Opioids Flashcards Preview

CRNA - drugs > Opioids > Flashcards

Flashcards in Opioids Deck (25)
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1

Phenantherane Alkaloids drugs

Morphine, Codeine (Natural) Hydromorphone, Tramadol (Semisynthetic):
Derived from opium poppy

2

Phenylpiperidines derrivtives (synthetic)

Meperidine, fent, sufent, alefent, remi

3

Diphenylheptane

Methadone

4

Most likely to cause histamine release?

Morphine, codeine, meperidine

5

Cross-class allergy?

Cross-sensitivity exists within classes, however, no cross-sensitivity between the 3 classes

6

Gold standard for potency comparison?

Morphine sulfate (=1) - purely serve as guideline because each patient response can vary drastically

7

Highest concentration of opioid receptors in the body?

Likely in the GI nervous system compared to CNS

8

High dose opioids?

Only provide analgesia, additional drugs needed to provide anesthesia/amnesia/unconsciousness/relaxation

9

Meperidine (Demerol)

Potency: 0.1
Duration: 2-4 hr
Analgesic Dose: 100 mg

10

Fentanyl

Potency: 100
Duration: 1-1.5 hr
Analgesic Dose: 100 mcg

11

Sufentanil

Potency: 500-1,000
Duration: 48-78 min
Analgesic Dose: 10-20 mcg

12

Alfentanil

Potency: 10-20
Duration: 15-25 min
Analgesic Dose: 500-1,000 mcg

13

Remifentanil

Potency: 100 (same as fentanyl)
Duration: 2-5 min
Analgesic Dose: infusion

14

Hydromorphone

Potency: 5
Duration: 2-4 hrs
Analgesic Dose: 2 mg

15

Morphine Sulfate

Potency: 1
Duration: 3-5 hrs
Analgesic Dose: 10 mg

16

Chronic effects of opioids

Tolerance, physical dependence, constipation

17

Never develop a tolerance to (2)?

Miosis, constipation

18

Effect on breathing?

Shift the CO2 response curve to the right, decreased respiratory response to elevated CO2 levels

19

Stronger the opioid?

Higher the likelihood of physical dependence

20

Mu receptor effects

Analgesia (supraspinal and spinal), euphoria, sedation, skeletal muscle rigidity, biliary spasm

21

Kappa receptor effects

Analgesia (supraspinal and spinal), dysphoria, sedation, antishivering

22

Opioid MOA specifics

Binds to G-protein coupled receptor - cAMP activation, depression of voltage gated Ca channels, activated inward rectifier K channels (K efflux)

23

Opioid MOA general

Activate opiate receptors on pre-synaptic (1st order) sensory neurons resulting in a decreased amount of substance P (excitatory NT) to be released into synaptic cleft - blocks transmission of pain signal

24

Endogenous opioid peptides

Enkephalins, endorphins, dynorphins

25

SuRF in the AM Man - potency

Sufentanil, Remifentanil/Fentanyl, Alfentanil, Morphine, Meperidine