opioids

Question 1

pain ladder

Answer 1

1. paracetamol / NSAIDs
2. weak opioids tramadol or buprenorfine + laxative
3. strong opioids, oxycodon, morphine, fentanyl + laxative
4. opioids im/iv/sc

Question 2

opium alkaloids

Answer 2

benzylisoquinolines
phthalideisoquinolines
phenanthrene alkaloids

Question 3

receptor types

Answer 3

• mu
• delta
• kappa

Question 4

opioid effect

Answer 4

central;
- cough suppression
- nausea, vomitting
- muscle rigidity

peripheral;
- cardiovascular
- histamine release; bronchoconstriction, itching, redness, urticaria, hypotension, sweating
- endocrine effects
- urinary retention

Question 5

ascending pathway

Answer 5

information from the periphery to the brain

Question 6

descending pathway

Answer 6

from top to bottom
inhibiting the ascending pathway, so you dont feel constant pain, under constant inhibition

Question 7

endogenous opioids

Answer 7

encephalins
endorphins
dynorphins
endomorphines

Question 8

grouping of opioids

Answer 8

based on structure;
- natural; morphine, codeine
- semisynthetic; oxycodone, heroine, apomorphine, ethylmorphine
- synthetic; morphinas, phenylheptylamines

based in effectiveness;
- high efficacy; fentanyl
- medium efficacy; morphine
- lower efficacy; codeine, buprenorphine

based on pharmacological properties;
- agonist
- mixed agonist/antagonist > partial agonist
- antagonist; naloxone, naltrexone, methyl-naltrexone