Opiods

Front 1

Physiology of pain (Excitatory example)

Back 1

substance P in primary sensory afferents

Front 2

Physiology of pain (Inhibitory example)

Back 2

GABA, endogenous opiod peptides

Front 3

Endogenous opiod peptides

Back 3

Inhibitory transmitters which modify pain transmission and perception: endogenous analgesics.
Modulate hormonal fluctuations.
Pentapeptides are name of them.
Located on presynaptic and postsynaptic sites in pain pathways.

Front 4

Opiod receptors ___ neuronal activity

Back 4

inhibit

Front 5

Endogenous opiod peptides are ____ during stress or anticipation

Back 5

released

Front 6

Mu receptors (Morphine)

Back 6

mediate analgesia, well-being (euphoria), respiratory depression, physical dependence.

Front 7

Delta receptors

Back 7

Mediate tolerance and analgesia.

Front 8

Kappa receptors

Back 8

analgesia, sedation, and psychotic effects, miosis

Front 9

Morphine and exogenous opioid analgesics

Back 9

Opiod receptor agonists!!
Inhibit pain pathway from peripheral sensory receptors to limbic system.
Pattern of effect depends on agonist activity.
Concentrated in the GI tract.

Front 10

Codeine, propoxyphene, oxycodone, hydrocodone

Back 10

Partial mu agonists.
Are mild to moderate agonists with lower efficacy.

Front 11

Mechanism, Indications, and Disadvantages of Pentazocine (Talwin)

Back 11

Mixed agonist/antagonist opiod.
Analgesia due primarily to kappa receptor agonist activity.
Only partial agonist or perhaps antagonist at mu receptor.
Get ceiling effect analgesic and some respiratory depression with dependence
Dysphoria, anxiety and hallucination may occur.

Front 12

What receptor does the analgesia come from for Pentazocine (Talwin)?

Back 12

kappa receptor

Front 13

Is Pentazocine (Talwin) a mixed, agonist, or antagonist?

Back 13

Mixed

Front 14

Mechanism of Naloxone (Narcan)

Back 14

Pure competitive Antagoinst. Has highest affinity for mu receptors.
Used to treat overdoses, accelerate postop recovery, or treat dependence

Front 15

What drug is used to treat overdoeses, accelerate postop recovery, or treat dependence of opiod?

Back 15

Naloxone (Narcan). It occupies the opiod receptor wihtout producing a pharmacological effect.

Front 16

Mechanism of Morphine

Back 16

With pain allows for analgesia, euphoria, drowsiness, and mental clouding.
Without pain can lead to nausea, apathy, dysphoria.
Leads to pupillary constirction.
Respiratory depression due to action on the brain stem.

Front 17

Indications of Morphine

Back 17

Used against continuous dull pain.
Suppresses the cough reflex.
Decreases glandular secretions in GI tract.
Depresses propulsive perstalsis, increases non-propulsive contractions.

Front 18

Advantages of Morphine

Back 18

Used for diarrhea by allowing increased water absorption from small and large intestines.
Only effect is by oral absorption.

Front 19

Disadvantages of Moprhine

Back 19

Constipation.
Easily crosses placental and fetal BBB.
Develop tolerance.
When crushed lose the effect.
Get abrupt withdrawal causing abstinence syndrome.

Front 20

What drug is the receptor antagonist that prevents constpatin but does not penetrate the CNS?

Back 20

methyl naltrexone (Relistor)

Front 21

Mechanism of Methadone

Back 21

Longer duration of action and a longer but less intense withdrawal sydrome than morphine.

Front 22

Indications of Methadone

Back 22

Used in heroin detoxification and maintenance programs.

Front 23

Mechanism and Indications for Meperidine (Demerol)

Back 23

More consistent oral absorption than morphine.
Indicated for labor pain.

Front 24

Disadvantages of Meperidine (Demerol)

Back 24

May produce CNS excitation and convulsion.

Front 25

Advantages of Mepridine (Demerol)

Back 25

Fewer GI and GU tract effects.

Front 26

Fentanyl (Sublimaze)

Back 26

Used as an adjunct for sedation and anxiolytic properties.
Used alone for cardiovascular surgery.
Lollipop by way of buccal/transmucosal administration.