Opioids             Chapter 14

   I. Pain 
      A. nociceptors
      B. neuropathic
      C. Physiology

  II. Opioids
      A. History
         1. opium
         2. morphine
         3. endogenous opiates
      B. Types
      C. Opioid Receptors
      D. Two pathways

 III. Morphine
      A. Trade Name
         1. MS Contin
      B. Background
      C. Actions
      D. Pharmacokinetics
      E. Adverse effects
      F. Tolerance

  IV. Codeine
      A. Background
      B. Uses
      C. Pharmacokinetics

   V. Semisynthetic opioids
      A. oxycodone (Oxycontin)
      B. oxymorphone (Opana)
      C. hydromorphone (Diluadid, Exalgo)
      D. hydrocodone (Lortab, Vicodin, +)

  VI. Synthetic opioids
      A. fentanyl (Astral, Actiq, Duragesic, Fentora, Lazanda, Subsys)
      B. Other synthetic opioids
         1. sufentanil (Sufenta)
         2. alfentanil (Alfenta)
         3. remifentanil (Ultiva)
      C. methadone (Dolophine)
      D. meperidine (Demerol)
      E. tramadol (Conzip, Ultram)

 VII. Partial Agonist & Mixed agonists
      A. Definitions
      B. buprenorphine (Belbuca, Buprenex, Butrans, Probuphine, Subutex)
      C. pentazocine (Talwin)

VIII. Antagonists
      A. Definition
      B. Effects - Stage I, Stage II, Stage III
      C. naloxone (Evzio, Narcan)
         1. naloxone & buprenorphine (Suboxone)
      D. naltrexone (Vivitrol)

  IX. Heroin = diacetylmorphine