opioids

Question 1

morphine

Answer 1

most widely for severe pain

Question 2

opioids

Answer 2

severe pain 
reduction in pain perception 
inhibition of transmission 
activating the desending (modulation)
periphral,central,spinal MOA
anti tussive effect

Question 3

what are the who essential drugs

Answer 3

morphine
codiene
tramadol

Question 4

what are the opoids antagonists

Answer 4

naloxone

naltrexone

Question 5

strong opoids

Answer 5

morphine 
methadone 
meperidne
oxycodone
fentanyl
pethidine

Question 6

what happens when mu receptor is activated

Answer 6

by opoids .. causing sedation,low gi moti, analgesia, modulation of hormonal NT
remember that this receptor is present at the periphry,spinally,and centrally
1. its action by (-) transmission
2. (+) of desending pathway .. modulation
3. ulter the limbic system

Question 7

what is the role of ziconotides

Answer 7

ca+ channel blockers .. presynaptically .. spinal cord level analgesic effect

Question 8

what is tapentadol

Answer 8

spinal cord level analgesic by (-) NE reuptake w/out serotonine
moderate to severe pain

Question 9

at which level op will indirectly (-) pain or indirect activate pain (-) neurons

Answer 9

centrally … by (-) gaba on the PAG that will stimulate RVM to produce sero and NE as well as enk

Question 10

if the patient was injured,, post operative ,, will op work good

Answer 10

majority of indications works on the nociceptive pain than the neuropathic pain so yes
remember … major for acute nociceptive pain

Question 11

what is the ROA given if chronic pain

Answer 11

orally or transdermally

Question 12

what is the result of not having a cielling

Answer 12

accumulation of toxic metabolites and increasing the duration of action

Question 13

codeine

Answer 13

oral 
no first pass effect
cyp2d6 met, liver, excre in kidney
weak agonist,,, moderte pain 
less SE than morphine 
high morphine conversion dependant on the cyp enzyme availability
anti tussive effect

Question 14

why do you think higher rates of resp dep.. deaths.. depression among arabs,, africans when taking codeine

Answer 14

cuz of the high cyp levels genetically they have

Question 15

what is the SE that wont go fast

Answer 15

constipation

and remember that the resp depression is short lived and will be reduced by pain

Question 16

tramadol should not be taken with which class and why

Answer 16

anti depressant

cuz of the 5HT syndrome SE

Question 17

tramadol

Answer 17

atypical op .. orally .. 30 min and last for 6 hours(not immadiet)
both 5HT and NE reuptake in
less severe op SE
5HT syndrome caution.. as well as renal and liver dys
active metabollite( 0-desmethyltramadol)
acummulation caution

Question 18

tapentadol

Answer 18

atypical.. orally
moderate to severe pain and chronic pain
only NE reup in(STRONG)
very much effective in nociceptive pain treating
no metabolites.. no accuulation,, glucorindation
not immadiet effect (20 min )
faster than tramadol
drug interaction less common unlike tramadol