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32 Cards in this Set

  • Front
  • Back
Location of most opioid receptors and endogenous opioids
Spinal cord
How does accupuncture relieve pain.
Causes endogenous opioid release
Four opioid receptors
Mu, Kappa, Delta, Sigma (not important)
How does morphine cause respiratory depression?
Decreases response of brain stem respiratory neurons to CO2 and bronchoconstriction due to histamine release.
Should morphine be given to COPD or asthma patients
NO
How does morphine cause antitussiveness
Suppress the cough reflex. Occurs at subanalgesic doses
Morphine side effects
Mood changes, nausea and vomiting by CTZ, respiratory depression, antitussive, miosis, urinary retention, no gonadotropins, hypotension, constipation
How is morphine metabolized?
Glucuronide conjunction. Excreted in urine.
Tolerance to opioid happens how?
Pharmacodynamic. Internalization of receptors.
When does action of morphine first start and when is its peak.
First symptoms- 8-12 hours
Peak- 36-72 hours
Symptoms of opioid withdrawal
Diarrhea, vomiting, chills, fever, lacrimation, rhinorrhea, tremor, kicking legs.
What is the drug that can be used in opioid withdrawal?
Clonidine
Codeine
Natural opioid with 1/10th the potency of morphine. Used as antitussant and analgesic. Usually used with aspirin or acetaminophen. Taken orally.
Variable oral absorption. Crosses BBB rapidly due to high lipid solubility. Illegal.
Heroin
What is the difference between oxycodone and morphine.
Same effects and potency but has a higher oral activity.
Hydromorphone (Dilaudid)
Same effects as morphine but higher oral activity and 10x potency.
Apomorphine (fake morphine)
Little analgesic activity but can cause respiratory depression. Used to cause vomiting by action on CTZ (chemoreceptor trigger zone)
Dextromethorphan (romilar)
Antitussant. Little analgesic or side effects.
Meperidine (Demerol)
synthetic opioid. Shorter duration of action than morphine. 1/10th the potency. Used in pregnancy.
Fentanyl (Sublimaze)
Orally active but in i.v. anesthesia. 80x potency of potency. Very short half life. Redistribution is major means of action termination. Very lipid soluble. Used exclusively in cardiac surgeries . Synthetic
Alfentanil and Sufentanil
Similar to fentanyl. Synthetic
Methadone
(dolophine)
Same potency of morphine. 15 hour 1/2 life. Synthetic
LAAM
(L-alpha-acetyl-methadol)
Long acting form of methadone used for maintenance of heroin addiction. Synthetic
Propoxyphene
(Darvon)
About the same as codeine. Combo with aspirin and acetaminophen. Synthetic
Diphenoxylate
Used for diarrhea.Oral only. Abuse potential so combined with atropine to make Lomotil. Synthetic
Loperamide
OTC for diarrhea. As affective as diphenoxylate but poorly absorbed orally. Inhibit gut motility. Synthetic
Triad of opioid overdose.
Coma, respiratory depression, pinpoint pupils.
Naloxone
Competitive antagonist at all opioid receptors. Used for opioid overdose. Only given by injection (i.v. or i.m.)
Naltrexone
Pure opioid antagonist with longer duration of action than naloxone. 24 hours. Only taken orally.
Pentazocine
Agonist/antagonist. Used for mild to moderate pain. Mu antagonist that helps in opioid withdrawal but does not stop respiratory depression. Kappa and sigma agonist. Can cause hallucination at high dose due to sigma receptor.
Nalbuphine and Butorphanol
Moderate to sever analgesic. Mu antagonist. Will induce abstinence syndrome in dependents. Kappa agonists for analgesia. No sigma function.
Buprenorphine
Partial mu agonist. Induces abstinence syndrome.