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Pharm Block 4 > Opioids > Flashcards

Opioids Flashcards

1
Q

stimulatory effects of opioids

A

miosis
convulsions
constipation
vomiting

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2
Q

brain mu

A

mu 1

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3
Q

peripheral mu

A

mu 2

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4
Q

endorphin

A

mu

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5
Q

enkephalin

A

delta

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6
Q

dynorphin

A

kappa

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7
Q

analgesia: increase pain tolerance and decrease perception and rxn to pain
sedation
respiratory depression: decrease response to increase pCO2, increase intracranial pressure
(do not give O2, give naloxone)

A

Gi coupling side effects of opioids

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8
Q

cardiovascular - vasodilation ( avoid in head injury)
urinary retention, urgency to void
biliary: sphincter constriction causing biliary colic
renal fxn (gfr) is decrease by opioids due to decrease renal blood flow
can cause gynecomastia or SIADH (stim release of ADH, PRL, somatotropin)
increase histamine release - pruritus
cough suppression - codeine

A

other SE of opioids

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9
Q

CI: head injury, pulmonary dysfxn, pregnancy, hepatic/renal dysfxn, adrenal/thyroid def

A

opioids

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10
Q

mu agonist

glucuronidation
motphine 6 glucuronide is highly active, caution in renal dysfxn

A

morphine

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11
Q

MOA: ionic channel, through release of endogenous opioid peptides, modulate pain through ascending/descending nerves

A

opioids

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12
Q

Classic triad: OD toxicity

A

pinpoint pupils
respiratory depression
coma

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13
Q

tx for OD toxicity

A

IV naloxone

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14
Q

occurs to all effects, except mitosis and constipation

A

tolerance of opioids

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15
Q

physical and psychological - addiction

A

dependence of opioids

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16
Q

Mech of tolerance

A

1) increase cAMP
2) receptor recycling blockage
3) receptor and G protein coupling

17
Q

uses for opioids

A 
analgesia
Anesthesia 
manage acute pulmonary edema
cough suppression
antidiarrheal
18
Q

opioids used in anesthesia

A

fentanyl
morphine

can cause chest muscle tone increase, chest rigidity

19
Q

opioids in used in cough suppression

A

codeine

dextromethorphan

20
Q

opioids used as antidiarrheal

A

loperamide

diphenoxylate

21
Q

metabolized by liver p450 CYP2D6 (demethylation) to morphine

A

codeine

22
Q

proopiomelanocortin (POMC)

A

precursor for endorphins and enkephalins

23
Q

yawning, anxiety, sweating, goose bumps, lacrimation, rhinorrhea, salivation, spasms, muscle cramps, CNS originating pain

A

withdrawal - abstinence syndrome of opioids

24
Q

tx for withdrawal

A

methadone
buprenorphine
clonidine

25
Q

long acting t half 25-52 hrs
Maintenance programs for addicts
permits slow tapering effect and diminishes intensity of abstinence syndrome

A

methadone

26
Q

maintenance program
t half 24-60 hrs
low efficacy at mu receptor with high affinity

A

buprenorphine

27
Q

A2 agonist

cancel over activity of sympathetic nerve system

A

clonidine

28
Q

opioid antagonists

A

naloxone
Naltrexone
methylnaltrexone

29
Q

IV reversal for respiratory depression

A

naloxone

30
Q

PO, decrease craving for alcohol and used in opiate addiction

A

naltrexone

31
Q

tx for post op ileus, opioid induced constipation (doesn’t cross BBB) and won’t precipitate withdrawal

A

methylnaltrexone

32
Q

tx for baby with opioid withdrawal sx

A

1) diazepam
2) camphorated tincture of opium - oral
3) methadone - oral

33
Q

opioids that interact with SSRI or MAOI causing serotonin syndrome

A

meperidine
dextromethorphan
tramadol

34
Q

stong agonists

A 
morphine
methadone
meperidine
fentanyl
heroin
35
Q

moderate agonists

A

codeine

oxycodone

36
Q

mixed agonists/antagonists

A

buprenorphine
butorphanol
pentazocine
nalbuphine

37
Q

agonist and reuptake inhibitors

A

tapentadol

tramadol

38
Q

used in moderate pain and RA

A

tapentadol

tramadol

Pharm Block 4 (18 decks)

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