Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/39

Click to flip

39 Cards in this Set

  • Front
  • Back
oral bioavailability of morphine (low or high)
administration of morphine
rate of entering CNS (slow/fast)
low
IM or IV
slowly (compared to heroin or methadone, except in infants)
clinical uses of morphine
post-op
renal colic
MI
pain for terminal illness (esp CA)
contraindications for morphine
TBI
asthmatics (--> bronchoconstriction and histamine release)
pts with decreased resp reserve
hypovolemic pts
liver or kidney dz
which receptor does methadone act on?
low or high bioavailability
interaction of methadone with morphine
t 1/2 of methadone
mu
high
cross tolerance and dependence
15-40hrs
uses of methadone
similar to morphine
detox of morphineheroin abusers
receptors for meperidine
bioavailability
metabolism of meperidine
synthetic mu agonist
50%
to normeperidine (causes convulsions)
contraindications of meperidine
NEVER >1 week
NEVER with MAOI
which opiate is safe to use in pregnancy?
meperidine
what are the advantages to meperidine
doesn't delay labor
doesn't elevate biliary tract pressure
less constipation
less miosis
metabolism of heroin
converted to 6 monoacetyl morphine and morphine
which is more potent: morphine or fentanyl
fentanyl (100x more potent)
which are the strong opioid agonists
heroin
fentanyl
morphine
meperidine
methadone
mild-moderate opioid agonists
oxycodone
propoxyphene
codeine
tramadol
bioavailability of oxycodone
high; not susceptible to 1st pass inactivation
effects of propoxyphene
CNS excitation
delusions
hallucinations
no eurphoria
interesting points about codeine
10% of whites can't metabolize
commonly used as anti-tussive
mild analgesic
MOA of tramadol
centrally acting atypical agonist
weak mu agonist with GABA-ergic, NorE, and 5HT activiites
contraindications for tramadol
SSRI
examples of mixed agonists-antagonists
pentazocine
buprenorphine
nalbuphine
butorphanol
pentazocine acts at which opioid receptor
kappa agonist
mu partial agonist
effects of pentazocine at high doses
dysphoria
anxiety nightmares
effects of nalbuphine and butorphanol
similar to pentazocine
less likely to cause euphoria
ceiling effect seen in which drugs
mixed agonists-antagonists
receptor buprenorphine acts on
mu partial agonist
which drug is marketed as an alternative to methadone for opioid dependence
buprenorphine
MOA of dextromethorphan
doesn't bind mu agonist
binds to receptor tha tmediates cough suppression
safest anti-tussive available
which opioids are used as anti-tussives
dextromethorphan
codeine
hydrocodone
which opioids are used to treat diarrhea
diphenoxylate
loperamide
MOA of diphenoxylate
diminishes peristaltic reflex
At high doses, systemic my agonist effects are seen
what are the anti-diarrheal opioids combined with?
atropine
what are the pharmacological activities of opioid antagonists dependent on
whether endogenous opioids have been released
whether opiate agonists have been been previously administered
pharm profile of opiate
degree of physical dependence
which opiate antagonist has the longest half life?
naltrexone (14 h) > nalmefene (10 h) > nalaxone (48 min)
which are the opioid antagonists?
nalaxone
naltrexone
nalmefene
which opioids have reduced 1st pass hepatic glucuronidation?
what accounts for this?
codeine
hydrocodone
oxycodone
modification on the R1 (off of C3)
what do the delta opioid receptors do?
spinal analgesia
decreaed GI motility
what do kapp receptors do?
mediates analgesia through spinal cord
dysphoria
disorientation
anxiety
what do mu receptors do?
mediate analgesia through supraspinal mechanisms
respiratory depression
miosis
euphoria
decreased GI motility
physical dependence
which are the endogenous opioids and which receptors do they selectively activate?
enkephalins: delta
dynorphins: kappa
b-endorphins: mu
endomorphins: mu
nociceptin: nu
where are enkephalins found?
how are they stored?
adrenal medulla, GI, cortex, spinal cord
co-stored in adrenal medulla granules wiht NorE and Epi