Opoid analgesics

Question 1

1. What kind of strength does the following opiods have?
2. What are their uses?(3)
3. What are the adverse effects?(3)

Fentanyl
Hydromorphine
Meperidine
Morphine
Methadone
Oxymorphone

Answer 1

1. Strong u, k opiod agonists
2. Severe pain, anesthesia, dependance (methadone)
3. Respiratory depression, constipation, addiction

Question 2

Codeine, Hydrocodone

1. Mechanism?
2. What are the uses? (2)
3. Adverse effects?

Answer 2

1. partial u,k opiod agonists
2. mild to moderate pain, combination with NASID/Paracet, cough (codeine)
3. As strong opiods

Question 3

Buprenorphine
Nalbuphine

1. Mechanism?
2. What are the uses?(3)
3. Adverse effects?

Answer 3

1. Mixed agonist - antagonist
   
   • partial my ag, k antag (Buprenorphine)
   • k agonist, my antagonist (Nalbuphine)
2. Moderate to severe pain
   dependence
   alcohol craving (Buprenorphine)
3. Like strong agonists, but can antagonize their effect

Question 4

Naloxone
Naltrexone
Nalmefene

1. Mechanism?
2. What are the uses?
3. Adverse effects?

Answer 4

1. Antagonize all opiod receptors
2. Opiod overdose
   Dependence (naltrexone)
3. Rapid antagonism sympt.

Question 5

Tramadol
Tapentadol

1. Mechanism?
2. What are the uses?
3. Adverse effects?

Answer 5

1. Weak u agonist, block serotonin reuptake
2. Moderate pain, chronic pain
3. Seizure if overdose

Question 6

Codeine
Dextromethorphan

1. Mechanism?
2. What are the uses?
3. Adverse effects?

Answer 6

1. Weak u agonist, inhibits NE and 5-HT transporters
2. Acute debilitating cough
3. Reduce cough reflex, toxic in overdose