Opioids Flashcards
1
Q
Natural Opium Alkaloids
A
Morphine
Codeine
Noscapine
2
Q
Semisynthetic Opioids
A
Heroin Pholcodeine Hydromorphone Oxymorphone Hydrocodone
3
Q
Synthetic Opioids
A
Meperidine Tramadol Methadone Dextropropoxyphene Fentanyl Alfentanyl Sefentnyl Remitentnyl
4
Q
Opioid Agonists/Antagonists
A
Pentazocine
Buprenorphine
Nalbuphine
Butorphanol
5
Q
Pure Opioid Antagonists
A
Naloxone
Naltrexone
Nalmefene
6
Q
Opioid Receptor: Mu
A
- Supraspinal and spinal analgesia
- Sedation
- Inhibition of Respiration
- Slowed GI Transit
7
Q
Opioid Receptor: Delta
A
- Supraspinal and Spinal analgesia
8
Q
Opioid Receptor: Kappa
A
- Supraspinal and Spinal analgesia
- Psychomimetic Effects
- Slowed GI transit
9
Q
Endogenous Opioid Peptides
A
Mu = Endorphins Delta = Enkaphalins Kappa = Dynorphins
10
Q
Opioid Effects: CNS
A
- Analgesia
- Euphoria
- Sedation
- Resp Depression
- Cough Suppression
- Myosis
- Nausea/Vomiting
11
Q
Opioid Effects: Peripheral
A
- CVS: Tachycardia (Meperidine), Peripheral artery/venous dilation
- GI: DEC motility, INC Tone
- Biliary Tract: Contraction, Sphincter of oddi constriction, Biliary/Pancreatic reflux (Elevated plasma amylase and lipase levels) (Meperidine is Exception!)
12
Q
Clinical Uses of Opioid Analgesics
A
- Analgesia
- Acute Pulmonary Edema
- Cough (Codeine, Robitussin, Noscapine)
- Diarrhea (Diphenoxylate, Loperamide)
- Anesthesia (Premedicant, adjunct anesthetic and primary anesthetic in high doses)
13
Q
Alt Routes of Delivery
A
- Suppository (Morphine, Hydromorphone)
- Transdermal Patch (Fentanyl)
- Intranasal (Butorphanol)
- Buccal Transmucosal (Fentanyl lozenge)
14
Q
Toxicity and Undesired Effects
A
- Tolerance (2-3 weeks of use)
- Psychological dependence
- Physiological Dependence
15
Q
Opioid OD
A
- Pinpoint Pupils
- Resp Depression
- LOC
16
Q
Methadone
A
- Opioid Agonist
- Long duration of action
- Persistent effects w/ repeated use
- Tx of Opioid Abstinence syndromes, Heroin users, relief of chronic pain
17
Q
Mixed Receptor Opioids: Nalbuphine
A
- Strong Kappa Agonist
- Mu receptor Antagonist
18
Q
Mixed Receptor Opioids: Buprenorphine
A
- Potent and long acting partial Mu agonist
- Sublingual, Long acting, Detox of heroin users
19
Q
Mixed Receptor Opioids: Pentazocine
A
- Kappa agonist w/ weake Mu antagonist or partial agonist properties
20
Q
Butorphanol
A
Kappa Agonist
21
Q
Tramadol
A
Block 5HT Uptake