Shared Flashcard Set

Details

Pharmacology Final part 1
Opioids
39
Health Care
Graduate
12/18/2008

Additional Health Care Flashcards

 


 

Cards

Term
what are the withdraw symptoms of opioids?
Definition

Anxiety

Chills

Hyperventilation

Hyperthermia

Hostility

Lacrimation

Muscle Aches

Mydriasis

piloerection

rhinorrhe

Vomiting/Diarrhea

Yawning

Term
what are the uses for opioids?
Definition

ANALGESIA

anesthesia

acute pulmonary embolism

cough

diarrhea

shivering

Term
what are the main SEs for opioids?
Definition

constipation

itching

mental clouding/confusion

nausea/vomiting

respiratory distress

sedation

urinary retention

Term
which 2 opioids are used to treat acute pain, chronic pain and cancer pain?
Definition

Morphine

Fentanyl

 

they are both Preg. C and Class 2

Term
what should avoid using with fentanyl?
Definition

MAOIs

grapefruit

Term
what are some additional SEs that Fentanyl causes?
Definition

cough

insomnia

wt loss

~10% rigidity and mm aches

Term
what unique form does fentanyl come in?
Definition
the Actiq lollipop
Term
which opioids do you use for mild to moderate pain?
Definition

codeine

propoxyphene

tramadol

Term
besides using codeine for mild to moderate pain, what else can it be used to treat?
Definition
cough
Term
which of the drugs used to treat mild to moderate pain has been shown to not be of much use and is so easily obtained it is often used in suicides?
Definition
propoxylphene
Term
what are some things you need to look out for when using tramadol?
Definition

do not use in a pt with severe hepatic disease

 

do not used ER in renal pts

 

can cause N/V, dizziness and seizures

 

(also its a weak mu agonist)

Term
which opioids are used to treat moderate to severe pain?
Definition

hydrocodone

hydromorhpone

meperidine

oxycodone

oxymorphone

Term
which opioid used for moderate to severe pain is assc with drug dumping when alcohol is used?
Definition
hydromorphone
Term
which opioid drug used for chronic pain, cancer pain and acute pain is assc with drug dumping when the patch form is used?
Definition
fentanyl
Term
which opioid used for moderate to severe pain is class 3 and which is preg B?
Definition

hydrocodone

 

oxycodone

Term
which opioid is a prodrug of morphine?
Definition
codeine
Term
which other drug do you need to be especially careful with when its combined hydrocodone?
Definition

acetaminophen (combo is Vicoden)

 

becomes toxic at >4 g/d

Term
which opioid used for mod to severe pain has a toxic metabolite?
Definition

meperidine

 

(also can't be used with MAOIs)

Term
what are some additional SEs assc with meperidine?
Definition

agitation

mm jerks

seizures

hypotension at high doses

Term
what are the contraindications for all opioids?
Definition

Head Injury - increased ICP

Pregnancy - can have an addicted baby

Impaired pulmonary function

Endocrine disease

Hepatic / Renal failure

Term
which opioid used for mild to moderate pain has been assc with an increase in seizures?
Definition
codeine
Term
which opioid used to treat moderate to severe pain is also used to treat obstetric pain, anxiety and used as an anesthetic?
Definition
oxymorphone
Term

when is it best to take oxymorphone?

 

who should not take it?

Definition

on an empty stomach (50% more is released w/ food)

 

 

kids, those with mod-sev hepatic disease

Term
which opioid is used to treat chronic pain, cancer pain, opioid withdrawl (including heroin) and neuropathic pain?
Definition
methadone
Term
what additional SEs can methadone cause?
Definition

sweating

high doses can cause prolonged QT intervals and cardiac arrhythmias

Term
which two drugs should be avoided when using methadone?
Definition

rifampin

phenytonin

 

may cause withdrawl

Term
which opioid has derivatives and what are they?
Definition

fentanyl

 

sufentanil

remifentanil (used in short painful procedure, post op and has a more rapid onset)

Term
which drugs are opioid antagonists?
Definition

naloxone

alvimopan

methylnaltrexone

Term
which opioid antagonists are used to treat constipation caused by opioids?
Definition

methylnaltrexone

naloxone

Term
what preg categories are the opioid antagonists?
Definition

naloxone - C

alvimopan - B

methylnaltrexone - B

Term
which opioid antagonist is used a lot in code situations?
Definition

naloxone

 

for drug OD, opioid AEs/reversal

Term
which opioid antagonist is used to treat post op ileus?
Definition
alvimopan
Term
when is methynaltrexone indicated?
Definition
only in advanced illness, pallative care and when other laxatives have failed
Term
what are the additional SEs of methylnaltrexone and alvimopan?
Definition

methyl - abd pain, NVD, dizziness

 

Alv - constipation, flatulence, back pain, hypokalemia, urinary retention

Term
which 2 opioids should not be used with MAOIs?
Definition

fentanyl

meperidine

Term
What is the MOA of opioids?
Definition

bind to opioid receptors (mainly mu) in the CNS

 

1. inhibits transmission of nociceptive input

2. activates descending inhibitory pathways

3. alters limbic activity

 

(opens K channels which hyperpolarizes it)

Term
which opioids should not be used in kids?
Definition

fentanyl

oxymorphone

Term
which opioid is good for using long term at home?
Definition
oxycodone
Term
what problem did alvimopan cause in high doses? (doses no longer used anymore)
Definition
cardiac toxicity
Supporting users have an ad free experience!