Opioids

Question 1

Opioids MOA

Answer 1

Opioid receptor agonists, blocks release of pain neurotransmitters from nociceptors and inhibits GABA release

Question 2

Opioid receptors

Answer 2

Mu receptors, kappa receptors, delta,

Question 3

Mu receptor location

Answer 3

found in the brainstem and medial thalamus

Question 4

Mu receptor actions

Answer 4

analgesia, respiratory depression, euphoria, sedation, decreased GI motility, physical dependence

Question 5

Kappa receptor location

Answer 5

limbic and other diencephalic areas, brainstem, spinal cord

Question 6

Kappa receptor actions

Answer 6

analgesia, sedation, dyspnea, dysphoria, respiratory depression

Question 7

Delta receptor location

Answer 7

brain

Question 8

Opioid agonists

Answer 8

morphine, fentanyl, hydromorphone, codeine, oxycodone, methadone, heroin

Question 9

Partial agonists

Answer 9

buprenorphine, butorphanol

Question 10

anatagonists

Answer 10

Naloxone, naltrexone

Question 11

Suboxone

Answer 11

buprenorphine + naloxone

Question 12

Short acting

Answer 12

codeine, hydrocodone, hydromorphone, morphine, oxycodone, oxymorphone, fentanyl

Question 13

Long acting

Answer 13

fentanyl, levorphanol, methadone, morphine, oxycodone, oxymorphone

Question 14

ADR

Answer 14

sedation, lethargy, constipation, respiratory depression, NV, pruritis/urticaria

Question 15

Over dose triad

Answer 15

miosis, loss of consciousness, respiratory depression

Question 16

Over dose antidote

Answer 16

naloxone

Question 17

Morphine ADR

Answer 17

direct histamine release, respiratory depression, orthostasis, constipation, NV

Question 18

Codeine MOA

Answer 18

weak mu agonist, metabolized to morphine

Question 19

Codeine drug interactions

Answer 19

inhibited by bupropion, cimetidine, celecoxib, cocaine

Question 20

Oxycodone MOA

Answer 20

activity at mu and kappa receptors, high potency analgesic

Question 21

Hyrocodone MOA

Answer 21

weak activity at mu receptor

Question 22

Hydromorphine MOA

Answer 22

activity at mu and delta receptors

Question 23

Fentanyl MOA

Answer 23

strong mu agonist

Question 24

Meperidine (demerol) MOA

Answer 24

weak mu agonist

Question 25

Meperidine interactions

Answer 25

MAOI- respiratory depression

Question 26

Propoxyphene MOA

Answer 26

weak mu agonist, NMDA antagonist

Question 27

porpoxyphene ADR

Answer 27

dizziness, sedation, weakness, falls, agitation, insomnia, neurotoxic, cardiotoxic

Question 28

Methadone MOA

Answer 28

mu agonist serotonin-norepinephrine reuptake inhibitor, analgesic effect

Question 29

Methadone ADR

Answer 29

cardiotoxicity- torsades

Question 30

Buprenorphine MOA

Answer 30

mu receptor partial agonist, kappa receptor antagonist

Question 31

Buprenorphine ADR

Answer 31

sedation, NV, dizziness, HA, respiratory depression

Question 32

Naloxone (Narcane) MOA

Answer 32

mu receptor antagonist. reversal agent for opioid OD, reverses respiratory depression, sedation, hypotension

Question 33

Naltrexone (vivitrol)

Answer 33

opioid receptor antagonist

Question 34

Tramadol

Answer 34

synthetic codeine analog

Question 35

tramadol ADR

Answer 35

seizure risk, suicide risk, serotonin syndrome risk, dizziness, vertigo, nausea, constipation, HA, somnolence, vomiting, pruritis

Question 36

Tramadol interactions

Answer 36

CYP2D6, CYP3A4 inhibitor, serotinonergic drugs, Carbamazepine

Question 37

Tapentadol MOA

Answer 37

mu opioid agonist, NE reuptake inhibitor

Question 38

Tapentadole indication

Answer 38

specifically approved for diabetic neuropathy

Question 39

Tapentadole ADR

Answer 39

fatal if taken with EtOH, drowsiness/dizziness

Question 40

Opioid withdrawal symptoms

Answer 40

irratbility, anxiety, restlessness, chills, sweating, abd pain, ND, sneezing, rinorrhea, dilated pupils, muscle weakness, pain, insomnia