Opioids Lecture Flashcards
What are opioids?
-they are naturally produced in the body
-substances that act on same receptors in brain = stronger and dangerous
-medical use for short-term and chronic pain
What occurs when opioids, natural or synthetic, attach to receptor?
-suppress pain
-slow breathing
-produce a sense of calm
What happens to endorphins with prolonged opioid use?
the longer opioids are used, the less endorphins are released by the brain until eventually the brain stops making them
= if the drug was removed, there would be nothing filling those receptors = intense need for the drug to refill those synapses
What are the 3 basic components of opioid addiction?
-overwhelming psychological desire to use
-increased tolerance to the drug
-withdrawal symptoms when opioids are unavailable
How does opioid tolerance occur?
-after some time, opioid receptors become less sensitive = pt uses larger does to get the same effect
-can occur in very short amount of time
What is the withdrawal timeline?
10-24h = vomiting
36-48 = sweating, nausea, runny nose, dilated pupils, watery eyes
48-72 = anxiety, insomnia, localized pain
72 - 1 week = symptoms gradually start fading away
What are some health effects related to opioids?
-depends on dosage and admin
-most critical = overdose
-neurological
-cardiovascular
-gastro/hepatic
-dermatologic
-behavioral
-respiratory
-muscular
-extremities
-infection
List 5 health risks associated with injection drug use
-HIV
-Hep C
-inflames or collapsed veins
-skin infection
-endocarditis
What are the three main opioid receptors?
-mu
-delta
-kappa
Where are opioid receptors located?
-CNS (cortex, thalamus, gray matter, spinal cord)
-peripheral neurons
-inflamed tissue
-immune cells
-resp and GI tract
What part of morphine and hydromorph is addictive?
-the metabolites cause neuroexcitation
-metabolites have no analgesic properties
What is Opioid Induced Neurotoxicity and what causes it?
-neurotoxicity = agitation, confusion, myoclonus, hallucinations, siezures
-factors: high doses, prolonged use, dehydration, renal failure, advanced age, other drugs
What is respiratory depression?
-when the breathing rate is so slow from increased acetylcholine
-it is a risk for opioid-naive pt and even for those who have no resp pain or symptoms
what does it mean to be opioid naive?
-when the receptor in body has not seen opioids in some time
opioids and constipation
-high variation in pt
-use osmotic or stimulant laxative
-fentanyl patch may result in less constipation
-laxaday better than lactulose
