second chapter opiates

Question 1

semisynthetic with strong mu activity

Answer 1

hydromorphone- used as alternative for kidney problems
oxymorphone
oxycodone- tablets, cancer couch etc
heroin

Question 2

semisythnetic with middle weak mu activity

Answer 2

dihydrocodone

hydroconde

Question 3

synthetic- strong mu activity

Answer 3

1) fentanyl- used as sublingual pill for breakthrough pain, patch for chronic pain and i.v. for anesthesia.
strongest analgesic
given with dropediol for anti-psychotic
2) sufentanyl- more potent
3) remifentanyl
4) alfentanyl

5) methadone-
besides mu activity, also has NE reuptake, sertonin reuptake inhibitor. and NMDA activity
used for heroin addicts and nociceptive and neuropathic pain
can cause TdP.

Question 4

synthetic- strong mu activity,

meperidine

Answer 4

less adverse effects: less urinary, uterine, no constipation or antittusive effects and low respiratory depression.
can cause tachycardia, serotonin syndrome and seizures.
should only be used 2 days max.

Question 5

synthetic- middle activity

Answer 5

tramdolol- shows mu activity, reuptake inhibitor of NE and releases sertonin.
can cause sertonin syndrome and contraindicated in epilepsy.

2) loperamide and diphenoxylate- used for diarrhea mainly.

Question 6

mixed agonist and antagonist-

Answer 6

) butorphanol

1) buprenorphine- u partial and K antagonist
used for breakthrough treatment in heroin addicts.
sublingual administration and patches.
low adverse effects

2) nalbuphine- mixed K and antagonist U
precipitates withdrawl in addicts.

Question 7

U antagonist

Answer 7

naloxone (short duration- 1-2 hours-> continous PARENTAL administration.
naltrexone- oral, 10 hours h.L. can lead to hepatoxicity.