Pharm Pain, Martin II

Question 1

codeine affects what R

Answer 1

mu at low dose

at high dose starts to work on kappa

Question 2

hydrocodone works on what R

Answer 2

mu

Question 3

oxycodone works on what R

Answer 3

mu

Question 4

what are the most widely prescribed outpatient analgesics

Answer 4

tylenol with codeine
codeine/aspirin
hydrocodone/acetaminophen
oxycodone/acetaminophen
oxycodone/aspirin

Question 5

what is a common mixed opioid agonist-antagonist

Answer 5

buprenorphine

Question 6

what occurs when partial agonist given with full agonist

Answer 6

act as antagonist!!

important concept

Question 7

buprenorphine action on mu R

Answer 7

partial agonist

Question 8

major use beuprenorphine

Answer 8

opioid detoxification

Question 9

what R activated by high dose codeine cause psychotomimetic effects

Answer 9

kappa

Question 10

what occurs with the antagonist side of opioid agonist/antagonist drugs

Answer 10

precipitate withdrawal Sx in physically dependent individuals since block effects of full agonists

Question 11

what are the opioid antagonist

Answer 11

naloxone(narcan)

short acting, injected

Question 12

what is naloxone used for

Answer 12

treat opioid overdose

Question 13

what occurs if give naloxone to patient dependent on opioids

Answer 13

precipitate withdrawal syndrome

Question 14

reward pathway

Answer 14

reduce excitability and transmitter release

inhibits VTA on GABA interneurons and increase ventral pallidum outflow which correlates to positive reinforcing state

Question 15

which way does dose response curve shift in tolerance

Answer 15

to the right

Question 16

what occurs in tolerance

Answer 16

R down regulated and signal transduction pathways desensitized

Question 17

what effects of opioids develop tolerance

Answer 17

analgesia
respiratory depression
euphoria
sedation

Question 18

what effects of opioids do not develop tolerance

Answer 18

miosis

constipation

Question 19

tolerance can be how high

Answer 19

35x fold

Question 20

opioid withdrawal Sx

Answer 20

rhinorrhea
lacrimation
yawning
chills
piloerection
hyperventilation
hyperthermia
mydriasis
vomiting
diarrhea
anxiety

Question 21

firs 8 hours withdrawal Sx

Answer 21

anxiety and drug craving

Question 22

8-24 hours withdrawal Sx

Answer 22

anxiety
insomnia
GI disturbance
rhinorrhea
mydriasis
diaphoresis

Question 23

up to 3 days Sx withdrawal

Answer 23

tachycardia
nausea vomiting
HTN
diarrhea
fever
chills
tremors
seizure
muscle spasm

Question 24

Tx opioid withdrawal

Answer 24

monitor

if need– clonidine a2 agonist

Question 25

effects of clonidine during withdrawal of opioids

Answer 25

reduce cravings
reduce anxiety
reduce sympathetic outflow

Question 26

primary signs of opioid overdose

Answer 26

lethargy or coma
depressed respiration
pinpoint pupils

Question 27

secondary signs opioid overdose

Answer 27

hypotension
hypothermia with cold or clammy skin
PE
conbulsions
hypoxia with dilated pupils

Question 28

when see dilated pupils but know opioid overdose

give what

Answer 28

naloxone