Opioids - General Info Flashcards
Where are opioid receptors located
CNS
What are the opioid receptors
Mu
Delta
Kappa
What 2nd messenger do opioids act throught
Gi
What receptor do the majority of opioids act through
Mu
Where are Delta and Kappa mostly found
Spinal level for analgesia
What effect do Kappa receptors have
Psychotomimesis
How do opioids act
Close VG Ca on presynaptic and open K on postsynaptic
Decreases NTs
Inhibit ascending pain transmission
Activate descending pain-inhibitory pathways
Block inhibitory GABAergic neuron transmission
Can tolerance be seen with opioids
Yes
Is dependence seen with opioids
Yes
Is addiction seen with opioids
Yes but not therapeutically
What are the CNS effects of opioids
Analgesia Euphoria Sedation and drowsiness Truncal rigidity N/V
How do opioids cause resp depression
Decrease central response to CO2
What effect do opioids have on cough
Supression
What do opioids do to pupils
Miosis
Pathognomonic for toxic dose
General uses of opioids
Analgesia Acute Pulmonary Edema Cough Diarrhea Shivering Anesthesia
Which opioids can you give for cough
Dextromethorphan
Codeine
Levopropoxyphene
Noscapine
What opioids can you give for diarrhea
Loperamide
Diphenoxylate
What opioids can you give for shivering
Meperidine
How are opioids excreted
Converted to glucuronides and excreted by kidney
What does 2D6 metabolize
Codeine
Oxycodone
Hydrocodone
How do opioids cause hypotension
Peripheral vasodilation
Inhibition of baroreceptor reflex
Increased histamine release
How do opioids cause biliary colic
Contraction of billiary SM
How do opioids cause decreased renal function
Decreased RBF
How do opioids cause prolong labor
Just does, OK
How do opioids cause Pruritis
Central effects and histamine release
What is the main opioid AE
Constipation
What happens if you give a pure agonist with a weak partial agonist
Diminish analgesia
State of withdrawal
Opioid + Head injury
CO2 retention leading to cerebral vasodilation
Opioid + Pregnancy
Fetal dependence
Opioid + Impaired pulm function
Acute resp failure
Opioid + Impaired liver function
Decreased morphine metabolism
Opioid + Impaired renal function
Longer t1/2
Opioid + Endocrine disease
Prolonged/Exaggerated response
Opioid + Sedatives/Hypnotics
Increase CNS depression (resp)
Opioid + Antipsychotics
Increased sedation
Resp depression
Accentuate CV effects of Anti-Ms or alpha blockers
Opioid + MAOIs
LIFE THREATENING
Meperidine and Tramadol
