Pharm -2- Opioids
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| What is the difference between opiate and opioid | opiate is naturally derived drug from opium (morphine and Codeine) a opioid is a drug natural or synthetic with morphine like qualities
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| A drug with addictive properties that can produce analgesic and sedative effects is termed what | narcotic
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| What are the functional classifications of opioids | Agonist, Antagonist, Agonist/antagonist and other
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| What type of drug is Fentanyl (Sublimaze, Duragesic) | Strong Opioid Agonist
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| What type of drug is alfentanil, remifentanil and sufentanil | strong opioid agonist used for anesthesia related to fentanyl
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| What type of drug is heroin | Strong Opioid Agonist that has no medical use
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| What type of drug is Hydromorphone (Dilaudid) | Strong Opioid Agonist
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| What type of drug is Meperidine (Demerol) | Strong Opioid Agonist
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| What type of drug is methadone | Strong Opioid Agonist
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| What type of drug is Morphine Sulfate (MS Contin) | strong opioid agonist
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| What type of drug is Codeine (Robitussin AC) | Moderate Opioid Agonist
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| What type of drug is Oxycodone (OxyContin) | Moderate Opioid Agonist
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| What type of drug is Hydrocodone | Moderate Opioid Agonist
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| Tylenol | 2,3,4 are combos of what drugs
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| Vicodin and Lortab combine what drugs | acetaminophen/hydrocodone
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| Vicoprofen combines what drugs | Ibuprofen/Hydrocodone
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| Percocet is a combo of what drugs | acetaminophen/Oxycodone (class II schedule drug)
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| What type of drug is Loperamide (Imodium) | weak opioid agonist
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| What type of drug is Diphenoxylate (Lomotil) | Weak opioid Agonist combined with atropine
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| What type of drug is Propoxyphene (Darvon | Weak Opioid Agonist combined with acetaminophen
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| What type of drug is Dextromethorphan (Delsym, Robitussin DM) | Weak Opioid Agonist
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| What type of opioid is Tramadol (Ultram( | Classified as Other opioid
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| What type of drug is Pentazocine (Talwin | Opioid Agonist/antagonist
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| What type of drug is Nalbuphine (Nubain) | Opioid Agonist/antagonist
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| What type of drug is Butorphanol (Stadol) | Opioid Agonist/antagonist
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| What type of drug is Naloxone (Narcan) | Opioid Antagonist
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| What Type of drug is Naltrexone (ReVia) | Opioid Antagonist
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| Define a schedule I controlled substance | no medical use high addiction potential (Heroin)
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| Define a schedule II controlled substance | medical use but has high addiction potential (strong and moderate opioid agonists)
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| Define a Schedule III controlled substance | Medical Use potential for dependence (Lortab, Tylenol
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| Define a Schedule IV controlled substance | Medical Use low abuse potential (Weak Opioid agonists)
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| What are the 5 types of opioids receptors | Mu "reap, Kappa "Sam", Delta, Epsilon, Sigma
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| What is the Mu opioid receptor associated with in regards to opioids tx | REAP- respiratory depression, euphoria, analgesia, physical dependence
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| What is the kappa opioid receptor associated with in regards to opioid tx | SAM- Sedation, Analgesia, Miosis
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| What are the endogenous Opioids | Endorphins, Dynorphins, Enkephalins
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| T/F the highest number of opioid MU receptors are found in the cerebral cortex | T
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| Pain can be modified anywhere along the pain pathway where are the three main sites for opioids to exert their analgesic effects | Spinal Cord, Thalamus and Limbic System, Brainstem
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| Opioids blocking pain in the spinal cord are typically modifying ascending pain signal (afferent) or Efferent pain signal | Inhibit release of neurotransmitters in spinal cord form afferents
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| What are the contraindications for using morphine | respiratory compromise, Asthma, Intracranial injuries, Paralytic Ileus
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| What are the adverse effects of morphine | euphoria, dysphoria, respiratory depression, Nausea, Constipation, sedation, pruritis, urticaria, bronchospasm, urinary retention, anxiety, hypotension.
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| What schedule is morphine | schedule 2
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| What receptors does morphine act on | Mu (REAP- respiratory depression, euphoria, analgesia, physical dependence), Kappa (SAM- Sedation, Analgesia, Miosis)
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| What options exists for route of delivery of morphine | PO, IV, SC, IM, PR
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| What type of pain is morphine most effective on | visceral pain
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| T/F morphine could potentially be given to suppress a cough | T
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| What effect does morphine have on the skin | it causes histamine release and causes pruritis
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| What effects does morphine have on the lungs besides respiratory depression | Bronchospasm avoid use in asthmatics
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| If you give morphine to stop pain during labor what could you cause | prolongation of labor because it effects contractions of the uterus
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| What is the half life of morphine | 2.5- 3 hours lose 90% in the first day
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| What is the clinical uses for Methadone | absorbed well orally used in maintenance program for narcotic dependence treatment and powerful pain reliever
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| Why is Meperidine (Demerol) a good pain relief choice for patients with biliary disease | it does not constrict the sphincter of Odi
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| When is Meperidine (Demerol) contra indicated | pts receiving MAOI
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| How much more potent is Fentanyl than morphine | 80-100 times
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| Fentanyl comes in a dermal formula (Duragesic) what are some concerns with using this route | Easy overdose potential if pt forgets to take of previous patch and puts another one on (especially elderly)
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| What are some common uses for Fentanyl (Sublimaze, Duragesic) | Used in epidurals, and transdermally (Duragesic) for chronic pain patients
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| Apart from analgesia what positive effects does Codeine have | antitussive
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| T/F Codeine has a high abuse potential | F it rarely produces dependence
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| T/F propoxyphene a derivative of methadone is equal to aspirin in its analgesic effects | T so there is no real reason to prescribe in place of aspirin except for maybe when you are worried about aspirin toxicities
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| What other drugs do you want to avoid giving with Tramadol (Ultram) | antidepressants Tramadol inhibits serotonin and norepi uptake like the antidepressants and can cause serotonin syndrome if combined
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| What is the clinical use for Dextromethorphan | antitussive
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| What is the clinical use for loperamide (Imodium and Diphenoxylate (Lomotil) | Antidiarrheal
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| What is the use for buprenorphine (Subutex) | it is a partial agonist and can be used for outpatient opioid detox
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| What is the only benefit of using the opioid agonist/antagonists pentazocine (Talwin), Nalbuphine (Nubain) and Butorphanol (Stadol) | They don't cause respiratory depression
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| What use do Naloxone (Narcan) and Naltrexone (ReVia) have | they are opioid antagonists and can dramatically and completely reverse the effects of opioids
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| What is one concern of using Naltrexone (ReVia) long term to treat addiction | it is very hepatotoxic
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| Which has a longer half life Naloxone (Narcan) or Naltrexone (ReVia) | Naltrexone (ReVia) has a half life of about 48hrs; Narcan 1-2hrs
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