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Opiates

What term is used to describe natural opium alkaloids?

Opioids

What is the general classification for semi-synthetic or synthetic opium-like agents?

Morphine

Which natural opiate is considered the reference standard analgesic and prototype for the class?

25-30 %

Morphine is characterized by a poor oral bioavailability of approximately _____% to _____%.

Codeine

Which natural opiate is the reference standard for antitussive activity?

It is less effective.

How does the analgesic efficacy of Codeine compare to that of Morphine?

Thebaine

Which natural opiate serves as the precursor for the synthesis of Naloxone?

Antidote for Narcotic poisoning

What is the clinical indication for Naloxone?

Definition: A semi-synthetic opioid, also known as Diacetylmorphine or Diamorphine, primarily used for recreational purposes.

Term: Heroin

They have the same efficacy.

How does the efficacy of Heroin compare to the efficacy of Morphine?

Apomorphine

Which semi-synthetic opioid acts as a D_2 agonist to increase dopamine levels?

Management of Parkinsonism

What is the primary clinical use for Apomorphine?

Hydrolytic

Apomorphine is the _____ product of morphine.

It has no analgesic effect.

Describe the analgesic effect of Apomorphine.

Morphine

Hydromorphone and Oxymorphone are semi-synthetic derivatives of which natural opiate?

8-12 times more potent

Relative to Morphine, how much more potent are Hydromorphone and Oxymorphone?

Codeine

Hydrocodone and Oxycodone are semi-synthetic derivatives of which natural opiate?

8-12 times more potent

Oxycodone is approximately _____ to _____ times more potent than Codeine.

Methadone

Which synthetic opioid is frequently used in the management of Morphine or Heroin addiction?

Methadone has good oral bioavailability (whereas Morphine's is poor).

How does the oral bioavailability of Methadone compare to that of Morphine?

Low tolerance tendency

What is the tendency for developing tolerance when using Methadone?

Pethidine

What is the alternative name for the synthetic opioid Meperidine?

Meperidine (Pethidine)

Which synthetic opioid is noted for having no cardiac or biliary effects?

Acute pain

For what specific type of pain management is Meperidine primarily indicated?

Normeperidine

What toxic metabolite is formed during the long-term use of Meperidine?

Seizures

What is the primary clinical risk associated with the accumulation of Normeperidine?

Morphine, Codeine, and Thebaine

3 examples of Opiates

Semi-synthetic and Synthetic

2 types of Opioids

Heroin, Apomorphine, Semi synthetic Morphine derivatives, and Semi-synthetic Codeine derivatives

Semi-synthetic opioids: enumerate

Hydromorphone and Oxymorphone

Drug examples under Semi-synthetic Morphine Derivatives

Hydrocodone and Oxycodone

Drug examples under Semi-synthetic Codeine Derivatives

Methadone, Fentanyl, Levorphanol, Loperamide, Tramadol, and Pentozocine

Drug examples under Synthetic Opioids

Fentanyl

Synthetic Opioid: 100x more potent than morphine

100 times

How many times more potent is Fentanyl to Morphine

Fentanyl

Synthetic Opioid: 100x more potent than morphine

Fentanyl

Synthetic Opioid: Used for induction of General anesthesia as Opioid combo

Levorphenol

Synthetic Opioid: 5-7x more potent that morphine

5-7x

Levorphenol is how many times potent than Morphine

Loperamide

Synthetic Opioid: The only synthetic opioid that gives no addiction

Atropine

Diphenoxylate is taken with what? to prevent addiciton

Tramadol

Synthetic Opioid: Weak Mu agonist

Pentazocine

Synthetic Opioid: Partial kappa agonist

Mu agonist

If pentazocine is paired with a full agonist, what is the ultimate effect?

• Morphine

• Heroin

• Hydromorphone

• Oxymorphone

• Methadone

• Mepiridine

• Levorphanol

• Fentanyl

• Strong full agonist in Specific agents (e.g Opiates, Opioids, etc..)

• Used for treatment of SEVERE PAIN

Mild

• Tramadol

Moderate

• Codeine

• Hydrocodone

• Oxycodone

• Mild to Moderate full agonist (Opiates, Opioids, etc…)

• Tx for Mild to moderate pain

• Nalbuphine

• Butorphanol

• Buprenerphine

• Pentazocine

Partial agonists (Opiates, Opioids, etc…)

• Naloxone

• Naltrexone

• Nalorphine

• Nalmefene

• Levallorphan

Full antagonist (Opiates, Opioids, etc..)