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11 Cards in this Set
- Front
- Back
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What is an opioid?
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An opioid is a molecule that interacts with the opioid receptor
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What type of analgesia do opioids provide?
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Analgesia without loss of touch, proprioception, or consciousness
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Regading the anatomic site of action of opioids, where in the ascending pathways do opioids act?
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Peripheral nerve terminals, doral horn of spinal cord, and thalamus
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Where in the descending pathways do opioids act?
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Midbrain, Periacqueductal gray area, rostral ventromedial medulla, and locus ceruleus
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In which laminae do spinal opioids act?
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Spinal opioids act in laminae II & III (substantia gelatinosa)
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Name the opioid receptors
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Mu-1, Mu-2, kappa and delta (all of which provide suprasinal and spinal analgesia)
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Which receptors are responsible for dysphoria?
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kappa receptors are responsible for dysphoria, sedation and miosis
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What is the mechanism of action fo opioids?
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Opioids mimic endogenous peptides by binding to G-protein coupled opioid receptor causing inhibition of adenylate cyclase and then inhibition of Ach and Substance P; this causes decreased neuronal excitability
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What factors affect onset, potency, and duration of action?
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1) Lipid solubility
2) Molecular weight 3) pKa 4) Protein binding |
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What are the potencies of the opioids?
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Morphine 1
Meperidine 0.1 Fentanyl 75-125 Sufentanil 500-1000 Alfentanil 10-25 Remifentanil 250 |
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What are advantages of Neuraxial opioids?
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-Not associated with sympathetic block, weakness or loss of proprioception
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