Opioid Drugs Flashcards
Opioid Agonist Examples (9)
Oxycodone Hydrocodone Morphine Hydromorphine Methadone Meperidene Fentanyl Codeine Propoxyphene
Partial Opioid Agonist Examples (4)
Buprenorphine
Butorphanol
Pentazocine
Nalbuphine
Opioid Antagonist Examples (2)
Naloxone
Naltrexone
General Opioid Drugs
Mechanism of Action and Black Box Warning
Bind opioid receptors in CNS causing inhibition of ascending pain pathways
Life threatening respiratory depression possible in case of overdose
Indications of Opioid Use
Primary (7) and Additional (5)
Myocardial Infarction Sickle cell Crisis Post-Operative Kidney Stones Trauma Cancer Low Back Pain
Adjunct to general anesthesia Epidural anesthesia Palliative care Antitussive Antidiarrheal (Loperamide)
Opioid Receptors
Subtypes (3) with Endogenous Peptide Affinities (3)
Mu: Endorphin > Enkephalin > Dynorphin
Delta: Enkephalin > Endorphin and Dynorphin
Kappa: Dynorphin»_space; Endorphin and Enkephalin
Opioid Physiologic Effects
Stimulant (2) and Depressant (4)
Stimulates: Antinociceptive system (analgesic) Bowel smooth muscle (spastic constipation)
Dampens: Pain sensation (analgesia) Mood alertness Respiratory center Cough center (antitussive)
Opioid Drug Acute Adverse Effects (7)
Respiratory depression Nausea/Vomiting Constipation Urinary Retention Sedation Delirium Seizures
Opioid Drug Chronic Adverse Effects (5)
Hypogonadism Immunosuppression Withdrawal Tolerance/Dependence/Addiction Hyperalgesia
Opioid Drug Interactions
Examples with Specific Reaction (3)
Sedative-Hypnotics:
Increased respiratory depression
Antipsychotics:
Increased sedation and CV depression
Monoamine Oxidase Inhibitors:
Hyperpyrexic coma and hypertension
Naloxone
Mechanism of Action, Indication, Adverse Effect
Pure opioid antagonist
Reversal of opioid overdose
Acute opioid withdrawal via catecholamine release
Naltrexone
Mechanism of Action (2) Indications (2) Adverse Effects (2)
Pure competitive opioid antagonist, especially at mu receptors
Alcohol use disorder
Opioid dependence
Opioid overdose from decreased tolerance
Acute Opioid Withdrawal: Pain, HTN, Sweating, Agitation
Morphine Sulfate
Mechanism of Action, Contraindications (3) Adverse Effects (5)
Opioid agonist
Asthma
Respiratory depression
Sulfa allergy
Sedation Lightheaded Dizzy N/V Constipation
Buprenorphine
Mechanism of Action, Indication, Drug Interaction, Adverse Effects (7)
Partial Opioid Agonist/Antagonist
Treatment of opioid dependence
CYP3A4 inhibitors
Headache N/V Hyperhidrosis Constipation Withdrawal Insomnia Pain
