Term
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Definition
| anything with action similar to morphine |
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Term
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Definition
| not used with precision - analgesic, CNS depressant anything capable of causing dependence - legal context |
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Term
| Endogenous Opioid Peptides |
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Definition
enkephalins
endorphins
dynorphins |
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Term
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Definition
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Term
| Which one do opioids not interact with? |
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Definition
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Term
| Action of opioid on Mu receptor |
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Definition
| activation include analgesia, respiratory depression, euphoria, sedation |
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Term
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Definition
| activate mu and kappa morphine pro-type -strong opioid codiene - pro type mod - strong |
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Term
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Definition
-Acts an antagonist to mu sites and agonist to kappa sites
- Do no give with a pure opioid it will block the action |
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Term
Agonist- Antagonist Drugs
Pentazocine |
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Definition
- Talwin
- mild to moderate pain
- activation of Kappa sites produces analagesia, sedation, little resp depression
- little euphoria, can produce anxiety at sub therapuetic levels
- can trigger withdrawl in opioid dep patients
- orally - 50 mg every 3-4 hours |
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Term
Agonist-Antagonist
Nalbuphine
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Definition
- Nubain
- when used in labor can cause bradycardia of fetus
- supplied Iv, IM, Sq
- Dose 10 mg every 3-6 hours |
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Term
Agonist-Antagonist
Butorphanol |
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Definition
- Stadol
- blocks mu stimulates kappa
- ceiling effect less than 1/2 of morphine
- increases cardiac work
- IV, IM, Nasal spray
- IV - 1-2 mg every 3-4, IM 2mg every3-4
- Used as nasal spray for migranes |
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Term
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Definition
- should be administered on a fixed schedule and given before pain returns |
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Term
| Opioid Withdrawl Reaction |
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Definition
- Seen when given at high doses for over 20 days
- withdraw slowly with tapering doses over 3 days
Physical Dependence - abstinence syndrome
Abuse- drug use that is inconsistent with medical or social norms
Addiction- behaviour pattern characterized by continued use of psychoactive substance despite harm |
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Term
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Definition
Meperidine ( Demerol) less likely to depress fetal respiration |
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Term
| Myocardial Infarction Opioid |
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Definition
- Morphine opioid of choice, also lowers BP and decrease cardiac work load |
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Term
Opioid Antagonists
Naloxone |
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Definition
Naloxone ( Narcan) - structural analog of morphine acts as a competitive antagonist
Reversal of Post operative Opioids - 0.1 to 0.2 mg IV every 2-3 minutes
Opioid Overdose - 0.4 mg every 2-3 minutes
Neonatal resp depression - 10 Mcg/ kg V |
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Term
Opioid Antagonists
Methylnaltrexone |
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Definition
- Used of opioid induced constipation, selective mu antagonist
- Does not readily cross blood brain barrier so it does not block opioid effect on the brain
-SQ, half life 8 hours |
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Term
Opioid Antagonist
Alvimopan
(Entereg) |
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Definition
-selective Mu antagonist
- approved for only short term use of opioid induced ileus
- long term use associated with MI
- 12 mg given 0.5 to 5 hours before surgery, then 12 mg 2 x day for a total of 15 doses |
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Term
Nonopioid Central Acting Analgesics
Tramadol ( Ultram) |
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Definition
MOA- analog of codiene weak agonist of mu receptors, blocking uptake of norepinephrine and serotonin
Peak in 2 hours with half life 5-6 hours
hepatic metbolism
- few side effects
- Can enhance ETOH and benzodiazepines, interaction with MAO's, SSI, tricyclic antidepressants, triptans. |
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Term
Non-Opioid Central Acting Analgesics
Clonidine (Duraclon) |
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Definition
- also treatment for HTN
- for pain relief it is my epidural infusion
MOA- alpha2-adrenergic agonist, binding with presynmaptic alpha receptors |
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