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15 Cards in this Set
- Front
- Back
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Pharmacological effects of Morphine in the CNS and site of action
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Cellular: Linked to G-Protiens Act. Gi--> Decreased CAMP,
Close voltage-gated Ca2+ Channels on presyn. nerve terminals Open./.K+ channels Hyperpolarization. |
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Pheripheral effects of Morphine
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G.I. Increase tone (Mu) receptor: Increase tone and Decrease Peristalusus
Billiary tract: Spasm Increase CSF pressuire Itching, Bronchoconstriction Supress NK cells |
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Ability of Opiods to cross the Placental Barrier
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Morphine CROSSES THE PLACENTA
Mepreridine has Lesser degree of resp. depression in fetuses and Does Not inhbit uterine contraction |
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Mech. By which Opiod action is terminated
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Naloxone: Parenteral
Naltrexon: Oral effective, Longer acting Nlamefene: Longer acting and injectable/ |
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Char of tolerance and physical dependence.
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Physical Dep: Amt. Freq. and Duration of drug use
Abrupt. Termination of the drug ir the injection of an opiod antagonist--> Withdrawl syndrome Tolerance: Tolerance to morphine: Tol. related to DOSe, freq. and duration.. Cross tolerance to other opioids |
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List the effects of Opiods to which tolerance doesn't dev
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Miosis. Constipation,
Convulsions., Antagonist actions |
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Compare the abuse liability of different Opiods
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Coedine and Proxyphenoen: MODERATE Opiod agonists: Decrease abuse
Loperimide, tramdol, Detrothrometaphan, Diphenyoxylat--> very lOw abuse pot. |
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Indicate primary contraindications to opiod use
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Asthma, Liver dammage, emphyseama. HEad injuries increase CSF pressure and screws up nuero exam.
Abdominal pain, Acute alcohol use. |
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Potential drug interactions
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Depressent effects may be prolonged or exaggerated by CNS depressants, Phenothiazines, MAO-I, TCA's, Cimetidine
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Withdrawl from Opiods
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Seizures
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ID a ACUTE Opiod Overdose
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Triad of COMA, Pinpoint pupils, Resp. Depression
Tx: ABC and NAloxone Side note::Overdose Flumenazil: Benzo's Naloxone: Opiods |
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Primary theraputic indications of opiods and suggest a agent of choice?
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Morphine: Analgesia: Selective for PAin.:Sedation (amphetamine in small dose may inc. effect)
Coedine: Antitussive Mild pain Meperdine: Shorter and Faster, Less addictive Fentanyl: 80X More potent than morphine, Buccal for breakthru pain.. Diphenoxylate: DIarrhea Lopermide: Diarrhea Methadone: Greater ORal, Dec tolerance: To wean addicts off: (Torssades) |
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What are the partial agonists
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They Bind to same receptor and may antagonise or synergive with morphine liek drugs:
Pentacoxine Buprenophine Butrophanol NALBUPHine |
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Which Opiods r PRo-Drugs
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Meperdine--> Normeperidine: accumulates.
Coedine: Met. 2 Morphine Heroin: Met. 2. Morphine Codones--> Morhpnone 2 be active |
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Differenciate between Pentazocine and Naloxone:
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PENTAcozien is a Mixed agonist-Antagonist: Produces action a K receptors, pt. mu action
Naloxone is a PURE ANTAgonist |
