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Pharm Midterm 2 > Opioid Drugs > Flashcards

Opioid Drugs Flashcards

1
Q

What are the strong agonists

A 
Morphine
Hydromorphone
Oxymorphone
Heroin
Meperidine
Fentanyl
Sufentanil
Alfentanil
Methadone
Levorphanol
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2
Q

What are the Mild to Moderate Agonists

A 
Codeine
Oxycodone
Hydrocodone
Propoxyphene
Tramadol
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3
Q

What are the Mixed Agonist/Antagonist

A

Pentazocine
Butorphanol
Nalbuphine
Buprenorphine

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4
Q

What are the Mu, Delta, Kappa Antagonists

A

Naloxone

Naltrexone

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5
Q

What are the Antitussives

A

Dextromethorphan

Codeine

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6
Q

What are the Antimotility Agents

A

Diphenoxylate

Loperamide

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7
Q

What is the standard for Analgesia

A

Morphine

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8
Q

How is Morphine metabolized

A

M3G causing neuro-excitation

M6G (10%) more potent

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9
Q

Can Morphine metabolites cross BBB

A

No

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10
Q

What is a hazard of renal impairment on Morphine metabolites

A

Increased effect

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11
Q

What is Heroin metabolized to

A

6-MAM then morphine

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12
Q

What is unique about 6-MAM and Heroin

A

Can cross BBB

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13
Q

Why does Meperidine have high metabolite toxicity

A

Normeperidine causes tremor, twitching, mydriasis, hyperreflexia, convulsions

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14
Q

What is a major AE of Meperidine

A

Serotonin Syndrome

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15
Q

What is seen in Serotonin Syndrome

A

Delerium
Hyperthermia
HA, rigidity, coma

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16
Q

What do you not give with Meperidine

A

MAOIs

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17
Q

Pt on Meperidine has seizures

A

Decreased renal function and Normeperidine accumulation

18
Q

Does Meperidine or Normeperidine have a longer t1/2

A

Normeperidine

19
Q

Which strong agonist has a rapid onset and short duration (100x more potent than morphine)

A

Fentanyl
Sufentanil
Alfentanil
Remifentanil

20
Q

What are the Fentanyls metabolized by

A

3A4

21
Q

Equal potency to morphine, but less euphoria and longer acting

A

Methadone

Levorphanol

22
Q

Opioid withdrawal in Heroin addict

A

Methadone

Levorphanol

23
Q

What do Methadone and Levorphanol act on

A

Mu
NMDA antagonist
5-HT/NE reup inhibitor

24
Q

What can cause QT prolongation

A

Methadone

Levorphanol

25
Q

Which mild/moderate do you combine with Aspirin or Acetaminophen

A

Codeine
Oxycodone
Hydrocodone

26
Q

What is metabolized by 2D6

A

Codeine
Hydroxycodone
Hydrocodone

27
Q

Affinity of Codeine to opioid receptors

A

Low

28
Q

No longer on the market

A

Propoxyphene

29
Q

What about Propoxyphene makes it toxic

A

Metabolite Norpropoxyphene

30
Q

Good for Neuropathic pain

A

Tramadol

31
Q

What does Tramadol act on

A

Weak Mu

5-HT/NE reup inhibitor

32
Q

What are the Tramadol AE

A

Risk of seizures

Serotonin Syndrome

33
Q

Why are mixed not routine

A

Ceiling

34
Q

Which mixed can cause psychotomimetic effects

A

Pentazocine
Butorphanol
Nalbuphine

35
Q

Which mixed act on Mu and Kappa

A

Butorphanol (K ag, Mu anti)

Buprenorphine (Mu ag, K anti)

36
Q

What were Mixed developed for

A

Reduce addiction potential esp. Buprenorphine

37
Q

What is given for acute opioid overdose

A

Naloxone

38
Q

What is given to decreased EtOH craving

A

Naltrexone (also for opioid addicts)

39
Q

What are the most effect cough suppressors

A

Dextromethorphan

Codeine

40
Q

Is the antitussive effect through opioid receptors

A

No

41
Q

Diarrhea Tx

A

Diphenoxylate

Loperadine

42
Q

What do the Antimotility Agents act on

A

Mu

Delta

Pharm Midterm 2 (52 decks)

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