• 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

1/14

Click to flip

14 Cards in this Set

  • Front
  • Back
what is the cause of death in opioid overdose?
respiratory failure
activation of opioid receptors:
mu:
kappa:
delta:
where are opioid-Rs mostly located?
mu: analgesia, resp depression, miosis, reduced GI motility, euphoria, sedation (most of morphine's actions)
kappa: similar to mu
delta: binds leu-enkephalin.
All are associated with Gi (thus lower cAMP) or K channel efflux (hyperpolarize cell); both limit NT release and response
-mostly in CNS and GI tract
how does morphine block pain?
causes IPSP in pain sensory neurons. also inhibits the inhibitor of, thus stimulating descending neurons which normally inhibit ascending pain transmission.
how long will morphine remain in the plasma?
3 hours
what is the most efficacious opioid agonist?
morphine, fentanyl, as well as most others, all have very high efficacy. however, some may be much more potent, eg fentanyl.
how does meperidine relate to morphine?
more rapid onset, shorter duration.
how do diphenoxylate and loperamide relate to morphine?
they are insoluble, act mainly only in GI to reduce diarrhea and GI secretions and motility. obviously they are only oral
how is methadone dif than morphine?
better oral uptake. it remains in plasma longer than morphine
how does propoxyphene relate to morphine?
very low potency. can lead to pulmonary edema. often combined with aspirin. not for severe pain
what are the two opioid-R antags? difs
naloxone - IV
naltrexone - oral, longer duration
list two mixed opioid agonist/antag. what are their use?
pentazocine (agonist at kappa)
buprenorphine (agonist at mu)
-both can be used as an analgesic in someone naive to opioids
-used to produce withdrawal in an opioid abuser
discuss dif mechanisms to treat opioid dependence
Methadone (either acutely, with a gradual reduction, OR in very high doses, leading to cross-tolerance, reducing the psychological dependence on heroin)
-or using antagonists, Naltrexone , or partial agonists, buprenorphine, which will lead to more violent, yet more quickly resolved withdrawal episodes
signs of opioid overdose
signs of withdrawal, will also occur on antagonist-precipitated withdrawal
overdose: miosis, constipation, sedation, resp depression, no cough reflex
-withdrawal: mydriasis, diarrhea, hyperventilate, anxiety,
would meperidine be a good choice for helping wean a chronic opioid abuser?
no, it has a shorter duration than morphine. the better choice is methadone, which has a longer duration