Opioids and Analgesics Overview
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Questions and Answers

What is a common disadvantage of opioids?

  • Increased GI motility
  • Weight gain
  • Decreased heart rate
  • Respiratory depression (correct)

    • Which opioid is noted for having a potency of 100 times that of morphine?

  • Meperidine
  • Hydromorphone
  • Butorphanol
  • Fentanyl (correct)

    • Which opioid has a ceiling effect, making it less effective when high doses are used?

  • Methadone
  • Fentanyl
  • Buprenorphine (correct)
  • Morphine

    • Which medication should not be used with serotonin reuptake inhibitors?

    <p>Tramadol (A)</p> Signup and view all the answers

    What is one of the advantages of hydromorphone compared to other opioids?

    <p>Strong analgesic with minimal cardiovascular effects (A)</p> Signup and view all the answers

    Which opioid can be associated with dysphoria as a disadvantage?

    <p>Fentanyl (C)</p> Signup and view all the answers

    Which opioid is characterized as a weak MU agonist with poor potency?

    <p>Meperidine (B)</p> Signup and view all the answers

    What is the primary mode of action for tramadol?

    <p>Prevention of serotonin reuptake (C)</p> Signup and view all the answers

    Which opioid administration method is NOT applicable to morphine?

    <p>Transdermal patch (C)</p> Signup and view all the answers

    Which of the following opioids is transported by G-glycoprotein in dog brains?

    <p>Butorphanol (C)</p> Signup and view all the answers

    What class of receptors do opioids primarily affect to manage pain?

    <p>Mu and Kappa receptors (A)</p> Signup and view all the answers

    Which opioid is known for producing minimal cardiovascular effects?

    <p>Hydromorphone (C)</p> Signup and view all the answers

    What is a primary disadvantage associated with fentanyl?

    <p>Can result in dysphoria (C)</p> Signup and view all the answers

    How does butorphanol differ from full mu agonists in its mechanism?

    <p>It is a partial mu antagonist (C)</p> Signup and view all the answers

    Which opioid is associated with the risk of respiratory depression and ileus as disadvantages?

    <p>Methadone (D)</p> Signup and view all the answers

    What is required for tramadol to exert its analgesic effects?

    <p>Metabolization to its M1 metabolite (D)</p> Signup and view all the answers

    Which characteristic of hydromorphone differentiates it from morphine?

    <p>It is 5x more potent than morphine (B)</p> Signup and view all the answers

    What is a key instruction regarding the use of a fentanyl patch?

    <p>It should never be touched once applied (A)</p> Signup and view all the answers

    Which opioid is often better for use in cats due to metabolism issues in dogs?

    <p>Tramadol (A)</p> Signup and view all the answers

    What type of receptor does apomorphine primarily act upon?

    <p>Dopamine receptor (C)</p> Signup and view all the answers

    Flashcards

    Opioids

    Narcotic drugs that act on MU and Kappa receptors for pain relief.

    MU Receptors

    Receptors found throughout the body; crucial in the entire pain pathway.

    Kappa Receptors

    Receptors that can influence mild to moderate sedation.

    Morphine

    Primary MU agonist used for managing pain; serves as a standard for opioid potency.

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    Hydromorphone

    Strongest pure MU agonist, 5x more potent than morphine, with some sedation effects.

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    Fentanyl

    Highly potent MU agonist, 100x stronger than morphine, short-acting and used for profound analgesia.

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    Butorphanol

    Partial MU antagonist and Kappa agonist; good for GI-compromised patients with mild analgesia.

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    Buprenorphine

    Partial MU agonist and Kappa antagonist; offers moderate analgesia with a slow onset.

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    Methadone

    MU agonist with NMDA receptor binding, providing profound analgesia without histamine release.

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    Tramadol

    Opioid derivative requiring metabolism for pain relief; works on serotonin and acetylcholine.

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    Hydromorphone Potency

    It is 5x more potent than morphine and known as the strongest analgesic.

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    Fentanyl Administration

    Can be given IV, CRI, or transdermally, provides profound analgesia.

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    Meperidine Disadvantages

    Short acting with high cardiovascular depressant effects making it less ideal.

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    Butorphanol Use

    Good for GI-compromised patients due to its mild analgesia and reversibility.

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    Buprenorphine Characteristics

    Partial MU agonist that provides moderate analgesia but has a slow onset.

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    Methadone Advantage

    Binds MU receptors and NMDA receptors, providing profound analgesia with no histamine release.

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    Tramadol Mechanism

    Works by preventing serotonin reuptake, requiring metabolism to activate its analgesic effects.

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    Apomorphine Use

    Used to induce vomiting through its action as a dopamine agonist.

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    Study Notes

    Opioids and Analgesics

    • Opioids affect MU and Kappa receptors throughout the body, impacting pain pathways. MU receptors have a more profound effect on pain management.
    • Common opioid disadvantages include hypersalivation, nausea, vomiting, respiratory and cardiovascular depression, decreased GI motility.
    • Opioid potency is measured relative to morphine.
    • Morphine is a MU agonist with low Kappa agonist activity. It can be administered intravenously (IV), subcutaneously (SQ), intramuscularly (IM), or epidurally. IV administration results in less emesis (vomiting) as it reaches the emetic center faster. It's classified as a class 1 narcotic and is effective for visceral pain.
    • Hydromorphone is a pure MU agonist, stronger than morphine (5x potency), and can lessen vomiting.

    Specific Opioids

    • Hydromorphone: A strong analgesic with some sedation, effective at reducing the need for anesthetic sparing. It has minimal cardiovascular effects and reduced histamine release. However, it can cause hyperthermia.
    • Fentanyl: A potent MU agonist (100x morphine potency) with profound analgesia. It’s available as an IV, continuous-release intravenous (CRI), and transdermal patch. Quick onset (30 minutes to 2 hours) and reduced vomiting. Patch lasts 12-24 hours, up to 72 hours. Client education is critical regarding proper patch placement and handling to prevent accidental consumption. Potential for dysphoria.
    • Meperidine: A weak MU agonist with a moderate analgesic effect but high cardiovascular depressant effects. Shorter acting than other opioids, not the ideal opioid option. Low potency (0.1x morphine).
    • Butorphanol: A partial MU agonist and Kappa agonist. Transported by G-glycoprotein in dog brains. Partially reversible activity via naloxone and is a mild analgesic. Helps with GI issues (less GI motility issues and ileus) and can function as a cough suppressant, but cannot be used with other opioids. Short duration. Duration is 60 minutes in dogs and up to 90 minutes in cats.
    • Buprenorphine: A partial MU agonist and Kappa antagonist. Moderate analgesia with a slower onset. More gentle on the cardiovascular system; useful for mild to moderate pain. Less effective with severe pain and has a ceiling effect; cannot be combined with pure MU drugs. Can be administered intravenously (IV), subcutaneously (SQ), intramuscularly (IM), or transmucosally (cats).
    • Methadone: A MU agonist that also binds NMDA receptors. Provides profound analgesia and is available via IV or IM injection. It has no histamine release, but may cause bradycardia, respiratory depression, ileus, and nausea.
    • Tramadol: Requires metabolization to be effective. An M1 metabolite functions as an MU agonist. Prevents serotonin and acetylcholine reuptake. An analgesic, but not indicated for cats due to poor metabolism. Cannot be given with serotonin reuptake inhibitors.
    • Apomorphine: A dopamine agonist. Used to induce emesis (vomiting) via subcutaneous (SQ), intravenous (IV), or transmucosal (cats) administration.

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    Description

    This quiz explores the effects, benefits, and drawbacks of opioids, particularly focusing on MU and Kappa receptors. Topics include the potency of morphine and hydromorphone, their administration methods, and potential side effects associated with opioid use. Test your knowledge on how these medications manage pain effectively!

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