Pharm Test 2 Opioids And Immunomodulators

Front 1

­ specialized sensory receptor cells that are activated by noxious inputs to peripheral tissues

Back 1

nocireceptors

Front 2

inflamation causes which pain

Back 2

nocireceptor

Front 3

burning or an electric sensation

Back 3

neuropathic pain

Front 4

hypersensitivity to noxious stimuli

Back 4

hyperalgia

Front 5

hypersensititvity to an innocuous

Back 5

allodynia

Front 6

myelinated and mediate fast, sharp pain

Back 6

A

Front 7

unmyelinated and mediate slow burning and dull pain.

Back 7

C fibers

Front 8

how many months for neuropathic pain to be established as neuro

Back 8

6mo

Front 9

what opioids are for

Back 9

Analgesic /cough/ diarrhea/ acute pulmonary edema/ air hunger/ opiod overdose

Front 10

what nsaids are for

Back 10

Analgesic, Antipyretic, Anti inflammatory, Overdose-variable, Salicylates-CNS excitation,

Acetaminophen-liver toxicity

Front 11

where are OH groiups on morphine

Back 11

3 and 6
cns depressant

Front 12

what can codiene cause in kids?

Back 12

seizures

Front 13

codeine CH3 is where

Back 13

3

Front 14

order of strength / ease crossing BBB

Back 14

­ HEROIN> CODEINE> MORPHINE

Front 15

where is codeine and heroin converted to ...

Back 15

morphine in LIVER

Front 16

morphine exreted in .. how?

Back 16

KIDNEY

GLUCURONIDATION

6-glucuronyl-morphine
3 is inactive

Both 3 and 6 glucuronyl-morphine forms are excreted by the kidney.

Front 17

morphine binding site

Back 17

MU

Front 18

MU does what?

Back 18

therapeutic and adverse effects of opioids

o Analgesia,
euphoria,
respiratory depression,
miosis,
decreased GI motility,
physical dependence

Front 19

■ NE and 5-HT on spinal interneurons that inhibit transmission of pain

Back 19

descending inhibition

Front 20

pre post nocireceptors act how

Back 20

■ decrease the action potentials in nociceptive neurons reducing release of glutamate and substance P.
■ decrease the responses of the dorsal horn interneurons by activating K+ channels and hyperpolarizing the interneuron

Front 21

3d way morphine works

Back 21

) reduced emotional reaction to pain mediated through the limbic system

Front 22

why is morphone PCA admin

Back 22

so pts cant feel IM and "get better now" always used to be ok and wotn have withdrawl

Front 23

: lacks other opioid activities “Robitussin DM” (may interact with MAOI's)
o Cough suppression: oral; depression of cough reflex centrally

Back 23

dextromethorphan

Front 24

to decrease abuse
o Antidiarrheal effect: oral; increases GI muscle tone, delays gastric emptying, reduces peristaltic activity

Back 24

diphenoxylate

Front 25

OTC, poorly absorbed, low abuse potential
o Antidiarrheal effect: oral; increases GI muscle tone, delays gastric emptying, reduces peristaltic activity

Back 25

Loperomide

Front 26

TOXICITY

Back 26

PHYS DEPENDANCE worst at 2 days past last dose

Front 27

­
­ Tolerance
o Remain constipated and miotic

Back 27

respiraroty depression

Front 28

.
■ Must ventilate patients, sleepy
­

Back 28

Nausea vomiting, mess with CTZ zone activate vomit center
­ CNS stimulates SEIZURES on codeine and children

Front 29

GI reduced motility and constipation. Biliary colic

Back 29

­ GU – increased tone in bladder sphincter, urinary retention

Front 30

. Pinpoint pupils

Back 30

miosis
eyes overdoise of opioid

Front 31

less potent than morphine, but higher PO bioavailability.
2. Prodrug that must me metabolized to morphine
3. Primary use is antitussive. Second line analgesic, usually combined with an NSAID.

Back 31

codeine

Front 32

why is meperidine good in OB

Back 32

­ Shorter half life, good in OB bc doesn’t prolong labor

Front 33

meperidine is metabolized to what and where

Back 33

LIVER
to NORMEPERIDINE

Front 34

causes what?

Back 34

­ in liver which has long half life and toxic can cause seizures.

Problem in renally compromised pts

Front 35

why is meperidine abused by healthcare workers

Back 35

antimuscarinic effect, no pinpoint pupils

Front 36

meperidine has fatal reactions with what drugs

Back 36

MAOIS!!!!

Front 37

why is meperidine good for pancreatitis

Back 37

less sphincter of odi contraction

Front 38

­ 80x more potent then morphine.
­ Anathesia + droperidol
­ Spinal and epidural anathesia
­ Available in patch for severe pain

Back 38

FENANYL

Front 39

­ Mixed with acetaminophen
­ Moderate opioid agonist

Back 39

hydrocodone

Front 40

­ a semisynthetic opioid derived from thebane
­ ORAL combined with aspirin or Tylenol
­ As effective as morphine

Back 40

oxycodone

Front 41

how is oxycodone metabolized

Back 41

in liver

excretion in KIDNEYS

Front 42

­ MU recepot agonist
­ Inhibits reuptake of SE and NE – pain transmission
­ Seizures

Back 42

TRAMADOL

Front 43

mixed agonists are bettte why

Back 43

LESS RESPIRATORY DEPRESSION

Front 44

mixed agonist resistant to nalaxone

Back 44

buprenorphine

Front 45

o sublingually effective (lollipops)
o 25-50x more potent than morphine
o partial  agonist.
o Ceiling effect on resp depression and analgesia
o RESISTANT TO NALAXONE tx bc slowly comes off receptor s
o Recently approved for therapy of opioid dependence. Also used for migraines (nasal spray).

Back 45

buprenirphine

Front 46

"pure" competitive opioid antagonist
o reverses acute opioid toxicity
o Used IV or IM to reverse acute opioid intoxification
o Complete first pass effect so not useful orally

Back 46

NALAXONE

Front 47

NALAXONE admin which wa

Back 47

IM or IV - short half life
first pass 100%

Front 48

o Can be ORAL
o LONGER HALF LIFE – 10 hrs
o Useful in smokers and addicts ?
o Heroin effects blocked for 48 hrs

Back 48

NALTREXONE
antagonist