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28 Cards in this Set

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Opioids metabolized by CYP2D6
Codeine, oxycodone, hydrocodone
Metabolite of morphine that is neuro-excitatory
Morphine-3-glucuronide
May cause seizures at high plasma levels
normeperidene - metabolite of meperidine
Receptor associated with respiratory depression
mu-receptor
Receptor associated with sedative actions
kappa-receptor
Endogenous peptides
enkephalins, dynorphins, beta-endorphin
Cellular MOA of opioids
G proteins - activate phospholipase C, or inhibit adenylyl cyclase
MOA at post-synaptic level
Open K+ channels to hyperpolarize
MOA at presynaptic level
Close voltage-gated Ca++ channels
Full opioid agonists
Morphine, methadone, meperidine, fentanyl, levorphanol, heroin
Partial opioid agonist with mild to moderate analgesic efficacy
Codeine, hydrocodone, oxycodone
Weak agonist opioid
Propoxyphene
Increased PCO2 as a result of respiratory depression leads to
Increased cerebral blood flow and increased ICP
the SE of opioids (nausea and vomiting) are a result of
activation of the chemoreceptor trigger zone and are increased by ambulation
Which opioid has a muscarinic blocking action?
meperidine
Drug class that blocks opioid tolerance
Antagonists of glutamate NMDA receptors - ketamine
Abstinence syndrome presents with
rhinorrhea, lactimation, chills, gooseflesh, muscle aches, diarrhea, yawning, anxiety and hostility
Treatment of Diarrhea
diphenoxylate and loperamide
Triad of opioid overdose
pupillary constriction, comatose state, and respiratory depression
treatment of opioid overdose
IV naloxone
Additive CNS effects of opioids combined with
Ethanol, sedatives, anesthetics, anti-psychotics, TCA's, and antihistamines
Meperidine with MAOI's increases the risk of
hyperpyrexic coma
Kappa agonist - antagonists
Nalbuphine and pentazocine
Mu partial agonist
Buprenorphine
Resistant to naloxone
Buprnorphine
Opioid antagonist with longest half-life
Naltrexone
Antagonist that decreases cravings for alcohol
Naltrexone
Tolerance does not increase with respect to
pupillary constriction and constipation