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16 Cards in this Set
- Front
- Back
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Morphine Cardiovascular effects
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Orthostatic hypotesnion, syncope
Decrease SBP? ?(due to histimine release) Bradycardia |
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Morphine Respiratory effects
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Depression of ventilation via Mu2 receptors
Decreased response to CO2 Apnea with high doses Decreased rate increased TV. |
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Morphine CNS effects
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Cerebral vasoconstriction
Decreased CBF and ICP Miosis (excites oculomotor nerve Skeletal muscle rigidity Decreased MAC *Sedation precedes analgesia |
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Morphine Gi effects
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Spasm of biliary smooth muscle (+biliarry pressure)
May see epigastric distress or biliary colic, may mimic angina (give naloxone or NTG) Decreases peristalsis Enhases bladder sphincter tone= difficult urination |
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Morphine side effects
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Nausea and vomiting caused by direct stimulation of dopamine receptors in chemoreceptor triggerzone of 4th ventricle.
Depresses vomiting center in the medulla May be vestibular component to n/v |
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Meperidine metabolism
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Hepatic.
(demerol) Metabolite Normaperidine can cause CNS stimulation in high concentration. May cause seizures |
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Meperidine antishivering effects from what?
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From stimulation of Kappa receptors and drug-induced decreased in shivering threshold.
Mydriasis occurs due to atropine-like effects. |
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Meperidine cardiovascular effects
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large doses may decrease myocardial contactility (unique to opioids. )
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Fentanyl metabolism
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Hepatic, mostly cytochrome P450.
Elimation half-time 3.1-6.6 hours |
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Fentanyl kinetics
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More lipid soluable. redistribution can result in accumulation in tissues.
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Fentanyl Side effects
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Bradycardia, stiff chest, potentiates other sedatives
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Fentanyl Dosing
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1-2 mcg/kg analgesia
2-20 mcg/kg blunts airway reflexes Use preemptively, not as effective after teh surgical stimulation produces HTN. |
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Sufentanil metabolism
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Hepatic
half-time 2.2-4.6 hours |
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Sufentanil effects
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Chest rigidity. Ventilatory depression, bradycardia.
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Alfentanil kinetics
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elimination half-time 1.4-1.5 hours, 1/3 duration of fent. very rapid due to low pKa and lipid soluability.
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Naloxone
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Opioid antagonist
dosing 1-4 mcg/kg IV |
