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36 Cards in this Set
- Front
- Back
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opoid peptides hacce a common amino acid terminal seuence
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Opoid Motiff = Tyr-Gly-Gly-Phe- emt/Leu
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this is an endorphin precursor
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POMC
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POMC is a precursor to these three hormones
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LPH ACTH and melanocyte stimulating hormone have what precursor
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which cells make precursor to endorphins and where do the project
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arcuate nucleus, nucleus tractus solitarius, which project to the spinal cord, brainstem and limbic brain
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precursor of Enkephalins Dynorphins and where is it found
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proenkephalins, prodynorphins found everywhere
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these are the main opoid receptor subtypes and what to they couple too?
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mu, delta, kappa opoid receptors and couple to pertussis toxin sesnitive proteins
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Main mechanism of mu kappa, delta receptors
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increase threshold to painful sesnory stimuli
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3 subways opoids inhibits
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inhibits adenylyl cyclase activity, supress Ca2+ currents, activate receptor K+ channel to hyperpolarize
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what kind of metabolism does morphine undergo and what do you need to watch out for
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first pass metabolism and adjust for hepatic insufficiency
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analgesia
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decreases perception and affective compoents of pain
-worse btetter on dull longer pain |
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morphina MOA for diarrhea and what dp you have to watch for in children?
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decrease gastric motility, watch for paralytic ilesus in children
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how does type of dyspnea does morphine relieve andwhat is the mOA relieve dyspnea
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relieves pulmonary edema secondary to LVent failure, stops the SOb and struggle, decreases preload / afterload and resp centers
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MOA of morphine cough supression
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supresses cough center, D has no analgesic action, there isL only agents available
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how do opoids produce irregular and periodic breathing?
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direct ionhibition and decreas medul;lary drive to CO2
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morphine contraindications
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emphysamea (decreased reserve), excessive secretionms obstructive lung disease and preggars
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whoa re most senstive to resp depression?
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children, elders and encephalopathic patients
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how does morphine produce hypotension and what disease is this useful for
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through the vasomtor center (nucleus tractus solitarus)
-MI/ Angina through decrease preleoad |
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what SE is caused by stim of the chemoreceptor zone in the area postrmea of the medulla
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Nasuse and vomitsin in the vomiting center of the area postremna
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How does morphne cause pinpoint pupils?
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stims of PNS to EQ nucleus that is mediated by ach and blocked by atroppoine=pathognomic
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opoids + MOIs cause this syndrome...name some symptoms
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opoids block uptake of sertonin an cause faver, header, ridigity, convulsions coma death
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occasionaly mil dSE of morphoine bc o cutaneous dilation
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pruitius
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hydromorphone brand name is and is similiar to what drug
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Dilaudid, similar to morphine
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what is the brand name of meperidine
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Demerol
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why is it used and what is the diff moA
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less constipation, less resp depression
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what doe yo have to watch for with metabolites of meperidine, what is the name of it and wha tpatietns is contraindicated
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normeperidine can cause seizrues so bc with ESRD
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why is Fantany good and why is it used
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short duration and more potent, give IV and pre and post anesthesia
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what special surgey is methadone used for and why?
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cardiax surgery bc minimal cardiac depression
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what do you combine methadone with to make neuroleptopanalgesion
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combine methadone with fentanyl for wakeful state with cooperation of patients
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how does methodone help abusers? 2 ways
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long lasting so stops withdrawl and blocks eurphoria of elicit drug use
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Codein ( hydrocodein, oxy and dihydrocodone)- what is the use and do you have to watch for
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lower pain, less SE watch for CYP450 polymorphism that prevent metabolism
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what is tramadol and how does it work and what is contraindication
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sythetic codein analog for moderate pain and works via NE and sert uptake inhibition wach for MAOIs
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what two drugs releive dairrhea
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diphenoxuyalte lomotila nd loeramide imodium
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how to Pentazone Nalbuphome amd Nuphenorphine act
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kapp agonist with mu antagonism except buphenorphim
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Naloxone use
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mu antagonist used for acute opoid overdoese with short duration
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Naltrexone use
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etoh and opoid dependence for longer duration of action
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mom is giving opoids and baby has resp depression what do yoi give
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naloxone
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