Question | Answer |
What is an opiate? | General description of drugs derived from opium |
What is an opioid? | synthetic substance that has morphine-like actions |
What is a narcotic? | originally applied to any drug that induced sleep, now refers to any drug that can cause dependence |
What is an analgesic? | drug used to relieve pain without loss of conciousness |
Where are the opioid receptors in the CNS? | brainstem, medial thalmus, spinal cord, hypothalamus, limbic system, periphery, immune cells |
What affects are felt when the mu receptor is activated? | supraspinal.spinal analgesia, respiratory depression, euphoria/sedation, physical dependence/tolerance, decreased GI motility, pupil constriction, hypothermia, bradycardia |
What effects are felt when the kappa receptor is activated? | spinal analgesia, sedation/dysphoria, pupil constriction, diuresis, mild respiratory depression, low addiction liability |
What effects are felt when the delta receptor is activated? | spinal analgesia, dysphoria, delusions, hallucinations, respiratory/vasomotor stimulation |
What effects are felt when the sigma receptor is activated? | tachycardia, hypertension, mydriasis, tachypnea, hallucinations |
How are opioids administered? | IM, SC, PO |
Which opioids are least affected by first pass metabolism? | codeine and oxycodone |
How can lipid soluble opioids be administered? | transdermally (fentanyl patch) or by buccal mucosa |
How are opioids abused? | snorting, inhaling vapros, crushing/injecting/chewing slow release tablets, using multiple transdermal patches at once |
Where do opioids bind? | plasme proteins; accumulates in fatty tissue with continuous use |
How are true opiates metabolized? | metabolism to glucoronides, more polar and readily excreted by kidney |
What are full agonists? | bind strongly to specific receptors |
What are the strong full agonists? | high affinity for mu, low affinity for sigma
Ex: morphine, fentanyl, heroin, meperidine, methadone |
What are some moderate full agonists? | propoxyphene, codeine, oxycodone, hydrocodone |
What are mixed agonist-antagonists? | stimulate one receptor but block another |
What are some common uses for opioids? | chronic pain, trauma, burns, cough supression, diarrhea, detox from opioid use |
How do opioids work? | spinal sites: inhibit neurons that transmit pain
brainstem: activate neurons that transmit inhibitory pulses to the spinal cord |
What symptoms manifest in opioid impairment? | sedation, loss of motivation, impaired task performance, euphoria, loss of muscle tension |
What DRE category includes opioids? | Narcotic Analgesic |
What are some non-opioid analgesics? | aspirin, NSAIDs, acetaminophen |
What are some uses for aspirin? | anti-inflammatory, antipyretic, analgesic, mild anticoagulant |
What are NSAIDs? | Non Steroidal Anti-Inflammatory Drugs
Act as analgesics, antipyretics, anti-inflammatories |
What are some effects of acetaminophen? | analgesic, antipyretic, hepatotoxic |