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Pharm
opioids
| Question | Answer |
|---|---|
| opioids | include former opiates and other structurally different agents, their antagonists, and the receptors stimulated by the opioids |
| classification of opioids | mechanism of action at receptor sites, chemical structure, or efficacy |
| opioids moa | bind to receptors located in CNS and spinal cord-produces altered perception of rxn to pain |
| opiod receptors | Mu, Kappa, Delta |
| Kappa receptor | causes analgesia, sedation, myosis, diuresis and is responsible for dysphoria (depression, anxiety, restlessness) |
| Mu receptor | cause analgesia, sedation, RESPIRATORY DEPRESSION, euphoria, constipation, physical dependence |
| Delta receptor | analgesia |
| Naloxone | antagonist for ALL 3 receptor sites...used for drug OD's |
| Butorphanol (Stadol) | nasal opioid spray |
| Morphine | drug against which the others are measured |
| codeine | raises pain threshold & affects cerebral cortex to depress rxn of pain |
| opioids-sedation and euphoria | sedation is produced by Kappa stimulation, Euphoria can result in larger doses |
| Oxycodone | combined w/ aspirin (Percodan) or with acetaminophen (Percocet, Tylox) to provide additional analgesic w/ fewer side effects |
| Hydrocodone | Usually combined w/ acetaminophen, origional "APAP" is used for dental patients, available as generic and is inexpensive****total dose of acetaminophen not to exceed 4 grams*** |
| Codeine | most commonly used opioid in dentistry |
| Propoxyphene | Darvocet N-100, similiar to methadone.....deaths w/ overdose, esp in combo w/ alcohol- |
| Meperidine | Demerol-fav for druggies |
| hydromorphone | Dilaudid-severe pain-rare use in dentistry |
| methadone | Dolophine-treat opioid addicts |
| Pentazocine | Talwin-only oral opioid agonist-antagonist-increasing the dose does not result in an increase in resp. depressionn**can increase bp and heart rate |
| tramadol | Ultram |
| Myosis | constriction of pupils-diagnostic sign in OD or id an addict |
| Drug interactions | all opioids interact w/ MAOI's (treat hypertension or depression) |
| Drug interactions | Propoxyphene (antiepileptic) & Carbamazapine (Tegretol) |
| Drug interactions | Meperidine (Demerol) & Barbiturates |
| Drug interactions | Meperidine & Chlorpromazine & neuroleptics, decrease BP and CNS |
| Drug interactions | Meperidine and MAOI's severe rxn: excitation, rigidity, increase in BP |
| Drug interactions | Methadone and Phenytion (Dilantin) decrease in methadone |
| Drug interactions | Methadone and Rifampin (antituberculosis antibiotic): decrease methadone levels |
Created by:
jfgwinn
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