Opioids Flashcards
What is the MOA of Opioid Drugs?
Opioid receptor binding leading to decreased ascending pain pathways
What GI symptom is caused from Opioid drugs?
Constipation
Why do would we be concerned about the side effects of constipation with opioid drugs?
If a patient has unstable angina or is post MI then we do not want them straining to poop as it could stress their heart.
What is a systemic side effect of opioid drugs?
hypotension (orthostatic/syncope)
What CNS side effect occurs with opioid drugs?
CNS depression
What is the BBW for opioid drugs?
Severe respiratory depression
In comparison to morphine how much stronger is fentanyl?
90x - holy buckets that a lot
Which opioid drug exerts its effects only in the GI system as an anti-diarrheal?
Loperamide
What drug can be given to help patients combat alcohol, opioid, heroin addiction? has also shown to cause weight loss…
Naltrexone
Of the drugs given to help combat opioid addictions which was in a full agonist vs a partial agonist?
Full - methadone
partial - buprenorphine
Morphine overdose leads to what fatal symptoms?
Respiratory depression
What are the drug-drug interactions that occur with opioids and sedative-hypnotics?
increased CNS depression, particularly respiratory depression
What are the drug-drug interactions that occur with opioids and antipsychotic agents?
Increased sedation. Accentuation of cardiovascular effects .
What are the drug-drug interactions that occur with opioids and MAOIs?
Contraindicated with all opioid analgesics because of hyperpyrexic (high fever) coma; HTN has also been reported (hypertensive crisis is a bad side effect of MAOIs)
What is the MOA of Naloxone?
pure opioid antagonist that competes and displaces opioids at the receptor site
What is Naloxone used for?
Opioid overdose - competes for mu receptor
If someone comes into ER that is a known drug user and is in respiratory depression what drug can be given to confirm opioid overdose?
Naloxone
What is a concern of giving Naloxone?
Withdrawal symptoms
What is the MOA of Naltrexone?
pure opioid antagonist, highest affinity for mu receptor
What are the indications for Naltrexone?
Alcohol use disorders and opioid dependence
What is a concern in giving Naltrexone?
Withdrawal symptoms
What drug are patients drinking in smoothies if they cant get opioids?
Loperamide, as many as 400-500 tablets in a smoothie
What are side effects of oxycodone?
Face, eyes, mouth, tongue, lips, throat - swelling
Respiratory depression
CNS - hallucinations, confusion, fainting, dizziness
Skin- hives, rash
Heart - variable fast or slow
MSK - seizures
Indications for Morphine sulfate?
management of pain unresponsive to non-narcotic analgesics
Contraindications of Morphine sulfate?
Hypersensitivity or allergy to morphine
What are warning or precautions for Morphine sulfate?
Dosing errors based on formulation
Respiratory depression
CNS toxicity
CNS depressants - respiratory depression
Adverse effects of morphine sulfate?
sedation, lightheaded, dizziness, nausea, vomiting, constipation
What is Buprenorphine used for?
opioid dependence tx
What is a warning/precaution for Buprenorphine use?
Has been shown to cause significant respiratory depression and death when paired with IV benzodiazepines
drug interactions of buprenorphine?
Just need to monitor patients on CYP3A4 inhibitors or inducer so we can adjust up or down the dose.
