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20 Cards in this Set
- Front
- Back
Generally, pain meds work (are agonists) for what receptors?
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opiod receptors
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What are the 3 opiod receptors and what endogenous neurotransmitters bind to each?
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1) mu= morohine
2) delta= enkephaline 3) kappa= dynorphin |
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Name the 9 drugs that are 100% opiod agonsits
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1) morphine
2) fentanyl 3) codeine 4) heroin 5) methadone 6) meperidine 7) loperamide 8) dextromethorphan 9) diphenoxylate |
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Opiods
MOA: general uses: general S/E: antidote: |
MOA:
1) open K channels (prolong repolarization) 2) closes Ca channels (if Ca cant get out, Na cant come in for automaticity) thus, dec synaptic transmission general uses: pain, acute pulmonary edema general S/E: Pinpoint pupils, Addiction, Resp depression, Constipation, Colicky pain "Narcs cause PARCC" antidote: naloxone, naltrexone "nal's null narcs" |
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Naloxone, Naltrexone
MOA: |
MOA: opiod receptor antagonists
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Dextromethorphan
MOA: uses: |
MOA: opiod rec agonist, NMDA rec antagonist
uses: 1) opiod rec agonist--> suppress cough 2) NMDA rec antagonist--> dec tolerance to opiods (morphine) |
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Which opiod agonist can be used to control diarrhea by decreasing motility?
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loperamide, diphenoxylate
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Which opiod agonist can be used to ween addicts?
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methadone
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Why do opiods cause
1) constipation? 2) colicky pain? 3) urinary retention |
there are mu receptors on
1) myenteric plexus 2) sphincter of oddi 3) bladder sphincter (also opiods block urinary voiding reflexes) |
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sites of mu receptors
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1) myenteric plexus
2) sphincter of oddi |
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sites of delta receptors?
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????
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sites of kappa receptors?
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????
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Butorphanol
MOA: uses: S/E: |
MOA:
1) partial agonist at mu rec 2) full agonist at kappa rec uses: pain S/E: 1) PARCC 2) w/d sx's if previously on full opiod agonist |
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What is an advantage of Butorphanol over other opiod agonists?
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causes less resp depression than full agonists
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Tramadol:
MOA: uses: S/E: |
MOA:
1) weak opiod agonist 2) inh 5HTand NE re-uptake "tram it all in" uses: chronic pain S/E: 1) PARCC 2) ***decrease seizure threshold |
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What does opiod w/d look like?
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dilated pupils, n/v, cramps, diarrhea, piloerection, sweating, lacrimation, rhinorrhea, weakness
*remains concscious, no tremors, confusion, seizures, lethargy, delirium |
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What does opiod intox look like?
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resp depression, pinpoint pupils (but become dilated if anoxic), drowsy, siezures, delirium
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Which opiates are used in anesthesia?
Mode of administration? Purpose? |
Morphine, fentanyl
IV lowers MAC for all inhaled anesthetics |
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Mechanism for tolerance to morphine
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NMDA rec activation--> inc phosph of opiod rec--> inc NO levels
(high NO levels show tolerance to morphine) |
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mechanism to dec tolerance to morphine
2 drugs accomplish this |
block NMDA rec
1) ketamine 2) dextromethorphan (cough suppressant) |