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10 Cards in this Set
- Front
- Back
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What's the difference between opioid, opiate, opium, narcotic and endorphin?
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Opioid - all natural/sympathetic agents with morphine-like action
Opiate - only natural agents Opium - specific natural agent Narcotic - sleep-inducing agent Endorphin - agent from any of the opioid families (enkephalins, beta-endorphins & dynorphins) |
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What are the relevant pharmacodynamics of opioids?
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A - gastric emptying delayed in OD
D - large Vd M - delayed elimination in liver failure |
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Describe the opioid toxidrome.
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Neurologic - CNS depression
Respiratory - decreased RR/tidal volume/response to hypercapnia Opthalmologic - miosis Cardiovascular - orthostatic hypotension/bradycardia GI - N/V/decreased motility/ileus Urinary - retention Dermatologic - pruritis, flushing & urticaria secondary to histamine release |
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Which opioid agents do not cause miosis?
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Meperidine, propoxyphene and diphenoxylate-atropine (Lomotil)
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What is cotton fever?
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Fever seen in IV drug users that strain their drug through cotton balls or cigarette filters. It is benign.
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Describe opioid withdrawl. Is it life threatening?
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The opposite of the toxidrome.
Agitation, tachypnea, mydriasis, hypertension, tachycardia, dysphoria, craving, N/V, diaphoresis, etc It is NOT generally life threatening, although it can cause electrolyte abnormalities and is very uncomfortable. |
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What drugs can give a similar toxidrome to opioids?
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Benzo's
Clonidine Tramadol |
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Are GL, WBI, AC or dialysis indicated for opioid OD?
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Not really. Treatment is generally supportive.
Dialysis doesn't work secondary to large Vd |
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What is the antidote to opioid OD?
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Naloxone 0.2-2mg q1-2h IV (ineffective orally due to first-pass metabolism)
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How can opioid withdrawl be treated?
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Methadone therapy
Clonidine controls symptoms by suppressing sympathetic hyperactivity (0.1mg po 30-60m) |
