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+

Opiates, NSAIDS,
Prostaglandins, and Steroids
Shan Nanji

+ Opiates
nMOA:
n Agonize Opiate receptors (MU-morphine; Deltaenkephalin; Kappa-dynorphin)
n Open K+ Channels
n Close Ca2+ Channels
n Decreases Synaptic Transmission
n Inhibit release of Ach, 5-HT, Glutamate, and
Substance P.

Shan Nanji - NanjiMD@gmail.com

+ Opiates
nS/E:
n Addiction
n Respiratory Depression
n Constipation
n Will not develop tolerance to this side effect
n Miosis
n Will not develop tolerance to this side effect
n Toxicity (overdose) can be treated with
n _______________ or __________________
n Opioid Receptor Antagonists

Shan Nanji - NanjiMD@gmail.com

Opiates
n

__________________
n

MC Abused On the Streets

n Methadone
n Rx For Heroin WITHDRAWAL
n Because __________________
n Tincture

of Opium

n For Infants
n Meperidine
n __________________
n __________________
n Can Be Used For Gallstones
n Because It Doesnt Mess With CCK
n Loperamide
n Used to Control Diarrhea
n Decreases Mortality in Inflammatory Bowel Diseases (IBD)
Shan Nanji - NanjiMD@gmail.com

Opiates
n Diphenoxylate
n

Used to Control Diarrhea

n Dextroamethorphan
n Best Anti-Tussin DM

n Oxycodone
n Codone
n Fentanyl
n Used as an Anesthetic (also available in patch form)

n Pentazocine
n Morphine
n For severe pain
Shan Nanji - NanjiMD@gmail.com

Opiates
GABA Receptor Agonist
nBaclofen
n

Back pain, has GABA-ergic effects

Used to Treat Multiple Sclerosis

Shan Nanji - NanjiMD@gmail.com

Prostaglandins

PGA2 - Vasoconstricts and


promotes platelet aggregation

__________________

PGI2 Inhibits Clotting


Prostacyclin

PGF2

_________________
Can also induce
abortion

Latanaprost
Shan Nanji - NanjiMD@gmail.com

The PGF2 drug that can be used to


grow out eye lashes.?
n

_______________ PGF2
n

n
n

Shan Nanji - NanjiMD@gmail.com

Can be used to grow out


eyelashes
Treatment of glaucoma
Can cause brown
pigmentation of the iris

Prostaglandins
nPGE1 Protects stomach via mucus and
dilates afferent arteriole
n

__________________
n

Keeps PDA open

__________________
n

Can cause abortion due to vasoconstriction

nPGE2
n

__________________
n

Can induce abortion

Shan Nanji - NanjiMD@gmail.com

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Three drugs that can be used as


abortifacients.?
nPGE

1 Misoprostil

nPGE2

Dinoprostone

nPGF2

Carbaprost

Shan Nanji - NanjiMD@gmail.com

11

Aspirin (ASA)
n

__________________ COX 1 and COX 2 inhibitor

Great anti-platelet drug (81mg)

Acidic
PC02
FIRST
SECOND
THIRD -gaba

Shan Nanji - NanjiMD@gmail.com

HCO3

pH

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NSAIDs
Indomethacin Most potent __________________
n Phenylbutazone
n Ibuprofen MC OTC
n Naproxen - __________________
n Ketorolac Morphine like potency, used in ________________
n Ketoprofen
n Sulindac
n Diclofenac
n

Shan Nanji - NanjiMD@gmail.com

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Steroids
nMechanism

of Action I-KISS
nI Inhibits __________________
nK

Kills T Cells
an__________________
nI Inhibits __________________
nS Stabilizes __________________
nS Stabilizes __________________
Shan Nanji - NanjiMD@gmail.com

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Steroids
n Prednisone
n Methylprednisolone
n Triamcinolone
n Budesonide
n Hydrocortisone
n Beclomethasone
n Betamethasone

Induces Surfactant Production

Induces Surfactant Production


n B is for Breath

Shan Nanji - NanjiMD@gmail.com

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Steroids
n Dexamethasone

Best CNS Penetration

n Fludrocortisone

__________________

n Cypropterone
n Megesterol
n Fluticasone

Shan Nanji - NanjiMD@gmail.com

Blocks ________________

__________________

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Steroids
n Danazol

Rx for endometriosis

n Mometasone
n Bodosimide
n Cyclosenide

Shan Nanji - NanjiMD@gmail.com