Katzung (Opioids, Stimulants, Abuse)

Situational questions

Morphine, Methadone, & Fentanyl

• Strong µ-receptor agonists

• Variable affinity for δ and κ receptor

Morphine, Methadone, & Fentanyl

• Analgesia

• relief of anxiety

• sedation

• slowed gastrointestinal transit

Hydromorphone & Oxymorphone

Like morphine in efficacy, but higher potency

Meperidine

Strong agonist with anticholinergic effects

Oxycodone

Dose-dependent analgesia

Sufentanil, Alfentanil, & Remifentanil

Like fentanyl but shorter durations of action

Carfentanil

Like fentanyl but much more potent

Codeine & Hydrocodone

• Less efficacious than morphine

• Can antagonize strong agonists

Codeine & Hydrocodone

opioids for Mild-moderate pain

Tapentadol

Moderate µ agonist, strong NET inhibitor

Tramadol

Mixed effects: weak µ agonist, moderate SERT inhibitor, weak NET inhibitor

Naloxone

Nonselective antagonist of opioid receptors

Naloxone

Reverses the acute effects of opioids; can precipitate severe abstinence syndrome

Naltrexone

Antagonist of opioid receptors

Methadone

Slow-acting agonist of μ opioid receptor

Varenicline

Partial agonist of nicotinic acetylcholine receptor of the α4β2-type

Varenicline

Smoking cessation