Opioid Pharmacology Part 2

Question 1

What are the CV effects of Morphine?

Answer 1

1. Hypotension
2. Vasodilation
3. Decreased mycardial oxygen demand

Question 2

What are the GI effects of Morphine?

Answer 2

1. Constipation

2. Increased biliary sphincter tone and pressure

Question 3

What are other effects of Morphine?

Answer 3

1. Inhibition of LH release
2. Stimulation of ADH and prolactin
3. NK cell suppression
4. Increased ICP

Question 4

What are the hallmarks of Opiate overdose?

Answer 4

1. Coma
2. Respiratory depression
3. Miosis

Question 5

How is Opiate overdose treated?

Answer 5

Naloxone; Opioid receptor competitive antagonist

Question 6

What are some contraindications of opioids?

Answer 6

Head injuries, Seizure disorders, Alcohol intoxication

Question 7

How is opioid withdrawal induced?

Answer 7

Drug is stopped abruptly or antagonist is administered.

Question 8

What are the signs of opioid withdrawal??

Answer 8

1. Diarrhea
2. Vomiting
3. Chills and Fever

Question 9

What is the Time course of withdrawal symptoms for Morphine?

Answer 9

Onset at 8-12 hours; Peak at 36-72 hours

Question 10

What is the time course of withdrawal sypmtoms of Meperidine?

Answer 10

Onset at 3 hours; Peak at 8-12 hours

Question 11

What is the time course of withdrawal symptoms of Methadone?

Answer 11

Onset at 24-48 hours

Question 12

Describe the PK of Morphine

Answer 12

1. High first pass effect

2. Peak effect 1 hour after injection, lasts 3-4 hours.

Question 13

Describe Heroin in relation to Morphine

Answer 13

Three times as potent; Faster onset

Question 14

Describe Codeine in relation to Morphine

Answer 14

1/10th as potent as Morphine; Used as antitussive

Question 15

Which patients will not be affected by codeine?

Answer 15

Deficient in CYP2D6