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IBSc PHEM Applied Science > Opioids > Flashcards

Opioids Flashcards

1
Q

Opiates

A

Drugs derived from opium inc morphine, codeine, paregoric

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2
Q

Opioids

A

Drugs with morphine-like activity
May be synthetic or naturally occurring

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3
Q

Opioid MOA

A

Activate Mu delta and kappa opioid receptors

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4
Q

Opioid like receptors

A

Nociceptin/ orphanin
Nocebo and hypoalgesia effects

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5
Q

Mu receptor effects

A

Supraspinal analgesia
Sedation
Resp depression
Bradycardia
Miosis
N+V
Decr gastric motility

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6
Q

Delta receptor effects

A

Analgesia spinal + supraspinal
Miosis
Decr gastric motility

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7
Q

Kappa receptor effects

A

Spinal analgesia
Diuresis via decr ADH
Dysphoria

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8
Q

How do opioids cause respiratory depression

A

Mu receptor blunts hypercapnia response and hypoxic drive

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9
Q

Opioid toxidrome

A

** COMA, RESPIRATORY DEPRESSION, MIOSIS **
Hypotension
Bradycardia

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10
Q

Fentanyl pharmacology

A

Highly lipophilic so crosses BBB rapidly
IV dose lasts 30-60 mins
Not absorbed well dermal,y
Effects may remain for hours after removal of oatch

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11
Q

Potency of fentanyl, 3 methylfentanyl, and carphentanyl relative to morphine

A

Fentanyl 100x
Methyl 1000x
Car 10,000x

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12
Q

MARCHE CBRN variant

A

Mask
Antidote
Rapid spot decontamination
Countermeasures
Hypo/hyperthermia
Extraction

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13
Q

Opioid antidote and MOA

A

Naloxone
Antagonised effects of opioids at central receptors

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14
Q

Naloxone onset of action, and duration of action

A

Onset <2mins IV, 13mins IN
Duration 20-90 mins
Resedation likely, may need repeat doses

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15
Q

Why can resedation occur after using naloxone

A

Most opioids have a longer duration of action than naloxone

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16
Q

Opioid withdrawal and how to avoid

A

Agitation
Tachycardia
N+V
Violence
NCPE
Titrate naloxone dose to avoid

17
Q

NCPE

A

Neurogenic pulmonary oedema
Likely secondary to catecholmines
Usually noticed after waking up from naloxone due to incr o2 requirement

18
Q

Opioid toxidrome mimics

A

Alpha 2 agonists
Imidazolines
Organophosphates
Carbamates
Olanzapine
Nerve agents

All cause pinpoint pupils + CNS depression

19
Q

Xylazine and dexmedetomidine

A

Alpha 2 receptor agonist
Veterinary sedative, analgesic, and muscle relaxant

20
Q

Alpha 2 agonist MOA and effects

A

Agonist of pre synaptic alpha 2 receptors
Pinpoint pupils, CNS depression

21
Q

Clonidine, oxymetazoline, and naphazole MOA

A

Imidazoline agonists
Also have alpha 2 effects

22
Q

What medication is used for opioid withdrawal

A

Clonidine

23
Q

Does naloxone help in xylazine OD

A

No - naloxone doesn’t effect alpha 2 receptors
Can be used in mixed ingestions

IBSc PHEM Applied Science (21 decks)

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