Neuro Opioid Analgesics

Front 1

Mu agonists yields _____ respiratory depression than Kappa

Back 1

more

Front 2

Are opiods better at prevention or suppression

Back 2

Prevention

Front 3

When should caution be used regarding opiods analgesics?

Back 3

In patients with compromised respiratory systems.
With MAO-inhibitors

Front 4

How are opioids generally metabolized?

Back 4

LIver and gut

Front 5

What are the expected signs of an opioid overdose?

Back 5

respiratory depression
coma
pinpoint pupil (dilated with hypoxia)
convulsions

Front 6

What is used to treat symptoms of opioid withdrawal?

Back 6

Clonidine

Front 7

NAME THAT DRUG:
-mu agonist
- mixed depressant & stimulant
Stimulation= miosis, constipation, billiary constriction, bladder sphincter constr.

Back 7

Morphine

Front 8

What are the actions of morphine?

Back 8

-Actions:
- analgesia
-drowsy, mental clouding
-mood alteration (euphoria , or dysphoria in pain free ppl)

Front 9

NAME THAT DRUG:
Side Effects
-miosis
-reduced respiration, decrease CO2 sensitivity (baroreceptor reflex suppressed)
- Nausea and Vomiting
-ambulatory pts (vestibular stimulation)
-Increased ICP
-itching (histamine release)
- Constipation
- increase biliary pressure
-inhibits urinary voiding

Back 9

Morphine

Front 10

NAME THAT DRUG:
Causes increase intracranial pressure

Back 10

Morphine

Front 11

NAME THAT DRUG:
Prolongs labor and suppresses fetal respiration

Back 11

Morphine

Front 12

NAME THAT DRUG:
-Anticholinergic properties
-shorter duration of action than Morphine
-parenteral
- ABUSED
-less biliary spasm
-OD→ excitatory effects
-dangerous MAO-I interactions
-CNS excitations→ renal or hepatic impairment
- no labor delay→ may enhance it
-LOMOTIL→ meperidine and atropine ( antidiarrheal)
-IMMODIUM→ less addictive, antidiarrheal, cant cross BBB

Back 12

Meperidine (Demerol)

Front 13

NAME THAT DRUG:
-oral absorption
-longer duration than morphine (protein binding)
-heroin abuse/WD programs→ decrease euphoria
-need to consider dose addivity

Back 13

"...Carmalita, hold me tighter..."

Methadone (Dolphine)

Front 14

NAME THAT DRUG:
-weak analgesic
-less activity than codine
-toxic psychosis due to its stimulant activity
-related to methadone

Back 14

Propoxyohene (Darvon)

Front 15

NAME THAT DRUG:
-useful for treatment of cough, mild pain and diarrhea
-good for oral administration
-biotransforms to morphine

Back 15

Codine

Front 16

NAME THAT DRUG:
-mu agonist
-80 times more potent than morphine
-Severe chronic pain → less constipation than morphine
-Useful for breakthrough pains due to rapid onset limited duration
-new versions have recently been introduced that have an even shorter onset and offset of action.

Back 16

Fentanyl (Sublimaze)

Front 17

NAME THAT DRUG:
-weak mu agoinst
-blocks serotonin and NE reuptake
-abused
-Side Effect are Nausea, constipation, diarrhea

Back 17

Tramadol (ultram)

Front 18

What should you know about Oxymorphone (percodan) (oxycontin) ?

Back 18

Sustained release
Better oral availability than morphine

Front 19

NAME THAT DRUG (Partial (mixed) agonists & antagonists):
-lipophilic
- analgesia= morphine
-respiratory depression reaches ceiling at HIGH doses
-opiod dependence treatment
-binds protein

*If given at high doses, it can precipitate morphine withdrawal.

Back 19

Buprenorphine (Tengesis)

Front 20

NAME THAT DRUG (Partial (mixed) agonists & antagonists):
-high doeses psychotic reaction
-effective orally
- less respiratory depression

Back 20

Pentazocine (Talwin)

Front 21

Name that drug (partial (mixed) agonists and antagonists)
-Kappa receptors
-Increased cardiac workload

Back 21

Butorphanol (Stadol)

Front 22

Rank the order of agonist effect:
pentazocine
nalbuphine
buphrenorphine

Back 22

Buphrenorphine > Pentazocine > Nalbuphine

Front 23

Pure opioid antagonists will reverse the effects of a single acute dose of morphine and can precipitate withdrawal in the dependent individual.
What are the three opioid antagonists?

Back 23

Naloxone, Nalmefene, Naltrexone

Front 24

Naloxone, Nalmefene or Naltrexone
Short acting

Back 24

Naloxone

Front 25

Naloxone, Nalmefene or Naltrexone
Intermediate

Back 25

Nalmefene

Front 26

Naloxone, Nalmefene or Naltrexone
Long acting

Back 26

Naltrexone

Front 27

Patients recieving MAO inhibitors require ______ opioids

Back 27

Less

Front 28

________ doses of opioids can be used with NSAIDS or ASA

Back 28

Lower

Front 29

Concurrent amphetamine __________ euphoria and analgesia while decreasing sedation.

Back 29

Increases

Front 30

The ___________ effects of opiods are enhanced by tricyclic antidepressants and phenothiazines, while the analgesic effects may be increased, decreased or not altered.

Back 30

depressent

Front 31

What is the action of Dantralene?

Possible toxicity?

What else is it used for?

Back 31

Action: Decreased release of Ca from sarcoplasmic reticulum to cause decreased muscle spasms, but this will cause gen muscle weakness, dizziness and fatigue.
Toxicity: Hepatotoxicity
Also used for malignant hyperthermia, & neuroleptic malignant syndrome.

Front 32

alpha 2 receptors are located on noradrenergic cells on the neuronal _________

Back 32

bouton

Front 33

What drug acts on boutons, synapsing on motor neurons?

Back 33

Tizanidine

Front 34

Explain the uses of Tizanidine

Back 34

a drug which is used as a muscle relaxant. It is a centrally acting α-2 adrenergic agonist. It is used to treat the spasms, cramping, and tightness of muscles caused by medical problems such as ms, spastic diplegia, back pain, or certain other injuries to the spine or central nervous system, dry mouth, stroke, dizziness.

Front 35

What type of drug is Baclofen?

Back 35

GABA-beta agonist

Front 36

What is the action of baclofen?

Back 36

Increase potassium conductance in terminals reducing the Ca influx after the action potential.

Front 37

What are some of the uses of baclofen?

Back 37

Spinal cord injuries, MS, some movement disorders and ALS.

Front 38

What are the adverse effects of baclofen?
Withdrawal symptoms?

Back 38

Lassitude, weakness, sedation, confusion.
Withdrawal syndrome of anxiety and hallucinations.

Front 39

What are the sedating drug families you should know from Lucot's lecture?

Back 39

Cyclobenzaprine, metaxolone and benzodiazepines.

Front 40

What type of drug is benzodiazepine?

Back 40

GABA-A agonists

Used for spasm and muscle trauma

Front 41

What type of drug is cyclobenzaprine and metaxolone?

Back 41

Anti-cholinergic used for spasms and strains.