Pharm -2- Opioids

Question Answer
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
A drug with addictive properties that can produce analgesic and sedative effects is termed what narcotic
What are the functional classifications of opioids Agonist, Antagonist, Agonist/antagonist and other
What type of drug is Fentanyl (Sublimaze, Duragesic) Strong Opioid Agonist
What type of drug is alfentanil, remifentanil and sufentanil strong opioid agonist used for anesthesia related to fentanyl
What type of drug is heroin Strong Opioid Agonist that has no medical use
What type of drug is Hydromorphone (Dilaudid) Strong Opioid Agonist
What type of drug is Meperidine (Demerol) Strong Opioid Agonist
What type of drug is methadone Strong Opioid Agonist
What type of drug is Morphine Sulfate (MS Contin) strong opioid agonist
What type of drug is Codeine (Robitussin AC) Moderate Opioid Agonist
What type of drug is Oxycodone (OxyContin) Moderate Opioid Agonist
What type of drug is Hydrocodone Moderate Opioid Agonist
Tylenol 2,3,4 are combos of what drugs
Vicodin and Lortab combine what drugs acetaminophen/hydrocodone
Vicoprofen combines what drugs Ibuprofen/Hydrocodone
Percocet is a combo of what drugs acetaminophen/Oxycodone (class II schedule drug)
What type of drug is Loperamide (Imodium) weak opioid agonist
What type of drug is Diphenoxylate (Lomotil) Weak opioid Agonist combined with atropine
What type of drug is Propoxyphene (Darvon Weak Opioid Agonist combined with acetaminophen
What type of drug is Dextromethorphan (Delsym, Robitussin DM) Weak Opioid Agonist
What type of opioid is Tramadol (Ultram( Classified as Other opioid
What type of drug is Pentazocine (Talwin Opioid Agonist/antagonist
What type of drug is Nalbuphine (Nubain) Opioid Agonist/antagonist
What type of drug is Butorphanol (Stadol) Opioid Agonist/antagonist
What type of drug is Naloxone (Narcan) Opioid Antagonist
What Type of drug is Naltrexone (ReVia) Opioid Antagonist
Define a schedule I controlled substance no medical use high addiction potential (Heroin)
Define a schedule II controlled substance medical use but has high addiction potential (strong and moderate opioid agonists)
Define a Schedule III controlled substance Medical Use potential for dependence (Lortab, Tylenol
Define a Schedule IV controlled substance Medical Use low abuse potential (Weak Opioid agonists)
What are the 5 types of opioids receptors Mu "reap, Kappa "Sam", Delta, Epsilon, Sigma
What is the Mu opioid receptor associated with in regards to opioids tx REAP- respiratory depression, euphoria, analgesia, physical dependence
What is the kappa opioid receptor associated with in regards to opioid tx SAM- Sedation, Analgesia, Miosis
What are the endogenous Opioids Endorphins, Dynorphins, Enkephalins
T/F the highest number of opioid MU receptors are found in the cerebral cortex T
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
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
What are the contraindications for using morphine respiratory compromise, Asthma, Intracranial injuries, Paralytic Ileus
What are the adverse effects of morphine euphoria, dysphoria, respiratory depression, Nausea, Constipation, sedation, pruritis, urticaria, bronchospasm, urinary retention, anxiety, hypotension.
What schedule is morphine schedule 2
What receptors does morphine act on Mu (REAP- respiratory depression, euphoria, analgesia, physical dependence), Kappa (SAM- Sedation, Analgesia, Miosis)
What options exists for route of delivery of morphine PO, IV, SC, IM, PR
What type of pain is morphine most effective on visceral pain
T/F morphine could potentially be given to suppress a cough T
What effect does morphine have on the skin it causes histamine release and causes pruritis
What effects does morphine have on the lungs besides respiratory depression Bronchospasm avoid use in asthmatics
If you give morphine to stop pain during labor what could you cause prolongation of labor because it effects contractions of the uterus
What is the half life of morphine 2.5- 3 hours lose 90% in the first day
What is the clinical uses for Methadone absorbed well orally used in maintenance program for narcotic dependence treatment and powerful pain reliever
Why is Meperidine (Demerol) a good pain relief choice for patients with biliary disease it does not constrict the sphincter of Odi
When is Meperidine (Demerol) contra indicated pts receiving MAOI
How much more potent is Fentanyl than morphine 80-100 times
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)
What are some common uses for Fentanyl (Sublimaze, Duragesic) Used in epidurals, and transdermally (Duragesic) for chronic pain patients
Apart from analgesia what positive effects does Codeine have antitussive
T/F Codeine has a high abuse potential F it rarely produces dependence
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
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
What is the clinical use for Dextromethorphan antitussive
What is the clinical use for loperamide (Imodium and Diphenoxylate (Lomotil) Antidiarrheal
What is the use for buprenorphine (Subutex) it is a partial agonist and can be used for outpatient opioid detox
What is the only benefit of using the opioid agonist/antagonists pentazocine (Talwin), Nalbuphine (Nubain) and Butorphanol (Stadol) They don't cause respiratory depression
What use do Naloxone (Narcan) and Naltrexone (ReVia) have they are opioid antagonists and can dramatically and completely reverse the effects of opioids
What is one concern of using Naltrexone (ReVia) long term to treat addiction it is very hepatotoxic
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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