Opioid drugs Flashcards
What are the opioids?
Morphine, fentanyl, Codeine, loperamide, methadone, meperidine, dextromethorphan, diphenoxylate
Mech of opiods
Agonists at opiod receptors (mu = morphine, delta = enkephalin, kappa = dynorphin) to modulate synaptic transmission- open K+ channels, close Ca+ channels, decrease synaptic transmission. Inhibit release of ACh, norepinephrine, 5-HT, glutamate, substance P
Dextromethorphan use
cough suppression
loperamide and diphenoxylate use
diarrhea
methadone
maintenance programs for heroin addicts
acute pulmonary edema, pain
all?
Toxicities of opioid analgesics
Addiction, respiratory depression, constipation, miosis (pinpoint pupils), additive CNS depression with other drugs.
What is toxicity treated with?
naloxone or naltrexone
What does tolerance NOT develop to?
Miosis and Constipation
Butorphanol mech:
mu-opiod receptor partial agonist and kappa-opioid receptor agonist; produces analgesia
Clinical use of Butrophanol
Sever pain (migraine, labor, etc). Causes less respiratory depression than full opioid agonists.
Toxicities of Butorphanol
Can cause opioid withdrawal symptoms if patient is also taking full opioid agonist (competition for opioid receptors). Overdose not easily reverse with naloxone.
Tramadol Mech
Very weak opioid agonist; also inhibits serotinin and norepinepherine reuptake (works on multiple neurotransmitters (‘tram it all’ in with tramadol)
Clinical use of Tramadol
Chronic pain
Toxicity of Tramadol
Similar to opiods. Decrease Seizure threshold. Serotonin Syndrome
