Term
| Name the opioid antagonists |
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Definition
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Term
| Name the mixed opioid agonists/antagonists |
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Definition
Buprenorphine (partial Mu agonist, weak delta and Kapa antagonist)
Nalbuphine ( kapa agonist Mu antagonist)
Pentazocin (kapa agonist Mu antagonist) |
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Term
| Name the strong opioid agonists |
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Definition
morphine
methadone
meperidone |
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Term
| Name the moderate opioid receptors |
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Definition
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Term
| Name the weak opioid agonists |
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Definition
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Term
| what receptors do opioids work on? |
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Definition
G-protein couples
3 subtypes
Mu
Kapa
Delta |
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Term
| How do opioids exert their effects? |
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Definition
Decrease AC
Decrease cAMP
Decreased Substance P
Decrease in Ca++ entry
Decrease in ACH release - decreased GI motility |
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Term
| When is morphine contraindicated? |
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Definition
Head injury as it decreases intracranial pressure
Billary colic - as it causes contraction |
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Term
| What are the main peripheral effects of opioids? |
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Definition
GI motility - causing constipation
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Term
| What specific properties does meperidine have |
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Definition
Tachycardia - antimuscurenic effects
Relaxation of biliary smooth muscle thus used in biliary colic |
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Term
| what are the CNS effects of morphine? |
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Definition
Analgesia - thus reduces anxiety thus used in MI to calm the patient
Respiration depression
Cough depression
Constriction of pupil
Decrease GI motility |
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Term
| What opioids are used in Cough suppression? |
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Definition
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Term
| What opioids are used in Diarrhoea? |
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Definition
Mu receptors are activated - decreases GI motility
Diphenoxylate
Loperamide |
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Term
| Tolerance to all effects of opioids is experienced...except? |
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Definition
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Term
What are the clinical withdrawl signs and symptoms of opioids?
What is given to Tx? |
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Definition
Chills
lacrimation
Mydrasis
hyperventilation
diarrhoea
anxiety
Give : methadone/ buprenorphine |
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Term
What is the clinical triad of Opioid/morphine OD?
Tx? |
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Definition
Miosis - Pinpoint pupil
coma
cynosis
RESPIRATORY DEPRESSION!
opioid antagonist:
Naloxone iv
Naltrexone - oral |
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Term
| When can Naloxone/ naltrexone not be given to a patient on opioids? |
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Definition
| If a patient is physically dependent on opioids you cannot give an antagonist of opioids to treat them as it will precipitate withdrawal. |
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Term
Which opioid is a pro drug?
which individuals will have reduced sensitivity to codeine? |
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Definition
Codeine - converted by CYP2D6 to Morphine
Patients with a genetic deficiency in the CYP2D6 enzyme |
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Term
Which opioid can be used for long term pain relief for terminal cancer patients?
what is the advantage of this method of adminsteration |
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Definition
Transdermal Fentynal
avoid tolerance as its given over time |
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Term
| WHat is another use of naltrexone? |
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Definition
| ALcohol withdrawal as it reduces the craving |
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