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Opiods
| Question | Answer |
|---|---|
| Codeine | most commonly used opioid in dentistry |
| Codeine + Tylenol | Tylenol 3, provides greater pain relief |
| Cocaine | Abusers exhibit dilated pupils (mydriasis) |
| Morphine | First natural opiate used for acute or severe pain |
| Oxycodone | semi-synthetic opioid |
| Oxycodone + acetaminophen | Percocet |
| Oxycodone + aspirin | Percodan |
| Naloxone (Narcan) | is an opioid antagonist and used to treat opioid overdose |
| Agonists | refers to a substance that binds to and activates a receptor in the body |
| Mixed opioids | also known as mixed agonist-antagonist opioids, refer to a class of opioids that have both agonistic (activating) and antagonistic (blocking) effects on opioid receptors in the nervous system |
| Antagonists | are substances that bind to receptors in the body but do not activate them. Instead, they block or inhibit the action of agonists |
| Narcotics | original name for opiod drugs. Derived from the Greek work which means "inducing stupor or sleep" |
| Opioid Agonists | morphine (MS Contin, Kadian, Roxanol, Duramorph) oxycodone [acetaminophen/oxycodone] (Percocet) hydrocodone [acetaminophen/hydrocodone] (Vicodin) |
| Opiod Agonists | codeine (Codeine 15) methadone (Methadose) fentanyl (Duragesic, Actiq, Subsys, Sublimaze) |
| Opioid Antagonists | naloxone (Narcan) |
| Mixed Opioids | buprenorphine (Buprenex) tramadol (Ultram) |
| Three Opiod Receptors | Mu, Kappa, Delta |
| Absorption | Absorbed well when taken orally and are absorbed through the GI tract |
| Distribution | Undergo variable first-pass metabolism in the liver or intestinal cell wall |
| Metabolism | Major route in conjugation with glucuronic acid in the liver |
| Excretion | Excreted by glomerular filtration (kidneys) as their metabolites |
| Opioid Pharmacologic Effects | Analgesia, sedation and euphoria, cough suppression, gastrointestinal |
| Opiod Adverse reactions | respiratory, nausea, constipation, miosis, urinary retention, CNS effects, cardiovascular effects, billary tract constriction, histamine release, pregnancy and nursing considerations, addiction, allergic reaction, drug interaction, |
| Generic Name: morphine | Brand Name: MS Contin, Kardian, Roxanol, Duramorph |
| Generic Name: Oxycodone/acetaminophen | Brand Name: Percocet |
| Generic Name: Hydrocodone/acetaminophen | Brand Name: Vicodin |
| Generic Name: Codeine | Brand Name: Codeine 15 |
| Generic Name: methadone | Brand Name: Methadose |
| Generic Name: fetanyl | Brand Name: Duragesic, Actiq, Subsys, Sublimaze |
| Generic Name: tramadol | Brand Name: Ultram, Conzip, Rybix |
| Generic Name: buprenophine | Brand Name: Buprenex |
| Generic Name: Naloxone | Brand Name: Narcan |
| Abstinence syndrome | A constellation of physiologic changes undergone by people who have become physically dependent on a drug or chemical who are abruptly deprived of that substance. |
| Addiction | Addiction is a chronic, relapsing brain disease that is characterized by compulsive drug-seeking use despite complications or negative consequences |
| Substance use disorders | occur when the recurrent use of alcohol and/or drugs causes clinically and functionally significant impairment |
| Enabling | The behavior of family or friends who associate with the addict that results in continued substance use disorder |
| Habituation | Physiologic tolerance to or psychological dependence on a drug |
| Misuse | Use of a drug for a disease state in a way considered inappropriate |
| Physical/physiologic dependence: | The state in which the drug is necessary for the continued functioning of certain body process |
| Psychologic dependence | The state in which, following withdrawal of the drug, there are manifestations of emotional abnormalities and drug-seeking behavior. |
| Relapse | Relapse is the return to drug use after an attempt to stop |
| Tolerance | With repeated dosing, the dose of a drug must be increased to obtain the same effect |
| Withdrawal | e constellation of symptoms, as specified in the DSM-5, that occurs when a physically dependent person stops taking the drug |
| Mixed Opiod: CNS depressant | ethyl alcohol |
| Opiod Analgesic: Agonists | Heroin, meperidine (Demerol) |
| Benzodiazepine: Sedative- Hypnotics | diazepam (Valium) |
| CNS Stimulants | cocaine, Methamphetamine (Desoxyn), Caffeine (Stay Awake) Nicotine (Nicorette, Nicoderm) |
| Withdrawal Drugs: | Norepinephrine-dopamine reuptake inhibitor (NDRI), bupropion (Wellbutrin SR), Nicotine receptor partial agonists, varenicline (Chantix) |
| Psychedelics (Hallucinogens) | Lysergic acid diethylamide (LSD), Phencyclidine (PCP), Ecstasy, Cannabis (Marijuana) |
| Additional Opioid Analgesics Substance Abuse Drugs | Methadone (Methadose), morphine (MS Contin), etanyl (Duragesic), oxycodone (acetaminophen/oxycodone, Percocet), hydrocodone (acetaminophen/hydrocodone, Vicodin) |
| Psychoactive Agents | Drugs that are capable of changing behavior or inducing psychosis like reactions |
| Therapeutic Value | opiods and sedative-hypnotics |
| No therapeutic Value | Psychedelics |
| Depressants | alcohol, barbituates, volatile solvents (glue and gasoline), opiods, benzodiazepiens, NITROUS OXIDE (abused mainly in dentistry) |
| Central Nervous System Depressants Opioid Analgesics | Triad: respiratory depression, pinpoint pupils, and coma: In this serious situation naloxone (Narcan Nasal) should be administered immediately. |
| Opioid Analgesics | Dental Implications: Pain Control: because an opioid abuser develops tolerance to the analgesic effects of any opioid, treating pain with opioids is ineffective and can lead toa recovering addict to relapse. The use of NSAIDs is recommended. |
| Stimuants | Cocaine, Amphetamines, Caffeine, Nicotine |
| Cocaine | a CNS stimulant with local anesthetic properties with applied topically. |
| Amphetamines | methamphetamines produce longer duration than cocaine, other forms crystal meth and bath salts |
| Caffeine | Its action on the CNS is stimulation, Withdrawal syndrome can be identified that begins around 14 hours after the last cup of coffee |
| Sedative- Hypnotics | barbituates, alcohol, benzodiazepines diazepam (Valium), N2O |
| Sedative Hypnotics | Symptoms resemble alcohol intoxication: loss of inhibition, euphoria, emotional instability, belligerence, difficulty thinking, poor memory and judgement, slurred speech and ataxia High Doses: drowsiness and sleep occur, respiration is depressed, cardi |
| Psychedelics (Hallucinogens) | LSD (lysergic acid diethylamide), DMT (dimethyltryptamine), Ecstasy (Molly), PCP (phencyclidine), MDMA (methylenediosxyamphetamine), STP (2,5-dimethoxy-4methylamphetamine) |
| Psychedelics (Hallucinogens) | Capable of inducing states of altered perception and generally do not have any medically acceptable therapeutic use. LSD is the most potent hallucinogen |
| Pregnancy and Breastfeeding: Cocaine | Increased spontaneous abortion, abruptio placentae, premature labor, abnormal development, decreased school performance seizures |
| Pregnancy and Breastfeeding: Heroin | Neonatal dependence, low birth rate |
| Pregnancy and Breastfeeding: Alcohol | Fetal alcohol syndrome is the syndrome associated with the changes that occur in an infant exposed to excessive alcohol intake by the mother. Three areas that are affected: 1) growth retardation, 2) CNS abnormalities, and 3) facial dysmorphology, - flat |
| Pregnancy and Breastfeeding: Smoking (nicotine) | DO NOT USE. Intrauterine growth retardation, Sudden infant death syndrome |
| Generic Name: meperidine | Brand Name: Demerol |
| Generic Name: diazepam | Brand Name: Valium |
| Generic Name: methamphetamine | Brand Name: Desoxyn |
| Generic Name: Caffeine | Brand Name: Stay Awake |
| Generic Name: Nicotine | Brand Name: Nicorette, Nicoderm |
| Generic Name: bupropion | Brand Name: Wellbutrin SR |
| Generic Name: varenicline | Brand Name: Chantix |
| Generic Name: cannabis | Brand Name: Marijuana |
Created by:
abelcher2