Episode 13: Opioids part 1

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 13: Opioids part 1

This is the first of a 2 part series on opioid medications.  In this first episode I will talk about how opioids are categorized and their effects on the different body systems.  In the next episode I will discuss their pharmacokinetics and pharmacodynamics as well as their various uses and some details on mixed agonist/antagonists.

CME: https://cmefy.com/moment?id=xPdz_TY

Slides to go along with this episode are here: Opioids part 1

PLEASE NOTE: Around minute 12 I say that auditory evoked potentials are the most sensitive to anesthetics.  This is incorrect.  I should have said visual evoked potentials.  Thanks to Howard Zee for catching that!

7 thoughts on “Episode 13: Opioids part 1”

  1. I’ve just discover your podcast at iVoox, i’m second year anaesthesia and critical care resident. I’m very grateful of your work, this podcast is and excellent companion while running or at an time. Thank so much, i’ve found solution to some doubts about pharmacology here and catch ideas that i actually remember!!! ;D

    1. Hi Elizabeth,

      Thanks so much for the comment. I’m really glad you’re enjoying the podcast. Best of luck with your ongoing training and thanks for all you do out there every day.


  2. You mentioned that a SE of meperidine is tachycardia, which is unlike all other opioids. I think it’s helpful for other listeners out there to realize the reason (which I only learned while studying for boards): meperidine is structurally similar to atropine.

    Like morphine, it causes histamine release which can cause hypotension. Meperidine has direct depressive effects on the contractility of myocytes, and is a reuptake inhibitor of serotonin in the presynaptic membrane.

    Despite how infrequently I have used meperidine, it certainly is tested out of proportion.

    Thanks for a great review show!

  3. Hello!

    I recently discovered your podcast and I’m really grateful that you are doing this.

    In this episode you mentioned that the opiateinduced rigidity can be treated with benzodiazepines. However, when I was searching for the dose of benzo to use in these situations, I came across some articles mentioning that benzodiazepines potentiate the effect of opiates. What is your opinion regarding this? And which dose of midazolam do you recommend for treating opiate induced rigidity?

    Regards from Sweden and keep up the good work!

    1. Hi Betul,

      The best medications to treat opioid induced rigidity are naloxone or sux. Benzos may help but it’s not clear they do. When we say Benzos potentiate the effects of opiods we mean the sedative and respiratory depressant effects, not the rigidity. Hope that helps!

  4. Hello!

    Just wanted to mention that you said at 13:47 “as the auditory evoked potentials … the most sensitive “ which is incorrect.
    VEPs are the most sensitive; BAEPs are the most resistant.

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