Neuro Opioid Analgesics WSU Flashcards

Morphine
Terms Definitions
Mu agonists yields _____ respiratory depression than Kappa
more
Are opiods better at prevention or suppression
Prevention
When should caution be used regarding opiods analgesics?
In patients with compromised respiratory systems.
With MAO-inhibitors
How are opioids generally metabolized?
LIver and gut
What are the expected signs of an opioid overdose?
respiratory depression
coma
pinpoint pupil (dilated with hypoxia)
convulsions
What is used to treat symptoms of opioid withdrawal?
Clonidine
NAME THAT DRUG:
-mu agonist
- mixed depressant & stimulant
Stimulation= miosis, constipation, billiary constriction, bladder sphincter constr.
Morphine
What are the actions of morphine?
-Actions:
- analgesia
-drowsy, mental clouding
-mood alteration (euphoria , or dysphoria in pain free ppl)
NAME THAT DRUG:
Side Effects
-miosis
-reduced respiration, decrease CO2 sensitivity (baroreceptor reflex suppressed)
- Nausea and Vomiting
-ambulatory pts (vestibular stimulation)
-Increased ICP
-itching (histamine release)
- Constipation
- increase bilia
Morphine
NAME THAT DRUG:
Causes increase intracranial pressure
Morphine
NAME THAT DRUG:
Prolongs labor and suppresses fetal respiration
Morphine
NAME THAT DRUG:
-Anticholinergic properties
-shorter duration of action than Morphine
-parenteral
- ABUSED
-less biliary spasm
-OD→ excitatory effects
-dangerous MAO-I interactions
-CNS excitations→ renal or hepatic impairment
- no labor delay→ may
Meperidine (Demerol)
NAME THAT DRUG:
-oral absorption
-longer duration than morphine (protein binding)
-heroin abuse/WD programs→ decrease euphoria
-need to consider dose addivity
"...Carmalita, hold me tighter..."

Methadone (Dolphine)
NAME THAT DRUG:
-weak analgesic
-less activity than codine
-toxic psychosis due to its stimulant activity
-related to methadone
Propoxyohene (Darvon)
NAME THAT DRUG:
-useful for treatment of cough, mild pain and diarrhea
-good for oral administration
-biotransforms to morphine
Codine
NAME THAT DRUG:
-mu agonist
-80 times more potent than morphine
-Severe chronic pain → less constipation than morphine
-Useful for breakthrough pains due to rapid onset limited duration
-new versions have recently been introduced that have an even short
Fentanyl (Sublimaze)
NAME THAT DRUG:
-weak mu agoinst
-blocks serotonin and NE reuptake
-abused
-Side Effect are Nausea, constipation, diarrhea
Tramadol (ultram)
What should you know about Oxymorphone (percodan) (oxycontin) ?
Sustained release
Better oral availability than morphine
NAME THAT DRUG (Partial (mixed) agonists & antagonists):
-lipophilic
- analgesia= morphine
-respiratory depression reaches ceiling at HIGH doses
-opiod dependence treatment
-binds protein

*If given at high doses, it can precipitate morphine withdrawa
Buprenorphine (Tengesis)
NAME THAT DRUG (Partial (mixed) agonists & antagonists):
-high doeses psychotic reaction
-effective orally
- less respiratory depression
Pentazocine (Talwin)
Name that drug (partial (mixed) agonists and antagonists)
-Kappa receptors
-Increased cardiac workload
Butorphanol (Stadol)
Rank the order of agonist effect:
pentazocine
nalbuphine
buphrenorphine
Buphrenorphine > Pentazocine > Nalbuphine
Pure opioid antagonists will reverse the effects of a single acute dose of morphine and can precipitate withdrawal in the dependent individual.
What are the three opioid antagonists?
Naloxone, Nalmefene, Naltrexone
Naloxone, Nalmefene or Naltrexone
Short acting
Naloxone
Naloxone, Nalmefene or Naltrexone
Intermediate
Nalmefene
Naloxone, Nalmefene or Naltrexone
Long acting
Naltrexone
Patients recieving MAO inhibitors require ______ opioids
Less
________ doses of opioids can be used with NSAIDS or ASA
Lower
Concurrent amphetamine __________ euphoria and analgesia while decreasing sedation.
Increases
The ___________ effects of opiods are enhanced by tricyclic antidepressants and phenothiazines, while the analgesic effects may be increased, decreased or not altered.
depressent
What is the action of Dantralene?

Possible toxicity?

What else is it used for?
Action: Decreased release of Ca from sarcoplasmic reticulum to cause decreased muscle spasms, but this will cause gen muscle weakness, dizziness and fatigue.
Toxicity: Hepatotoxicity
Also used for malignant hyperthermia, & neuroleptic malignant syndrome.
alpha 2 receptors are located on noradrenergic cells on the neuronal _________
bouton
What drug acts on boutons, synapsing on motor neurons?
Tizanidine
Explain the uses of Tizanidine
a drug which is used as a muscle relaxant. It is a centrally acting α-2 adrenergic agonist. It is used to treat the spasms, cramping, and tightness of muscles caused by medical problems such as ms, spastic diplegia, back pain, or certain other injuries to the spine or central nervous system, dry mouth, stroke, dizziness.
What type of drug is Baclofen?
GABA-beta agonist
What is the action of baclofen?
Increase potassium conductance in terminals reducing the Ca influx after the action potential.
What are some of the uses of baclofen?
Spinal cord injuries, MS, some movement disorders and ALS.
What are the adverse effects of baclofen?
Withdrawal symptoms?
Lassitude, weakness, sedation, confusion.
Withdrawal syndrome of anxiety and hallucinations.
What are the sedating drug families you should know from Lucot's lecture?
Cyclobenzaprine, metaxolone and benzodiazepines.
What type of drug is benzodiazepine?
GABA-A agonists

Used for spasm and muscle trauma
What type of drug is cyclobenzaprine and metaxolone?
Anti-cholinergic used for spasms and strains.
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