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What are the Five Pure Opioid Agonists??
- 1. Morphine
- 2. Fentanyl
- 3. Meperidine
- 4. Methadone
- 5. Oxymorphone
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What are the Therapuetic Uses of Pure Opioids??
Moderate to severe pain
Acute chronic pain
Pain not relieved by nonpharmacologic measures or NSAIDS
Pain of a myocardial infarction (MI)
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What are the Physiologic Actions of Pure Opioids??
Agonist to mu and kappa receptors
↓ release of substance P (modulates pain perception)
Mimics actions of endogenous opioid peptides
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What are the Respiratory Side Effects of Pure Opioids
Depression, cough suppression
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What are the Cardiovascular Side Effects of Pure Opioids
Low Blood Pressure
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What are the Gastrointestinal Side Effects of Pure Opioids
Nausea, Vomitting, Constipation, biliary colic
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What are the Genitourinary Side Effects of Pure Opioids
Urinary retention
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What are the Neurologic Side Effects of Pure Opioids
Sedation, euphoria, increased intraocular pressure, miosis, toxicity
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What are the interactions with Pure Opiods Agonists
- CNS depressents
- Anticholinergics
- tricyclic antidepressants
- MAOIs
- antihypertensives
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What do you want to monitor with Pure Opioid Agonists
- Pain level
- Heart Rate
- Blood Pressure
- Respirations
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What is Meperidine's other name
Demerol
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Meperidine is
Synthetic
Short half life, multiple drug interactions
Metabolite: Normeperidine
Biliary or pancreatic disease
Dosing for rigors
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Another name for Mehtadone is
Dolphine
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Methadone is a Pure Opioid that is for
- Pain relief
- cheap
- treatment for opioid addicts
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What Pure Opioid Agonists is a treatment for opoid addicts ??
Methadone (Dolphine)
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What does Methadone do for drug addicts
blocks euphoria from heroin and morphine
long half life (12-30 hrs): prevents withdrawal
cross tolerance with heroin and morphine
people are on it for decades
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What opioid is used for an MI
Morphine
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What do Mu receptors promote
constipation
Euphoria
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What do Kappa receptors promote
analgesia, some sedation, some GI motility,
no Respiratory depression and euphoria as with pure agonist
Monitor pt carefully
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Agonist-Antagonist Opioid
Pentazocine (Talwin)
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What are the Other 3 Agonist-Antagonist Opioids
- Butorphanol (Stadol),
- Nalbuphine (Nubain),
- Buprenorphine (Buprenex)
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Therapeutic Uses of Agonist-Antagonist Opioid
Relieves mild to moderate pain
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What is a Pure Opioid Antagonist
Nalaxone (pure antagonist)
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What does Nalaxone do
- Rapidly displaces all receptor bound opioid molecules (pure
- agonist)
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What is the Dosing and Routes of Nalaxone
Dosing: 0.4 mg to 2 mg for adults
Routes IV, IM, SC
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Adverse effects of Nalaxone
Dysphoria, vomiting, diarrhea, agitation
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