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35 Cards in this Set
- Front
- Back
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To what effect of the opioids does tolerance develop RAPIDly?
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Nausea and vomiting
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To what 4 effect of opioids does tolerance develop at a moderate pace?
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-Analgesia
-Resp depression -Euphoria -Endocrine effects |
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To what 2 effects of opioids does tolerance rarely develop or not at all?
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-Miosis
-GI constipation |
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How does tolerance to opioids interact?
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They are Cross-Tolerant: Tolerance to one means tolerance to ALL
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What do you do when tolerance to the opioids develops?
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GIVE MORE DRUG
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What develops when exposure to opioid analgesics is CONTINUOUS?
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PHYSICAL DEPENDENCE
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What is physical dependence?
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Abnormal body function when the drug is stopped or an antagonist is given
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What drug can induce withdrawal symptoms?
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Naloxone
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What are the main signs/sx of opioid drug withdrawal in the first 6-12 hrs?
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-Drug seeking behavior
-Restlessness -Lacrimation/runny nose -Sweating -Yawning |
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What are the main signs/sx of opioid drug withdrawal at 12-24 hrs?
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-Restlessness/tremor/irritable
-Sleeping -DILATED PUPILS -Gooseflesh |
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What are the main signs/sx of opioid drug withdrawal from 24-72 hrs?
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-Increased intensity of prior
-Nausea/vomiting/cramps -Weakness/depression -Involuntary limb movement -Increased HR/increased BP |
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What term describes the phase of 12-24 hrs? Why?
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Quitting cold turkey (goosebumps)
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What term describes the phase of 24-72 hrs? Why?
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Kicking the habit - involuntary limb movements
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What happens during opioid withdrawal after 72 hrs?
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Symptoms linger but decrease in severity
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When does an opioid addict recover from withdrawal symptoms?
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In 7-10 days
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What symptom always lingers in an opioid addict?
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Craving
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What opioids will have a faster or later onset of withdrawal symptoms?
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-Faster for shorter halflife opioids like Fentanyl
-Slower for drugs like Methadone |
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What are 4 signs of Opioid abuse?
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-Euphoria
-Craving -Drug-seeking behavior -Withdrawal |
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What 4 drugs are used for treating opioid abuse?
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Naloxone + Buprenorphine
Naltrexone Methadone |
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What is Buprenorphine again?
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A partial mu agonist and full kappa antagonist
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What is the combo of Buprenorphine and Naloxone called?
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Suboxone
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What is the formulation of Suboxone and why?
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Sublingual - to decrease the potential for abuse by injection
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What effects are seen with Buprenorphine at low doses?
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Similar to those of full Mu agonists, but with a ceiling and less side effects
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Why is Buprenorphine given to treat opioid dependency?
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It reduces withdrawal symptoms
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What does Buprenorphine do at HIGH doses?
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Actually blocks the effects of other opioids
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What would happen if you gave a high dose of Buprenorphine to an addict that had a full agonist in their circulation?
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You would PRECIPITATE withdrawal symptoms by blocking the full agonist effects.
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What drug is given in emergency kits to heroine addicts to prevent cardiovascular failure?
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Naltrexone
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What does naltrexone do?
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Fully blocks the effects of opioids by competitive antagonist action - precipitates withdrawal
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What other type of treatment is necessary for patients that have successfully undergone withdrawal?
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Behavioral
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What drug is used to KEEP patients off opioids?
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Naltrexone
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What is an additional drug that can precipitate withdrawal symptoms in opioid addicts?
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Nalbuphine
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What is Nalbuphine's receptor activity?
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-Mu antagonist
-Kappa agonist |
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Is Nalbuphine used for treating opioid dependence?
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no
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What is Nalbuphine used for?
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Treating pain (similar efficacy to morphine) but with lower abuse potential
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How is Nalbuphine administered?
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Injectable only
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