opioids

Question 1

Butorphanol

Answer 1

u antagonist and k agonist. thus reverses sedation and resp depression but still maintains analgesia.
(torbutrol, stadol, torbugesic - opioid agonist-antagonists)

Question 2

Morphine

Answer 2

u agonist
-less lipid soluble (slower onset)
-dont give IV (histamine release and hypotension)
-some dysphoria
-6 metabolite has analgesic effect and 3 metabolite has excitatory effects
analgesia 4-6 hrs after IM

Question 3

Oxymorphone

Answer 3

u agonist.

• no histamine release when IV
• good CV stability
• analgesia 2-4 hrs after IM
• least amount dysphoria

Question 4

Hydromorphone

Answer 4

u agonist

• no hist release but some excitement (IV)
• good CV stability
• more sedation than oxymorphone
• analgesia 2-3 hrs IM (longer in cats)
• CHEAP
• dogs vomit, cats get dysphoria if not in pain (premed sit.)
• alot of resp depression

Question 5

Fentanyl

Answer 5

• u agonist
• profound analgesia
• CRI, transdermal
• pronounced bradycardia (vagal) when IV (otherwise good CV stability)

Question 6

Remifentanil

Answer 6

• u agonist
• ultra short acting-used as CRI and faster anesthetic recover
• bradycardia, hypotension, resp. depression and histamine release (all signif. amts)
• NON-HEPATIC METABOLISM (muscle and intestine) thus used for patients with liver disease
• very expensive

Question 7

Butrophanol

Answer 7

u antagonist, k agonist
mild to moderate analgesi
-low doses partially reverse effects of pure agonist
-Torbugesic = brand
-1-4 duration for somatic pain, less for visceral and less for cats.

Question 8

Buprenorphine

Answer 8

Partial u agonist, k antagonist (opp. to butrophenol)

• long duration (6-8 hrs)
• good lingual absorption
• diff. to reverse with naloxone

Question 9

Tramadol

Answer 9

Weak u agonist (partial?)
-racemic mixture with 30 metabolites (11 are analgesic)(O-desmethyltramdol)
-OK for cats and horses
-serotonin and NE reuptake inhibitor (some alpha 2 action)
MULTIMODAL ANALGESIA!