opioid and HA meds

opioid and HA meds - Cliquez pour modifier le style des...

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Cliquez pour modifier le style des sous-titres du masque 2/16/11 Central Nervous NURS 324 Fall 2010 Dr. Smith
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2/16/11 Terminology and Receptors Opioid: a drug that has actions similar to morphine preferred term instead of ‘narcotic’ Endogenous opioids: peptides enkephalins, endorphins, dynorphins Three types of opioid receptors: Mu Kappa Delta
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2/16/11 Opioid Receptors Mu – activation causes analgesia (pain relief), respiratory depression, euphoria, sedation, decreased GI motility, and eventual physical dependence Kappa – activation causes analgesia, sedation, and decreased GI motility Therefore in addition to the desired effect of analgesia, drugs that
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2/16/11 Classification of Opioid Drugs Pure Agonists – agonists for Mu and Kappa receptors (divide into strong, mod-strong) -morphine, codeine, meperidine, etc Agonist-Antagonist – agonist for Kappa, antagonist for Mu receptors -pentazocine, nalbuphine (Nubain) Pure Antagonists – antagonists for Mu and Kappa
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2/16/11 Strong Opioid Agonists Common drugs in this class include morphine, hydromorphone, fentanyl, meperidine, methadone Morphine is the prototype MOA: mimics endogenous opioids and activates mu receptors Clinical use: relief of moderate to severe pain (postoperative, cancer- related, labor/delivery, MIs)
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2/16/11 Morphine Pharmacokinetics Absorption -can be given any route, longer duration with IM, IV, SC -small amount crosses BBB -affected by first-pass effect Metabolism -liver -inactivation Adverse Effects Respiratory depression -onset varies with route -most serious Constipation -most common Orthostatic hypotension Urinary retention Cough suppression Nausea/vomiting Toxicity: coma, respiratory depression, pinpoint pupils
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2/16/11 Morphine Tolerance – “state in which a larger dose is required to produce the same effect that
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opioid and HA meds - Cliquez pour modifier le style des...

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