morphine MOA
mu receptor agonist
- min. effect on Kappa and sigma Rc
morphine AE
nausea myoclonus hallucination pruritis d/t histamine release supraspinal analgesia resp depressin euphoria sedation dec. GI motility pupil constriction
Morphine Contraindication
renal insufficiency: Inc. AE
Morphine administation
PO IM IV SubQ rectal epidural intrathecal
Codeine administration
PO IV IM SubQ Combo with: - APA - guaifenesin - promethazine
Codeine prodrug
active form: morphine
codeine use
antitussive effect without conversion
cough
hydrocodone administration
always combined with - APAP - ASA - ibuprofen - antihistamine PO
hydrocodone use
analgesic
antitussive
oxycodone administration
PO in combination with - APAP - ASA No active metabolites: safer with renal dysfunction
hydromorphone administration
PO IV IM SubQ rectal epidural - semi-synthetic - no major metabolites: safer with renal dysfunction
Methadone administration
PO IV SubQ Long half life no active metabolites: safer with renal dysfunction
methadone use
opioid addiction treatment or maintenance
daily dosed
pain management: 2-3/day
Meperidine administration
PO IV IM rectal epidural intrathecal - synthetic main metabolite: normeperidine - long half life
meperidine use
post-op for shakes/chills
epidural
spinal analgesia ST
meperidine AE
CNS excitation
anxiety
seizures
Meperidine caution
elderly
renal dysfunction
fentanyl administration
IV
transdermal patch (q72h)
transmucosal lozenge
buccal tablets
fentanyl uses
- transdermal for chronic pain: after titration with short acting opioid
- transmucosal for breakthrough pain
Fentanyl precautions
80-100X more potent than morphine
buprenorphine administration
SL
parenteral
Has a ceiling effect
buprenorphine MOA
partial agonist
- can precipitate withdrawal s/s if already on full agonist: displaces full-agonist and has less effect
buprenorphine uses
sublingual tablets: opioid dependence tx.
- alone or combined with naloxone
Heroin
3x more potent than morphine due to greater lipid solubility
- metabolized to morphine
- crosses BBB quickly
-
module 1 pharmacodynamics and pharmacokinetics46
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Module 1 ADME20
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Module 1 ADME (ME)14
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module 1 pharmacokinetics24
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Module 1 special populations17
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module 1 synch16
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Module 17 preg categories, drug scheduling14
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module 17 drug regulation and monitoring18
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module 6 autonomics45
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module 6 adrenoreceptor antagonist13
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module 6 cholinergic agonists24
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week 2 synch7
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Module 7 hypertensives29
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module 7 beta blockers23
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module 7 adrenergic agonists14
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module 7 ACE inhibitors, angiotensin receptor blockers, renin inhibitors14
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module 7 calcium channel blockers12
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module 7 vasodilators and digoxin21
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synch session modules 7 and 1021
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module 10 lipid lowering meds30
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module 8 antiarrhythmics class 120
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module 8 antiarrhythmics class 2 and 322
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module 8 antiarrhythmic class 417
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module 9 antiplatelet meds23
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module 9 warfarin17
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module 9 anticoagulants24
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Module 9 thrombolytics and reversal agents10
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Module 2 immunology and eicosanoids25
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module 2 antihistamines18
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Module 2 anti-asthmatic drugs27
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module 2 anti-inflammatory asthma agents17
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module 2 management of asthma12
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Module 2 gout34
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Module 5 tobacco, alcohol, benzo34
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module 5 stimulant abuse11
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module 5 opiates and heroin27
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module 4 non-opioid alagesics21
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module 4 NSAIDS15
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module 4 opioid characteristics15
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module 4 opioid agents35
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module 4 opioid tolerance and dependence14
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module 4 adjuvant analgesics8
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module 4 anti-rheumatic drugs34
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modules 2,4,5 synch session15
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module 3 antidepressants and neurotransmitters15
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module 3 MAOI, SSRI, TCA19
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module 3 SNRI, atypical antiD, serotonin receptor agonist35
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Module 3 anti-migraine21
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module 3 antiemetics19
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module 3 seizure31
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module 3 anticonvulsants42
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Module 3 anti-parkinson24
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module 3 antipsychotics24
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module 3 atypical antipsychotic20
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module 3 sedatives and hypnotics27
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module 3 anti-alzheimer's drugs16
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Module 13 agents affecting GI motility25
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module 13 Upper GI tract, PUD, GERD14
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module 13 PUD and GERD meds26
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module 13 GERD meds 216
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module 16 DM overview33
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module 16 biguanides and TZD13
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module 16 non-insulin meds21
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module 16 non-insulin meds 217
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module 16 hyperglycemia management and CV impact16
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module 16 inhaled insulin5
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module 16 hyperthyroid meds15
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module 16 hypothyroid meds14
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module 16 weight management17
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module 16 wt management 219
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module 16 osteoporosis overview14
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module 16 antiresorptive agents, bone anabolic agents33
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module 16 phosphate binders, Ca, Vit. D27
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module 14 gonadal hormone inhibitors28
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module 14 uterotonics11
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module 14 birth control15
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module 14 HRT estrogen16
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module 14 HRT androgen and phosphodiesterase 5 inhibitors13
