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Pharm Exam 2 (Lectures 19-21)
Pharm Exam 2 (Lectures 19-21)
26
Pharmacology
Graduate
10/24/2011

Additional Pharmacology Flashcards

 


 

Cards

Term

Name the Opioid Drugs that are Stong Analgesics (μ receptors agonists)

(10 of them)

 

Definition

Morphine

Codeine

Fentanyl

Heroin

Hydrocodone

Hydromorphone

Meperidine

Methadone

Oxycodone

Porpoxyphene

Term

Name the Opioid Drugs that are Partial Agonists and mixed agonist/antagonist Analgesics

(4 of them)

Definition

Pentazocine

Buprenorhine

Butorphanol

Tramadol

Term

Name the Opioid Drugs that are Opioid Antagonists

(3 of them)

Definition

Naloxone

Naltrexone

Methylnaltrexone

Term

What are the two ways in which the body drives breathing?

 

How is this relavent to Opioid Poisoning?

Definition

1. CO2 receptors-when build up of the gas, tells body to breath MORE.

 

2. O2 Receptors- when build of of O2, tells the body to breath less.

 

**Opioids knock out the ability of CO2 receptors, that tell the body to breath more.  only have O2 receptors that only tell body to decrease respiration

Term
Why is the Opioid Side effect of Respiratory Depression beneficial in some cases?
Definition
WHen patient is experiencing Pulmonary Edema, breathing more can make matters worse.  Struggling to breath may aggrevate the pathophysiology of the edema, making it worse.  With Opioids, the pt. breaths less and isn't as scared.
Term

Systemically administered morphine cause the release of ____________ and may aggrevate asthma and other obstructive pulmonary diseases.

 

What are possible side effects of Spinal Morphine Administration?

Definition

Antihistimine

 

can also cause irritation of the skin.  Benadryl, and other H-1 Histimine antagonists can alleviate this effect.  

 

Severe itching of trunk and face.  Treat with Naloxone.

Term

What is the standard Therapeutic Dose of Morphine SC or IM?

 

 

Definition
10mg SC or IM
Term
What is the Characteristic Triad of symptoms for Opioid Poisoning?
Definition
  1. CNS Depression (stuppor, coma)
  2. Depressed Depth and rate of Respiration
  3. Pin Point Pupils (although, if very close to death, pupils may in fact be dilated)
Term

Morphine

 

Route of administration

Dose

Three Important Developments

Definition

Subcutaneously, IM or IV (Not as effective orally due to First Pass Metabolism

 

10mg SC, IM or 10-30mg P.O.

 

Infusion of autoinjector, Patient Controlled analgesia (pts. usually give less than needed), and Spinal Analgesia

Term

Codeine

 

  1. route of Administration
  2. Dose
  3. Uses
Definition
  1. orally effective
  2. 30-60mg P.O.  
  3. for mild to moderate pain, and Antitussive
Codeine is 1/12 the potency of morphine, and has weak opioid activity.  
Its effects come from the small amount of the codeine that is demehtylated to form morphine 
 
Genetic Polymorphisms may make people more/less sensitive to Codeine
Term

Hydromorphone

 

 

Definition
Similar to morphine, but MORE POTENT
Term
Oxycodone
Definition

Roxicodone, Percodan, OxyContin

 

cross between morphine and codeine

Orally with acetaminophen

moderate to severe pain

OxyContin used for chronic pain (Sustained Release)

Term

Hyrocodone

 

 

Definition

Lortab, Lorcet, Vicodin, Norco

 

Similar to Codeine and oxycodone

 

Used orally with acetaminophen for mild to moderate pain and antitussive

 

Most Widely Prescribed Opioid

Term

Meperidine

 

  1. Route of Administration
  2. Potency as compared to morphine
  3. Strength of effects on smooth muscle in comparison to morphine
  4. used for... (type of pain)
  5. duration of action
Definition

Demerol

 

  1. Administered orally and parenterally
  2. 1/10 potency of morphine
  3. weaker effecs, so less constipation and urin retention
  4. moderate to severe pain
  5. 1-3 hours **Not appropriate for long term use due to toxic accumulation of Normeperidine Metabolite
commonly used in Obstetrics, less respiratory depression than morphine.

 

Synthetic drug

Term

Heroin

 

  1. Potency compared to Morphine
  2. Taken by...
Definition

Diactylmorphine

 

  1. More potent, longer duration of action (4-6 hours), more euphoric
  2. snorting, injection, smoking
 
Available for medical use in some countries, but not the US
Term

Methadone

 

  1. duration of action in acute care?
  2. Duration of action in Chronic care?
  3. Used for..
Definition

Dolophine

 

  1. 4-6 hours
  2. 12-24 hours
  3. analgesic and in treatment of opioid addiction (less euphoric than heroine and morphine)
Term

Propoxyphene 

 

 

Definition

Darvon

 

Withdrawn from market in 2010

 

Much less potent than morphine

Serious cardiac toxicity at high doses

Term

Fentanyl 

 

  1. Potency?
  2. Administration?

 

Definition

(Sublimaze)

 

  1. Very potent  μ agonist  (100X more potent than morphine
  2. Administerd Parenterally to supplement Surgical Anaesthesia
  3. Lozenge Preparation available for breakthrough treatment of pain
  4.  Neuroleptic Analgesia=Innovar-Combo of fentanyl and droperidol to induce a state where diagnostic and small procedures can be performed without having to put patient under
  5. Neuroleptic Anesthesia= innovar +NO
Term
Sufentanil and Alfentanil
Definition

(Sufenta and Alfenta)

 

Similar to Fentanyl

 

Used IV as a supplement to Spinal anasthesia

Term

Opioid Combination Preparations

 

  1. what are the common combos?
  2. Used for...
Definition
  1. (codeine, hydrocodone, or oxycodone)+(aspirin, acetaminophen, or ibuprofen)
  2. used at very high doses for treatment of severe pain
EXAMPLES
  1. Codeine+Acetaminophen (tylenol with codeine)
  2. Codeine+Aspirin (empirin and generics)
  3. Hydrocodone+Acetaminophen (Vicodin)
  4. Hydrocodone+Ibuprofen (vicoprofen)
  5. Oxycodone+Acetaminophen (Percocet, Percodan)
Term

Pentazocine 

 

 

Butorphanol

Definition

Pentazocine

  • agonist at kappa receptors, partial agonist at mu receptors (At high doses, becomes antagonist for mu receptors)
  • Less effective than morphine for pain, and less sedation effects and less resp depression
  • More CNS effects and hallucinations
  • Less likely physical dependence
  • can potentiate withdrawal syndrome
  • Pentazocine+naloxone=Talwin Nx
Butorphanol
must be given parenterally or intranasally.
Term

Buprenorphine

 

 

Definition
Buprenex, Subatrex, Suboxone
  1. Partial mu Receptor Agonist
  2. mu Receptor antagonist at High doses
  3. slightly less analgesic effects than morphine
  4. much less abuse potential
  5. treats heroin addiction**New drug Suboxone is a combo drug (buprenorphine+Naloxone).  When taken sublingually, the buprenenorphine works, and naloxone (Opiod antagonist) doesn't reach its threshold--> get analgesic effects.  BUT, if pt. tries to take it IV, the Naloxone will reach threshold and act as an antagonist--> blocks opioid effects
  6. Administerd Injection, Sublingual, Intranasally
  7. Office Based Treatment of Opioid addiction
Term
Tramadol
Definition

(Ultram)

 

  1. Mild-moderate pain
  2. weak Mu agonist
  3. inhibits synaptic reuptake of NE and Serotonin, like tricyclic antidepressants
  4. good analgesia with only common opioid side effects
  5. low abuse/addiction potential
Term
Naloxone
Definition

Drug of choice for opiod poisoning (can reverse resp depressant effects of opioid)

 

  1. Not effective orally, give Parenterally
  2. Sometime in combination with oral narcotic analgesics to prevent abuse
  3. SHORT action duration (1-2hrs)
  4. can worsen withdrawal symptoms
Term
Naltrexone
Definition

(ReVia)

Opioid Antagonist

 

  1. orally, lasts 24 hours
  2. originally used in "immunizing" addicts (by inhibiting the high
  3. Risk of Hepatotoxicity
  4. Patient compliance is major problem
  5. oppiod addicts must first be detoxified before using this
  6. Effective in treatment of alcoholism
Term
Methylnaltrexone
Definition

(Relistor)

Opioid Antagonist

 

  1. Quaternary Salt-Treat opioid induced Constipation
  2. Given Parenterally (Subcutaneous)
  3. Treatment of Post-Operative Paralytic Ileus
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