Workbook:

Opioid Agonists & Antagonists

Copyright 2016 APEX Anesthesia Review

Pain Transmission
Transduction

Transmission

Modulation

Perception
Opioid Mechanism of Action Mu Delta Kappa
Endogenous
Ligand

Analgesia

Respiratory

Cardiovascular

CNS

Pupil

GU

GI

Pruritus

Antishivering
Opioid Side Effects
Key Facts Key Facts
Cardiovascular GI

GU

Neurologic Immunologic

Thermoregulation
Relative Potency Metabolism
Rank the opioids from most to least potent.

Equianalgesic dose Relative potency Has Active Metabolites Does Not Have Active Metabolites
Meperidine

Morphine

Hydromorphone

Alfentanil

Fentanyl

Remifentanil

Sufentanil
Meperidine Alfentanil
Remifentanil Methadone
Muscle Rigidity
Treatment: Cause:

Respiratory Cardiovascular Other

Dose Response Curve
Label the dose response curve with all of the opioid full agonists, partial agonists, and antagonists you can recall.
Partial Agonists

Buprenorphine Nalbuphine Butorphanol

MOA

Analgesia vs.
MSO4

Reversed by
naloxone

Key features
Antagonists
Naloxone Methylnaltrexone Nalmefene Naltrexone