Opioids

Question 1

Morphine

Answer 1

Indications: Pain in MI, surgical condition, trauma, cancer, back pain
MoA: mu receptor (binds to presynaptic receptor and inhibits AC)
Adverse effects: Constipation, addiction, tolerance
Contraindications:
Misc: Antidote is naloxone

Question 2

Meperidine

Answer 2

Indications: Analgesic for moderate/severe pain (biliary spasm, renal colic)
MoA: kappa receptor
Adverse effects: D/t its metabolite (norpethidine); serotonin syndrome, seizure, dysphoria, tremor, respiratory depression
Contraindications:
Misc: Also bind K+ channels, muscarinic receptors, DA transporters, DO NOT use naloxone to treat (acts in a different mechanism than morphine)

Question 3

Hydrocodone

Answer 3

Indications: Moderate to severe pain, cough
MoA: mu receptor, delta receptor
Adverse effects: Constipation, respiratory depression, nausea
Contraindications:
Misc: Recreational drug

Question 4

Codeine

Answer 4

Indications: Analgesic for mild/moderate pain d/t cough, diarrhea, IBS, narcolepsy
MoA: mu-receptor
Adverse effects: Euphoria, itching, urinary retention, depression, constipation, erectile dysfunction
Contraindications:
Misc: Active metabolite is morphine

Question 5

Pentazocine

Answer 5

Indications: Analgesic to mild-moderate pain (dental extraction)
MoA: delta agonist, kappa agonist, mu antagonist
Adverse effects: Hallucinations, psychotomimetic effects, CV effects
Contraindications:
Misc: Weakly antagonizes the analgesic effects of morphine and meperidine

Question 6

Naloxone

Answer 6

Indications: Opioid overdose
MoA: mu, delta, kappa antagonist
Adverse effects: Change in mood, trembling, change in heart rhythm, blocks action of pain-lowering endorphins
Contraindications:
Misc:

Question 7

Methadone

Answer 7

Indications: Treatment of dependence on opioid drugs
MoA: mu delta agonist
Adverse effects: Dependence
Contraindications:
Misc: