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14 Cards in this Set

  • Front
  • Back

Morphine

Respiratory depression


Opioid receptor agonist


Contraindicatdin head trauma


Codeine

Weak opiod, combined with NSAIDs`

Methadone

Opioid receptor agonist



Replaces heroin, morphine, etc., and due to a long t1/2 allows a slow taper to withdrawal without the reaction.


Accumulates with repeated dosing.

Meperidine



Phenylpiperidine:

Rapid Onset, short duration.



Accumulation of this metabolite is enhanced in those who are renally compromised



Metabolite Normeperidine may accumulate and cause seizures, CNS excitement.

Fentanyl



Alfentanil Sufentanil Remifentanil



:Phenylpiperidine

100x more potent than morphine IV analgesic



Available as transdermal (patch) and transmucosal (lozenge) formulations

Heroin

Semisynthetic is metabolised to morphine for action.



Diacetylmorphine is lipid soluble and crosses BBB (from morphine)

Tramadol

chronic pain,


litlle opiod tox



May cause high BP with MAOI on board. Often combined with acetaminophen (liver toxicity)



Codeine analog.

Diphenoxylate

Weak Mu or Kappa agonists



Antidiarrheal

Naloxone

Fast onset and short duration of action. Repeated administration needed until opioid is cleared from the body.



Antagonist at all opioid receptors (μ, σ, κ)

Naltrexone

Like Naloxone but 5x more potent; up to 72 hr duration



Maintenance therapy; can be given alternate days. May reduce alcohol cravings in alcoholics



Caution in hepatic patient.

Buprenorphine



Nalbuphine Pentazocine



Butorphanol

Buprenorphine (partial μ agonist, κ antagonist)



Buprenorphine used in some maintenance rehabilitation programs.



Analgesia without euphoria, less chance for dependence. (high doses)

Amphetamines

methamphetamine, MDMA, cocaine modafanil



Inhibit transporters of CNS amines: DA, NE, serotonin



hyperthermia, seizures “bug crawl”



Overdose: acidify urine, supportive therapy, lorazepam, haloperidol

THC

G inhibitory (Gi) Binds to cannabinoid receptor

Lvorphanol

isomer of morphine doesn'tcause addiction