Opioids & Antagonists

Question 0

Methadone (Dolophine) MOA & uses (2)

Answer 0

mu receptors, may also block NMDA receptors

maintenance tx of addicts
long term pain control- lower incidence of anesthesia tolerance

Question 1

hydromorphone (Dilaudid) special use

Answer 1

good for renal dysfunction

Question 2

meperidine unique effects

Answer 2

anticholinergic: tachycardia, pupil dilation

no cough suppressant, less resp. depression, less constipation & urine retention, possibly less N/V

Question 3

Meperidine (Demerol) contraindications (3)

Answer 3

don’t use > 48h- risk of seizures
renal failure- risk of seizures
MAOIs: Serotonin Syndrome

Question 4

fentanyl SE

Answer 4

Truncal rigidity if given IV

Question 5

hydrocodone & oxycodone contraindication

Answer 5

SSRIs- reduced analgesia due to inhibition of conversion to morphine

Question 6

Pentazocine (Talwin) MOA & SE (3)

Answer 6

kappa agonist, partial mu agonist

less sedating
dysphoria
may induce withdrawal in dependent pts

Question 7

buprenorphine MAO & use

Answer 7

partial mu agonist, may have kappa agonist

maintenance tx for addicts

Question 8

Tramadol MOA (2)

Answer 8

weak mu agonist

inhibits NE & 5-HT uptake

Question 9

Tramadol interactions (4)

Answer 9

antidepressants: seizures

MAOIs, TCAs, SSRIs: serotonin syndrome

Question 10

DOC for opioid OD?

Answer 10

Naloxone

Question 11

Naltrexone SE

Answer 11

liver toxicity