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