Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Opioids part 1
Pharm test 2
| Question | Answer |
|---|---|
| Sufentanil: lipid solubility, potency, and onset | 1 1 2 |
| Meperidine: lipid solubility, potency, and onset | 6 6 5 |
| Morphine: lipid solubility, potency, and onset | 5 5 4 |
| Alfentanil: lipid solubility, potency, and onset | 4 4 1 |
| Fentanyl: lipid solubility, potency, and onset | 3 3 3 |
| Remifentanil: lipid solubility, potency, and onset | 2 2 1 |
| bind to specific receptor site to elicit a specific response | opioid agonist |
| opioids are unique in their ability to provide analgesia without loss of ____, _____, or _____ | touch, proprioception, consciousness |
| term used for drugs derived from opium | opiate |
| partially bind to my receptors where they produce limited (partial agonist) responses or no effect (competitive antagonist) | opioid agonist-antagonist |
| fentanly, sufentanil, alfentanil, and remifentanil are examples of | semisynthetic opiods |
| opioids act as agonist at steriospecific opioid receptors at presynaptic and postsynaptic sites in the | CNS, spinal cord, brainstem, peripheral tissures |
| enkephalins, endorphins and dynophins are | endogenous peptide opioid receptor ligands |
| opiods in the ionized state bind most strongly to the ____ receptor site | anionic |
| only ____ forms have agonist activity | levrotatory |
| what are the opioid receptors | mu, delta, and kappa |
| Mu or morphine preferring receptors are principally responsible for _____ and ____ analgesia | supraspinal, spinal |
| receptors are responsible for hypoventilation, bradycardia, and physical dependence | Mu² |
| activation of ___ receptor is speculated to produce analgesia | Mu¹ |
| Morphine, Meperidine, Fentanly, Sufentanil, Alfentanil, Remifentanil are what type of agoinst | Mu receptor agonist |
| mu receptor antagonist | Naloxone |
| activation results in inhibition of NT release via N calcium channels results in analgesia, although dyshporia and diuresis may also occur | Kappa receptors |
| High intensity painful stimulation may be resistant to the analgesic effects of____receptors | Kappa |
| Kappa receptor agaonist is the endogenous ligand | dynorphins |
| kappa antagonist receptors include | Naloxone, Naoltrexone, Naolmefene |
| _____receptors modulate Mu receptors | delta |
| ____receptors respond to the endogenous ligands know as enkephalins | delta |
| are not blocked by naloxone therefore these receptors are not opioid receptors | sigma receptors |
| this receptor have a high affinity for phencyclidine, may be identical to receptors that bind to ketamine | Sigma receptors |
| the role of the opioid receptors and endorphins is to function as the | endogenous pain suppression system |
| opioid receptors are located in the | periaqueductal gray matter of the brainstem, amygdala, corpus striatum and hypothalmus and the substantia gelatinosa of the spinal cord |
| it is thought that endorphins inhibit the release of _____ NT | excitatory |
| administration of opioids into the epidural and subarachnoid space | Neuraxial Opioids |
| contradictions to epidural | anticoagulants➞epidural hematoma=paralysis hold for 7 days |
| the epidural space has which two meninges | dura and arachnoid |
| epidural administration of a poorly _____ opioid such as morphine will result in a slower onset of action and longer duration of action. | lipid soluble |
| most common location for an epidural is the | lumbar spine |
| spinal cord ends at | L-1 vertebrae |
| the epidural dose is _____ times the subarachnoid dose | 5-10 |
| analgesia is specific for ___rather than ____ pain | visceral, somatic |
| neuraxial opiods ____ MAC for volatile anesthetics increase or decrease | decrease |
| The administration of _____ with the opioid will decrease systemic absorption but does not decrese diffusion into the CSF | epinephrine |
| most common side effect of neuraxial opiods is ____ and can be relieved by giving ____ | pruritis, naloxone |
| cephalad migration can be increased by | coughing, increase the risk of resp. depress |
| delayed respiratory depression involves morphine usually occus in____hrs | 6-12 |
| with morphine ___ respiratory depression does not occur | early |
| with fentanyl ____ depression occurs and ___ depression of ventilation does not occur | early, late |
| DepoDur (morphine liposomal) provides pain relief before or during surgery for up to ___hrs | 48 |
| lumbar epidural only, not for pts <18yrs, no other drug given in epidural space for 48hrs, do not freeze med, and intrathecal admin. has resulted in prolonged resp. depress. | DepoDur warnings |
| Meperidine is a synthetic opioid agonist at ___ and ___ opioid receptors | mu, kappa |
| Analogues of meperidine | Fentanyl, Sufentanil, Alfentanil, and remifentanil FARS |
| has a extremely short duration of action, it is necessary to administer an opioid with a longer duration of action (care must be taken not to stop the infusion) | Remifentanil |
| an opioid receptor antagonist which blocks opioid binding at the mu receptor, derivative of naltrexone | Methylnaltrexone Bromide |
| onset in 30-60min, absorpt. SQ rapid, adverse reactions:GI | Methylnaltrexone Bromide |
| reports of reactivation of herpes virus with epidural morphine has been reported with ______ administration of opioids | Neuraxial |
| produces a analgesia, euphoria, sedation, and a diminished ability to concentrate. | morphine |
| ___pain is relieved more effectively by morphine than ___ pain | dull, sharp |
| poor lipid solubility, high ionization at physiologic pH, protein binding, rapid conjugation with aleuronic acid | reasons for morphine poor penetration into CSF |
| since morphine is highly ionized providing a alkalinized state in the blood by hyperventilation will ____ passage into the CSF | increase |
| undergoes significant first pass into the lungs | fentanyl |
| this drugs metabolism principle pathway is conjugation with glucuronic acid in hepatic and extra hepatic sites, especially (kidney), making which pts. at risk for accumulation? | morphine renal failure pts taken MAOI can lead to exaggerated effects by the formation of glucuronide metabolites |
| first 4 day of a neonates,their more sensitive to morphine clearance making them at risk for | respiratory depression |
| patients with reanal failure show higher plasma concentrations reflecting a ___ Vd with morphine | smaller |
| limiting the rate of administration to 5mg per min., maintaining the pt supine, keep pt hydrated are ways to minimizes | Histamine release and hypotension from morphine |
| the combination of an opioid with ____ will result in cardiovascular depression | nitrous oxide |
| all opioids produce a _____ depression of ventilation, due to Mu²receptor effects | dose-dependant |
| opioids may diminish sensitivity to CO2, giving ____, may antagonize respiratory depression but not analgesia | physostigime |
| use opioids with caution in pts with head injuries due to | wakefulness, production of miosis, and depression of ventilation with associated increases in ICP if the PaC02 is increased. |
| cause skeletal muscle rigidity, thoracic and abdominal (diaphragm) | opioids |
| these have induced biliary spasms effects | fentanyl, morphine, meperidine, pentazocine |
| reverses opioid induced biliary spasms | glucagon |
| opioid induced nausea and vomiting are caused by direct stimulation of the chemoreceptor trigger zone in the | floor of the fourth ventricle |
| morphine can increase the tone and peristaltic activity of the ureter, giving an ___ drug such as ___ can reverse these effects | anticholinergic atrophine |
| cause skin flushing | morphine |
| ventilary depression can occur in the ____ as a result of giving opioids to the mother | fetus |
| these drugs exaggerate the effects of some opioids by causings ventilatory depression | amphetamines, phenothiazines, MAOI (phenelzine, tranylcypromine), and TCA |
| _____ and physical dependence with repeated doses of opioids are characteristic of all opioids | tolerance |
| ____ tolerance develops between all of the opioids | cross |
| tolerance usually takes ___ weeks | 2-3 |
| physical dependence on morphine usually requires __ days, however some degree of physical dependence occurs after __ days | 25, 2 |
| yawning, diaporesis, lacrmation, or coryza, insomnia and restlessness are prominent | inital symptomes of withdrawal |
| abdominal cramps, nausea, vomiting, and diarrhea reach their peak in __ hrs and then decline | 72 |
| helps prevent withdrawal symptoms | clonidine |
| what is the withdrawal triad | miosis, hypoventilation, and coma |
| what is the treatment for opioid overdose | mechanical ventilation, Narcan |
Created by:
melbacs
Popular Science sets