment of severe pain
Fentanyl, meperidine, methadone, morphine.
Peripheral nerve pain - treatment
Local anesthetic.
Capsaicin (also postherpetic neuralgia)
Capsaicin - MOA
Activates peripheral nociceptors on primary sensory neurons. Increased release of substance P and eventually depletion of substance P in CNS
Capsaicin - adverse effects
Burning sensation the first days, replaced by analgesic effect after a few days
Coanalgesics
Antiepileptic drugs (carbamazepine, gabapentin, phenytoin, valproate, pregabalin) Antidepressants (amitriptyline, desipramine)
Antiepileptics - indications as coanalgesics
Trigeminal neuralgia
Postherpetic neuralgia
Continuous burning neuropathic pain
Pregabalin: fibromyalgia.
Antidepressants - indications as coanalgesics
Amitriptyline, desipramine, other TCAs: postherpetic neuralgia, diabetic neuropathy, migraine headache, neuropathic pain syndromes.
Duloxetine, milnacipran: fibromyalgia
Chronic opioid adm - management of constipation
Methylnaltrexone bromide
