ALL CORRECT ANSWERS | VERIFIED
/. Opioids Drugs - Answer-Drugs:
/.Opioids - MOA - Answer-- Bind to "opiate receptors" in the brain, which disrupts the
transmission of pain signals in the CNS.
- Mimic actions of endogenous opiates
(endorphins, enkephalins, dynorphins).
- Primarily activate mu receptors, but also activate Kappa
/.Opioids - Effect - Answer-* Relieve pain & induce euphoria
Also cause sedation, respiratory depression, miosis, constipation, nausea, & suppress
the cough reflex.
/.Opioids - Uses - Answer-- Pain relief
- Cough suppression
- Relief of dyspnea
- Preoperative sedation
/.Opioids - Side Effects - Answer-Hypotension
sedation
nausea
itching
miosis
muscle weakness
constipation
Urinary Retention
Biliary Colic
Increased ICP
/.Treatment of Opioid- Induced Constipation - Answer-methylnaltrexone (Relistor)
naloxegol (Movantik)
Blocks opioid receptors in the GI tract
* Does not cross blood-brain barrier, so does not reverse analgesia
/.Opioids - Drug Interactions - Answer-CNS depressants!
,Anticholinergics
Drugs that lower BP
/.Opioids - Contraindications/Warnings - Answer-Decreased respiratory reserve
Labor and delivery
Inflammatory Bowel disease
Head Injury
/.Opioids - Patient Educaiton - Answer-
/.Opioid toxicity - Answer-3 signs:
- coma
- pinpoint pupils
- respiratory depression - may be fatal!
/.Tolerance - Answer-a state in which a drug user needs larger amounts of the drug to
produce the same effect on the body
/.Physical Dependence - Answer-A state in which an abstinence syndrome will occur if
drug use is abruptly stopped
/.Abuse - Answer-drug use that is inconsistent with medical or social norms
/.Addiction - Answer-disease characterized by and individual pathologically pursuing
rewards and relief by substance use and other behaviors
/.Full opioid agonists - Answer-- Good for severe pain
- May give a feeling of euphoria
Example: Morphin, codeine, hydromorphone
/.Partial opioid agonists (Agonist-antagonist) - Answer-- Good for moderate pain
- May act as antagonists at some receptors and
precipitate withdrawal.
Example: pentazocine, Suboxone, buprenorphine, nalbuphine
/.Partial opioid agonists (Agonist-antagonist) Drugs: - Answer-Pentazocine
Suboxone
Buprenorphine
Nalbuphine
/.Partial opioid agonists (Agonist-antagonist) Action - Answer-Acts as antagonists at mu
receptors, and agonists at kappa receptors
, /.Buprenorphine (Suboxone) Action: - Answer-Acts as a partial agonist at mu receptors,
and an antagonist at kappa receptors
/.Medications for those with hx of Opioid abuse - Answer-morphine/naltrexone
(Embeda)
/.Opioid antagonists - Answer-Reverse all narcotic effects including pain relief, euphoria,
and respiratory depression.
/.Naloxone (Narcan) Action: - Answer-Competes for opioid receptors, thereby blocking
opioid actions
Structural analog of morphine
/.Tramadol (Ultram) action - Answer-- Weak agonist at mu receptors
- Blocks NE and serotonin uptake, thereby activating monoaminergic spinal inhibition of
pain
/.Tramadol (Ultram) Drug Interactions - Answer-CNS Depressants
MAOIs
SSRIs/TCAs/Triptans --> Serotonin syndrome
/.Schedule II Prescribing rules - Answer-1) Can write several C-II Rx's
on the same day, for the same patient, for the same drug...for up to a 90 day supply.
2) Must indicate the earliest date the patient can fill each Rx and sign and date
TODAY'S date.
3) If patient is in a LTCF or is terminally ill, an Rx may be partially filled. Note this on the
Rx.
/.CNS Stimulants - Drugs - Answer-amphetamine
Lisdexamphetamine
Dextroamphetamine
Methamphetamine
Methylphenidate
Dexmethylphenidate
/.CNS Stimulants - Action - Answer-↑ release of NE & dopamine in CNS
Inhibit reuptake of NE and dopamine
/.CNS Stimulants - Effects - Answer-↑ alertness
↓ fatigue
mood elevation