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27 Cards in this Set
- Front
- Back
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Morphine actions
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analgesia
sedation mood effect respiratory depression decreased GnRH and CRH miosis nausea and vomiting antitussive effect relief of dyspnea histamine release constipation |
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morphine MOA
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agonist at opiod receptors which are primarily in the CNS and GI tract
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opiod actions on neurons
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inhibition of Ca2+ channels
increase K+ channel conductance |
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mu receptors
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mediate most morphine actions
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kappa receptors
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mediate dysphoria and psychotomimetic actions
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met-enkephalin
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in many areas of CNS
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Beta endorphin
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mostly in pituitary and hypothalamus; a few pathways within brain
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heroin
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more potent than morphine and distributes to brain more quickly
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codeine
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selective antitussive
more likely to cause dysphoria than morphine |
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dextromethorphan
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selective antitussive with little opiod activity
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meperidine
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synthetic opiod agonist
marked CNS stimulation and delirium with MAOI- HTN, hyperpyrexia, coma, and severe resp. depression |
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diphenoxylate and loperamide
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used to control diarrhea
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fentanyl
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very potent opiod which can be used in transdermal, transmucosal, and transbuccal preparations
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methadone
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more potent, longer half-life, and longer duration of action than morphine; used in maintenance programs
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propoxyphene
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low potency; can cause CNS stimulation and pulmonary edema
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antagonist in subject who is physically dependent
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immediate, intense abstinence syndrome
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naloxone
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prototype opiod antagonist; can't be given orally due to 1st pass metabolism
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naltrexone
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opiod antagonist; can be given orally
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nalmefene
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long-acting opiod antagonist and used parenterally
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pentazocine
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agonist at kappa receptors and antagonist at mu receptors
causes dysphoria and pyschotomimetic effects may increase BP and cardiac workload |
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buprenorphine
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partial mu agonist; approved for maintenance therapy due to long DOA but must detoxify first
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opiod agonist tolerance
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functional and there is cross tolerance
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little tolerance seen to these effects
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miosis and constipation
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withdrawal syndrome
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hyperactivity of the ANS
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psychological dependence
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great with opiod abuse but rarely develops when used medically
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acute administration in treatment
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relieve or prevent abstinence syndrome
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Chronic maintenance program
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treat psychological not physical dependence
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