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Final Exam: 313 Pharm > Opioids and Non-Opioids > Flashcards

Opioids and Non-Opioids Flashcards

1
Q

Name the 3 main opiate receptors

A

Mu (analgesia, resp depression, euphoria, sedation, physical dependence), Kappa (Analgesia, sedation, pschytomimetic effects, psychotic), and Delta (No interaction)

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2
Q

Describe agonist”

A

drugs that occupy receptors and ACTIVATE them

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3
Q

Describe Antagonist+Agonist

A

Less activation

-Blocking/antagonist effect at Mu receptor and Activation/agonist effect at Kappa receptor

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4
Q

Agonist Opioids

A

FULL ACTIVATION; Drugs that bind to Mu and Kappa

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5
Q

Antagonist Opioids

A

No activation; drugs that occupy receptors, but don’t activate them.

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6
Q

What happens if you administer an antagonist after an agonist?

A

Withdrawal–> blocks agonist

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7
Q

Why would you use a pure antagonist?

A

Overdoses, respiratory depression, or sedation. Narcan (naloxone)

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8
Q

List 5 Strong Opioid Agonists

A
  1. Morphine Sulfate
  2. Hydromorphone (Dilauded)
  3. Fentanyl (Duragesic)
  4. Meperidine (Demerol)
  5. Methadone (Dolophine)
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9
Q

For what pain scale would you use a Strong Opioid?

A

7-10

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10
Q

List 4 Moderate-Strong Opioids

A
  1. Codeine & Tylenol (Tylenol #3)
  2. Hydrocodone & Tylenol (Vicodin, Lortab)
  3. Oxycodone & Tylenol (Percocet, Tylox)
  4. Oxycontin (ER oxycodone)
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11
Q

For what pain scale would you use a Moderate-Strong Opioid

A

4-6

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12
Q

List 4 Agonist-Antagonists

A
  1. Butorphanol (Stadol)
  2. Pentazocine (Talwin)
  3. Buprenorphine
  4. Nalbuphine
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13
Q

When would you use an Agonist-Antagonist?

A

Moderate-Severe Pain,

During birth

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14
Q

What are the SE of Agonist-Antagonists?

A

WITHDRAWAL, Less analgesia, less respiratory depression, Pstychotomimetic effects, strange thoughts, nightmares, hallucinations, delirium

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15
Q

What can Methadone cause?

A

Torsad’s De Point

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16
Q

What’s an advantage of Agonist-Antagonists?

A

Less potential for abuse

17
Q

Why would you give a mother Agonist-Antagonists during delivery?

A

Because they reduce risk for respiratory depression

18
Q

How long does Narcan last?

A

1 hour. Requires redosing due to long half-life of strong opiates

19
Q

What vitals should you look at before administering Opioids?

A

RR (<12 intervene), BP (don’t give if BP is too low, usually systolic <100)

20
Q

What are the 6 main SE of opioids?

A
  1. Respiratory Depression/Sedation
  2. Constipation
  3. Nausea/Vomiting
  4. Itching
  5. Hypotension/Postural hypotension
  6. Urinary Retention
21
Q

Other symptoms:

A

Neurotoxicity, Miosis, Euphoria/dysphoria, immune depression with prolonged use

22
Q

Name 2 contraindications (not RR) for opioids

A
  1. Increased ICP

2. Biliary colic (can cause spasms in the common bile duct. Use Demerol or Dilaudid)

23
Q

Special Concerns for Meperidine (Demerol)

A

Seizures

24
Q

Discuss Tramadol (Ultram)

A

Non-opioid, centrally-acting, analog of codeine. Substance 4
Relieves pain through combo of opioid and non-opioid mechanisms (weak action at Mu, AND blocks NE & serotonin) risk for suicide (contraindication)

25
Q

Discuss Alvimopan (Entereg)

A

Counteracts ADRs of opioid and bowel function. Used to prevent ileus in bowel resection surgery and accelerate bowel recovery. Stop as soon as pt has BM post-op.

26
Q

What is the key risk for Alvimopan (Entereg)?

A

HEART ATTACK!

27
Q

COX. What it do?

A

Synthesize prostaglandins (promote inflammation, sensitize receptors to painful stimuli)
Prostaglandins that protect GI mucosa
Synthesize thromoxane for platelet aggregation/clotting
Work on kidneys to promote vasodilation and renal flow
Work in brain to mediate fevers and contribute to pain perception.
Work in uterus to promote uterine contractions

28
Q

COX-1:

A

GOOD GUY

  • pathway does good for the body.
  • Promotes GI protection, bleeding/hemostasis, and renal impairment
29
Q

COX-2:

A

BAD BOI
-Promotes pain, inflammation, and fever
Causes the risk for MI/Stroke

30
Q

NSAIDS

A

Non-steroidal inflammatory drugs (cyclooxygenase inhibitors) inhibit COX function

31
Q

1st 1st generation NSAIDS

A

Aspirin, Goody’s Powder

32
Q

2nd Generation NSAIDS

A

Celebrex (Celecoxib)

33
Q

How much Aspirin is needed to prevent MI? How long does it last?

A

81mg. 8 days, the lifespan of the prostaglandin

34
Q

1st generation NSAIDS

A

ibuprofen, naproxone, diclofenac acid, ketoralac (IV form)

35
Q

What syndrome is a risk with NSAIDS?

A

Reye’s syndrome- don’t give to kids if they have viral illness

36
Q

What organ is most affected by NSAIDS? Acetaminophen?

A

Kidneys and Liver respectively

37
Q

What wound one give to reverse an acetaminophen overdose?

A

Acetylcystine (mucomyst)

Final Exam: 313 Pharm (7 decks)

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