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pharm III exam 1 > Opioids > Flashcards

Opioids Flashcards

1
Q

List the strong opioid agonists

A
  • Heroin
  • Morphine
  • Hydromorphone (Dilaudid)
  • Methadone (Dolophine)
  • Meperidine (Demerol)
  • Fentanyl (Sublimaze)
  • Alfentanil (Alfenta)
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2
Q

List the Moderate-to-Strong Opioid Agonists

A
  • Hydrocodone (Codan)
  • Oxycodone (OxyContin)
  • Oxymorphone (Opana)
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3
Q

List the Moderate Opioid Agonists

A
  • Codeine
  • Tramadol (Ultram)
  • Tapentadol (Nucynta)
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4
Q

List the Mixed Opioid Agonist-Antagonists

A
  • Pentazocine (Talwin)
  • Buprenorphine (Buprenex)
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5
Q

List the opioid antagonists

A
  • Naloxone (Narcan)
  • Naltrexone (ReVia)
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6
Q

List the opioid combination drugs

A
  • Hydrocodone/acetaminophen (Vicodin)
  • Oxycodone/acetaminophen (Percoset)
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7
Q

List the opioid antitussives

A
  • Dextromethorphan (with guaifenesin; Robitussin DM)
  • Codeine
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8
Q

List the opioid receptors

A
  • Mu - u
  • kappa - k
  • delta - S
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9
Q

MOA of all of the opioid receptors? What extra MOA does the Mu receptor have

A
  • coupled to Gi/o
  • close voltage gated Ca2+ channels on presynaptic nerve terminals
    • ​decreases neurotransmitter release and decreases neuronal activity in these pathways
  • u receptors: open K+ channels on postsynaptic neuron -> cause hyperpolarization and inhibit nerve transmission
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10
Q

effects of u receptor stimulation

A
  • analgesia: pain relief
  • euphoria
  • sedation
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11
Q

effects of k receptor stimulation

A
  • analgesia in some people
  • dysphoria in others
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12
Q

effects of delta (S) receptor stimulation

A
  • dysphoria
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13
Q

what is GABAs effect on pain modulation? What effect does opioids have on GABA

A
  • GABA normally inhibits descending neuronal pathways that modulate pain
  • opioids decrease the release of GABA, allowing the pathways to be activated which decreases pain transmission in the dorsal horn of the spinal cord
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14
Q

how does opioids cause analgesia

A
  • decrease sensation of pain
  • decreases reaction to pain : decrease suffering
  • tolerance develops to analgesia
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15
Q

list the effects of opioids

A
  1. analgesia
  2. sedation/mental clouding
  3. euphoria or dysphoria
  4. Emesis
  5. constipation
  6. inc tone, harder to urinate and pass stones
  7. Depression of cough reflex
  8. Respiratory depression
  9. Miosis
  10. Truncal rigidity
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16
Q

describe the sedative effects of opioids

A
  • dream-like state: mental clouding
  • not for sleep aids
  • causes CNS depression -> coma -> death
17
Q

why do opioids cause emesis

A

stimulate chemoreceptor trigger zone

18
Q

effect of opioids on respiration

A
  • respiratory depression
    • decreases response of brain stem to elevated CO2
19
Q

why are opioids useful in pulmonary edema

A
  • decrease response of brain stem to elevated CO2 and thus decrease the feeling of suffocating and make patient feel more comfortable
20
Q

why should opioids by cautiosly used in patients with head trauma

A
  • CO2 increases (due to decreases response of brain stem to elevated CO2) and causes vasodilation which increases cerebral blood flow and increases intracranial pressure
21
Q

which opioid does not cause miosis

A

meperidine

22
Q

what effects of opioids does a patient not develop a tolerance to

A
  • Miosis
  • Constipation
  • seizures
23
Q

truncal rigidity is most common with what type of opioids?

A
  • highly lipid soluable drugs like fentanyl
24
Q

what cardiovascular effects do you expect with opioids

A
  • slowing of heart rate due to pain control
    • exception is meperidine -> tachycardia
25
Q

effects of opioids on GU system

A
  • increases sphincter tone -> harder to urinate
26
Q

effect of opioids on histamine

A
  • opioids can produce histamine
    • cause flushing, itching, and sweating and drop in BP
    • treat with benadryl
27
Q

Tolerance is developed to what effects of opioids

A
  • analgesia
  • sedation
  • euphoria
  • nausea and vomiting
  • respiratory depression
28
Q

list the adverse effects of opioids

A
  • N/V
  • constipation
  • urinary retention
  • itching: due to histamine
  • respiratory depression
  • postural hypotension: histamine and decrease in vasomotor center in brain
  • restlessness
  • dysphoria in some people
29
Q

symptoms of withdrawal from opioids can be reduced by

A
  • clonidine or another opioid (methadone)
30
Q

opioid antagonists can cause what in chronic users of opioids

A

precipitate withdrawal

31
Q

List the classic triad of overdose of opioids

A
  • CNS depression
  • Respiratory depression
  • Pin point pupils
    • may dilate if severely hypoxic
32
Q

tx of opioid overdose

A
  • support respiration
  • opioid antagonist -> naloxone (Narcan)

pharm III exam 1 (11 decks)

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