Opioids

Question 1

A majority of the drugs in this deck are of what class?

Answer 1

Opioid AGONISTS

Question 2

What are the 2 Partial Agonists (mixed agonist/antagonist)?

Answer 2

Pentazocine

Buprenorphine

Question 3

What are the 2 Partial Agonists (mixed agonist/antagonist)?

Answer 3

Pentazocine

Buprenorphine

Question 4

What are the 2 Opioid Antagonists?

Answer 4

Naloxone

Naltrexone

Question 5

What are the 2 Opioid Antagonists?

Answer 5

Naloxone

Naltrexone

Question 6

What is the most potent Opioid Agonist compared to Morphine?

Answer 6

Fentanyl

Question 7

What is the least potent Opioid Agonist compared to Morphine?

Answer 7

Codeine

Question 8

MOA for Opioid Agonists?

Answer 8

Bind to opioid receptors in the cns

=> (-) ascending pain pathways and cause CNS depression

Question 9

List some times when Opioids are used

Answer 9

Pain
Anesthesia adjuncts
Palliative care
Antitussive (prevent cough)
Antidiarrheal

Question 10

What are some general adverse effects of Opioid Agonists?

Answer 10

CNS and Respiratory depression
Constipation
Hypotension

Question 11

What are some general adverse effects of Opioid Agonists?

Answer 11

CNS and Respiratory depression
Constipation
Hypotension

Question 12

When Opioid Agonists are combined with Sedative-Hypnotics, what can occur?

Answer 12

Increased respiratory depression

Question 13

When Opioid Agonists are combined with Antipsychotics, what can occur?

Answer 13

Increased sedation and accentuation of cardiovascular effects

Question 14

When Opioid Agonists are combined with Monoamine Oxidase Inhibitors, what can occur?

Answer 14

Hyperpyrexic Coma and HTN

Question 15

From their weakest dose to their strongest, describe the cascade of effects seen with Opioid Agonists?

Answer 15

Antidiarrheal
Antitussive
Euphoria
Nausea
Analgesic
Sedation
Respiratory Depression
Coma/Death

Question 16

What are the 3 Opioid Receptors?

Answer 16

Mu, Delta, Kappa

Question 17

Describe the highest affinity endogenous opioid peptides for the mu receptor

Answer 17

Endorphins» Enkephalins» Dynorphins

Question 18

Describe the highest affinity endogenous opioid peptides for the delta receptor

Answer 18

Enkephalins» Endorphins» Dynorphins

Question 19

Describe the highest affinity endogenous opioid peptides for the kappa receptor

Answer 19

Dynorphins» all the rest

Question 20

What are some contraindications for Morphine Sulfate? (3)

Answer 20

Bronchial Asthma
Upper Respiratory obstruction
Allergy to Morphine

Question 21

When if Fentanyl indicated?

Answer 21

Pain that requires continuous around the clock opioid administration and cannot be managed by other means

Question 22

What is Methadone used for?

Answer 22

Best at managing abstinence symptoms and TREATING OPIOID USE DISORDER in outpatient rehab settings!

Question 23

What Opioid Agonist is the best at treating opioid use disorder especially for heroin addicts?

Answer 23

Methadone

– manages abstinence symptoms and treats

Question 24

Hydrocodone is a very common Opioid Agonist. What are its common uses and what is it commonly combined with?

Answer 24

Analgesic and Antitussive

– Commonly combined with Acetaminophen

Question 25

What adverse effect should you watch for when Hydrocodone is combined with Acetaminophen?

Answer 25

Hepatotoxic

Question 26

What should Meperidine NOT be used with?

Answer 26

Partial Agonists (mixed agonist/antagonist) Analgesics

Question 27

What happens if Meperidine is combined with Mixed Agonist/Antagonist Analgesics?

Answer 27

Decreased analgesic effect and may precipitate withdrawal symptoms

Question 28

What were partial agonists combined with if the patient has decreased analgesic effect and precipitates withdrawal symptoms?

Answer 28

Meperidine + partial agonists

Question 29

What are 3 indications for Codeine?

Answer 29

Antitussive Mild pain Diarrhea

Question 30

What Opioid Agonist is the best at treating Diarrhea?

Answer 30

Loperamide

Question 31

Loperamide is the best at treating?

Answer 31

Diarrhea

Question 32

Loperamide slows GI motility by activating what opioid receptors?

Answer 32

Mu receptors

Question 33

Can Pentazocine treat addiction to Opioids?

Answer 33

NO

Question 34

Can Buprenorphine treat addiction to Opioids?

Answer 34

YES

Question 35

When is Pentazocine used?

Answer 35

Pre-op medication and anesthesia adjunct

Question 36

If Pentazocine is used during pregnancy, what may occur and what is the sign?

Answer 36

Neonatal Opioid Withdrawal Syndrome | = Shrill cry

Question 37

When is Buprenorphine used?

Answer 37

Pain and to treat addiction to opioids and narcotic pain relievers

Question 38

When patients are taking Buprenorphine, what should be monitored?

Answer 38

Potential incorrect dosing when they are starting/ending CYP3A4 activators/inhibitors

Question 39

MOA for Naloxone?

Answer 39

Displaces Opioids at receptor sites

Question 40

What drug can displace Opioids from their receptor sites?

Answer 40

Naloxone

Question 41

When is Naloxone used?

Answer 41

Suspected/known Opioid overdose

Question 42

Treatment for suspected/known opioid overdose?

Answer 42

Naloxone

Question 43

Naloxone causes a release of?

Answer 43

Catecholamines

Question 44

Once Naloxone causes a release of Catecholamines, what can that cause to occur?

Answer 44

Precipitate acute withdrawal or unmask pain with chronic users

Question 45

MOA for Naltrexone?

Answer 45

Competitive Antagonist with highest affinity for Mu receptors

Question 46

Naltrexone has the highest affinity to block what receptors?

Answer 46

Mu receptors

Question 47

What can Naltrexone treat?

Answer 47

Alcohol use disorder

Question 48

What can treat Alcohol use disorder?

Answer 48

Naltrexone

Question 49

Once patients are treated with Naltrexone, what can occur?

Answer 49

They will respond to lower opioid doses than previously used | => life-threatening intoxication if taken again

Question 50

Naltrexone may precipitate symptoms of acute withdrawal in opioid-dependent patients, what is the sign in neonates?

Answer 50

Shrill cry