Term
| Which receptor has the most prominent analgesic properties? |
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Definition
|
|
Term
| How do opioids essentially work? |
|
Definition
| Inhibiting periphery nociceptive input |
|
|
Term
| How do we suppress cough w/ opiates? |
|
Definition
| Codeine- depresses cough reflex center in medulla |
|
|
Term
| What is a hallmark clinical sign of opiate overdose? |
|
Definition
|
|
Term
| How do opiates cause itching? |
|
Definition
|
|
Term
| True or false- pts build tolerance to constipation effects of opiates |
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Definition
|
|
Term
| Cardiac adverse effects of opiates? |
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Definition
|
|
Term
| Symptoms of true opiate allergy? |
|
Definition
| Angioedema, bronchospasm, severe hypotension/shock |
|
|
Term
| Which opiates are considered full agonists? |
|
Definition
| Codeine, fentanyl, heroin, morphine, hydromorphone, oxymorphone, hydrocodone, oxycodone, methadone |
|
|
Term
| Which opiates are partial agonists? |
|
Definition
|
|
Term
| Which drug is an opiate antagonist? |
|
Definition
| Naloxone (narcan; used to treat OD) |
|
|
Term
| Which opiates are natural phenanthrenes? |
|
Definition
|
|
Term
| Which opiates are synthetic phenanthrenes? |
|
Definition
| Oxycodone, hydrocodone, oxymorphone, hydromorphone |
|
|
Term
| Which opiates are phenylpiperidines? |
|
Definition
|
|
Term
| Which opiate is a diphenylheptane? |
|
Definition
|
|
Term
| How is codeine metabolized? |
|
Definition
| In liver: glucuronidation to codeine-6-glucuronide; CYP2D6 to morphine (active metabolite) |
|
|
Term
| What schedule drug is codeine? |
|
Definition
|
|
Term
| Ultra-rapid codeine metabolizers have a mutation in which allele? |
|
Definition
|
|
Term
| What schedule drug is morphine? |
|
Definition
|
|
Term
| What is the trade name for immediate release hydromorphone? |
|
Definition
|
|
Term
| What are the trade names for the different formulations of Oxycodone? |
|
Definition
Immediate release: roxicodone
Extended release: oxycontin
W/ acetaminophen: percocet |
|
|
Term
| What is the active metabolite of oxycodone? |
|
Definition
|
|
Term
| Is fentanyl bioavailable? |
|
Definition
| No; no oral formulations- typically administered transdermally |
|
|
Term
|
Definition
| Mu-receptor agonist; MAOi; blocks NMDA receptor |
|
|
Term
|
Definition
| QT prolongation; seizures |
|
|
Term
| Which opiate has the greatest seizure potential? |
|
Definition
|
|
Term
| What is the generic bowel regimen for opiate users? |
|
Definition
| Stimulant laxative (senna) + stool softener (docusate) |
|
|
Term
| What schedule drug is tramadol? |
|
Definition
|
|
Term
| What schedule drug is buprenorphine? |
|
Definition
|
|
Term
| Which opiate should we potentially avoid in patients with renal impairment? |
|
Definition
|
|
Term
|
Definition
1) Determine 24-hr requirement
2) Convert to new opiate via ratio
3) Reduce 24-hr dose by 25-50%
4) Breakthrough pain coverage: 10% of 24-hr dose q4-6hr |
|
|
Term
| What does schedule I mean and what are examples? |
|
Definition
| No currently accepted medical use in US; high potential for abuse. (Heroin, MDMA, LSD, marijuana) |
|
|
Term
| What does schedule II mean and what are examples? |
|
Definition
| High potential for abuse; legal to prescribe but w/ strict federal regulations. (Most opiates, cocaine, pentobarbital) |
|
|
Term
| Can refills be written on a C-II scrip? |
|
Definition
|
|
Term
| Is there a time limit on filling a C-II scrip? |
|
Definition
| No; pharmacists use your judgment |
|
|
Term
| Can a C-II scrip be faxed over? |
|
Definition
| No; a hard copy must be presented, except for pts at long-term care facilities |
|
|
Term
| How frequently do C-II scrips need to be reviewed in the hospital setting? |
|
Definition
|
|
Term
|
Definition
| Ketamine, dronabinol, codeine |
|
|
Term
|
Definition
|
|
Term
| How many refills can be written for C-III to V? |
|
Definition
|
|
Term
| How long after C-III to V scrip is written til it expires? |
|
Definition
|
|
Term
| How often does C-III-V scrip need to be reviewed in hospital setting? |
|
Definition
|
|
Term
| Symptoms of opioid withdrawal |
|
Definition
| Rinorrhea, lacrimation, yawning, chills, goosebumps, hyperventilation, mydriasis (dilated pupils), muscle aches, diarrhea, anxiety, hostility, N/V, tremor |
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