Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Opioids and Analgesics Flashcards > Flashcards

Opioids and Analgesics Flashcards

1
Q

physiologic pain

A

Defensive role. Acute in nature (labor, surgery, trauma). Easy management.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

pathologic pain

A

No known benefit. Chronic and spontaneous. Low pain threshold to both noxious and innocuous stimuli. Associated with nerve damage (trauma, amputation, diabetes mellitus, HIV and VZV. Difficult to treat.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ascending pain transmissionpathway

A

From primary afferent nociceptors to dorsal horn cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

descending pathway. Pain response.

A

Inhibitory regulation. Starts in Frontal Cortex, Amygdala, and Cingulate Cortex. Synapses PAG, RVM, then Dorsal Horn Cells.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

desscending pathway receptors/transmitters

A

5HT, norepinephrine, glycine, GABA, and opioids.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Opioid Mu receptor

A

stabilize neuronal membrane by enhancing K+ conductance, and inhibiting voltage gated Ca++ channels. 1 - dependence, analgesia. 2 - euphoria, respiratory depression,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Opioid K receptor

A

Inhibitory.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Opioid D receptor

A

Inhibitory.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

physical dependence

A

diaphoresis, insomnia, restlessness, abdominal cramps, N/V/D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

psychological dependence

A

mediated by the ventral sriatum. Interactions between opioids and dopaminergic system in Nucleus Accumbens.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

tolerance

A

Mediated by NMDA signaling (Glutamate). Normally cosmetic. Rotation therapy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

euphoria

A

Mediated by Mu. Does not occur with Codeine or Pentazocine. Improves life quality and compliance.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

sedation

A

More so in the elderly. Greater in Phenanthrene derivatives than synthetic agents. Drowsiness, mental clouding, no amnesia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

antitussance

A

No correlation with analgesia or respiratory depression. Most potent with Codeine or Pholcodine. Dextromethorphan is preferred.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

2 opioid receptor antagonists

A

Naloxone, Naltrexone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

3 partial and mixed agonists

A

Butorphanol, Buprenorphine, Nalbuphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

7 synthetic opioids

A

Methadone, Meperidine, Fentanyl, Sufentanyl, Alfentanil, Ramifentanil, Diphenoxylate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

5 naturally occuring opioids

A

Codeine, Morphine, and derivatives (hydromorphone, hydrocodone, oxycodone). Most widely used fo pain control (epidural, trauma, surgery)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Morphine

A

Naturally occuring. Hepatic metabolism - M3G to M6G (analgesic).

21
Q

Hydromorphone

A

Widely used more potent Morphine derivative.

22
Q

Codeine

A

antitussant, no euphoria, naturally occuring. Useful for mild to moderate pain. Hepatic deamination to Morphine by CYP2D6. Genetic alteration of CYP 2D6 and 3A4 voids analgesic effect.

23
Q

Oxycodone

A

effective mild analogue of codiene.

24
Q

Hydrocodone

A

effective mild analogue of codiene.

25
Q

Pholcodine

A

potent antitussant

26
Q

Dextromethorphan

A

Preferred to Codeine and Pholcodine bc - Low adverse effects, neuroprotective, useful in neuropathic pain.

27
Q

Pentazocine

A

no associated euphoria

28
Q

Methadone

A

Long plasma T1/2 - lipophilic and plasma protein binding. Chronic pain and terminally ill cancer patients. High risk of respiratory depression and QT prolongation - torsades de pointes.

29
Q

Meperidine

A

poor oral bioavailability. Metabolites cause seizures. Similar efficacy to Morphine, but less potent. Causes mydriasis (contrast to other opioids)

30
Q

Fentanyl

A

short acting, 100x more potent than morphine, highly lipophilic. Available in transdermal patch for slow delivery. Sufentanil, Alfentanil, and Ramifentanil.

31
Q

Butorphanol

A

K agonist, Mu partial agonist yields analgesia with a milder euphoria. Opioid addiction Tx, and maintenance in balance anesthesia, labor pain.

32
Q

Buprenorphine

A

K antagonist, Mu partial agonist. Moderate-severe long-term chronic pain management.

33
Q

Nalbuphine

A

K agonist, Mu antagonist. High psychological dysphoria. Moderate-severe pain, pre and post-op, obstetrical analgesia.

34
Q

Naloxone

A

Competetive antagonist ant Mu and K. Shorter T1/2 than Morphine. Parenteral administration. Opioid antidote whether known or suspected.

35
Q

Naltrexone

A

Opioid antagonist. Oral admin. Outpatient settings. Tx - dependence, relapse, following detox, and prophylaxis. Alcohol withdrawal.

36
Q

opioid respiratory depression

A

decrease sensitivity of chemosensitive neurons to PCO2. occurs at therapeutic doses. Most common cause of death in acute poisoning.

37
Q

GI Disturbances

A

epigastric distress and biliary colic (confused with angina). Increse pyloric sphincter tone, enhance and decrease frequency of peristalsis - constipation.

38
Q

miosis

A

diagnostic tool. Mu and K mediated. Involves edinger westphal nucleus.

39
Q

N/V

A

involving area postrema

40
Q

Hypotension and Bradycardia

A

impaired sympathetic response - orthostatic hypotension (morphine). Rapid IV admin of large dose causes non-specific mast cell degranulation. Synthetics and short-acting opioids generally do not evoke histamine release.

41
Q

NSAIDs and Acetominophen

A

decrease prostaglandin synthesis and therefore pain sensation.

42
Q

Antidepressants

A

Amitriptyline, Nortriptyline, and Imipramine - Tx of chronic pain that in not responsive to opioids. Venlafaxine and Duloxetine - used for neuropathic pain.

43
Q

NMDA receptor antagonists

A

Ketamine and Dexamethorphan - chronic pain syndrome and post-op pain. Ketamine - acute severe pain, strong psychomimetic effects.

44
Q

Adrenergic agonists

A

Clonidine - acute and chronic pain state. As well as withdrawal.

45
Q

Gabapentin

A

synthetic GABA analog - inhibits voltage-gated Ca channels. Chronic pain and post-op pain state. Erratic oral bioavailability - has to be monitored.

46
Q

Pregabalin

A

GABA analog - inhibits voltage gated Ca2+ channels in the CNS. Faster onset, more potent, and predictable bioavailability than Gabapentin. Neuropathic pain, fibromyalgia, spinal chord injury.

47
Q

Lamotrigine

A

Na+ channel blocker. Tx - neuropathic pain, trigeminal neuralgia. Skin reaction - steven/johnsons.

48
Q

Carbamazepine

A

Na+ channel blocker. Tx - trigeminal neuralgia. May cause Hypotension.

Pharmacology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions