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Pharm III Unit 1 > Opioids and Antagonists > Flashcards

Opioids and Antagonists Flashcards

1
Q

Endogenous opioid peptides

A

Enkephalins, beta-endorphin, dynorphin

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2
Q

Beta-endorphins

A

decrease pain transmission in spinal cord, facilitate dopamine in reward system→ euphoria

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3
Q

Enkephalins

A

decrease pain transmission in the spinal cord

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4
Q

Dynorphins

A

bind to kappa receptors→ analgesia & dysphoria

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5
Q

Opioid receptors

A

Mu, kappa, delta

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6
Q

All opioid receptors MOA

A

coupled to Gi/o –> decrease cAMP;

close voltage-gated Ca2+ channels on presynp; Mu receptors open K+ channels

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7
Q

Effects of mu

A

analgesia, euphoria, sedation, side effects

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8
Q

Effects of kappa

A

Analgesia in some, dysphoria in others

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9
Q

Effects of delta

A

Dysphoria

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10
Q

Decreasing glutamate release in the dorsal horn__

A

Reduces activation of the ascending pathway

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11
Q

Inhibiting GABA release from inhibitory neurons __

A

Activates of the descending pathway that inhibits pain transmission

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12
Q

Effects of opioid

A

Analgesia; sedation/mental clouding; euphoria; dysphoria; emesis; antitussive; respiratory depression; elevation intracranial pressure; miosis; truncal rigidity; bradycardia; CONSTIPATION; increase sphincter tone (hard to urinate)

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13
Q

Commonly used for cough

A

codeine and dextromethorphan

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14
Q

Not an analgesic

A

Dextromethorphan

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15
Q

No antitussive property

A

Meperidine

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16
Q

Opioids may be useful for ___ due to its respiratory depression effect

A

Pulmonary edema

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17
Q

Do not use opioids if pt w/

A

pulmonary dz; head trauma

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18
Q

Opioid that causes mydriasis

A

Meperidine

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19
Q

SE of Truncal rigidity is seen commonly in

A

IV fentanyl - highly lipid soluble drugs (inject slowly to prevent)

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20
Q

Opioid that causes tachycardia

A

Meperidine

21
Q

Pt taking opioids can have flushing, itching, sweating due to __ and most common with

A

release of histamine, morphine injection

22
Q

Tolerance effects of opioid

A

Analgesia, sedation, euphoria, N/V, respiratory depression

23
Q

Non-tolerated effects of opioid

A

Miosis, constipation, seizures

24
Q

Hyperalgesia occurs when

A

long-term opioid use due to decrease in NMDA receptor antagonists

25
Q

Addiction ___ dopamine receptors

A

lower

26
Q

Reduce withdrawal sxs of opioid

A

clonidine or another opioid (methadone)

27
Q

Overdose triad

A

CNS depression, respiratory depression, pin point pupils

28
Q

Overdose treatment

A

Support respiration (ABCs), Naloxone

29
Q

Opioid clinical uses

A

Analgesic, acute pulmonary edema, relief of cough, tx of diarrhea, anesthesia

30
Q

Opioid and sedative hypnotics

A

increased CNS and respiratory depression

31
Q

Opioid and antipsych

A

Sedation

32
Q

Opioid and MAO inhibitor

A

Inhibit serotonin reuptake to some degree (Merperidine, dexytromethorphan)

33
Q

CYP2D6 require to convert to active compound (recommended to avoid acetaminophen)

A

Codeine, oxycodone, hydrocodone

34
Q

Opioid contraindication

A

Use of partial agonist w/ full agonist; head injuries; pregnancy; impaired pulmonary fxn; impaired hepatic or renal fxn; some endocrine dz

35
Q

Opioid precaution for seizure

A

Meperidine

36
Q

Administration of an antagonist or partial agonist may cause

A

withdrawal

37
Q

Relapse of withdrawal prevented with

A

Buprenorphine or methadone

38
Q

Morphine metabolized by

A

CYP2D6

39
Q

Commonly used in long-term control of pain

A

Methadone

40
Q

High abuse potential that is commonly used in short surgical procedures; available in transdermal patches or lollipops; metabolized by CYP3A4

A

Fentanyl

41
Q

Common route for codeine

A

oral

42
Q

Causes dysphoria due to kappa

A

Pentazocine/naloxone

43
Q

Tramadol w/ MAOIs, TCAs, SSRIs causes

A

Serotonin syndrome

44
Q

Tramadol w/ antidepressant causes

A

seizures

45
Q

Route for naloxone

A

Injected or intransaal

46
Q

Opioid antagonist that causes liver toxicity when used chronically

A

Naltrexone

47
Q

Shorter duration: naloxone or naltrexone?

A

Naloxone

48
Q

Robotripping caused by which drug? (dumb teens are the reason why i am scared of having babies)

A

Dextromethorphan

Pharm III Unit 1 (9 decks)

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