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!
W

N
O

Butorphanol
MECHANISM

Mu-opioid receptor partial agonist and kappa-opioid receptor agonist; produces analgesia.

CLINICAL USE

Severe pain (migraine, labor, etc.). Causes less respiratory depression than full opioid agonists.

TOXICITY

Can cause opioid withdrawal symptoms if patient is also taking full opioid agonist (competition for
opioid receptors). Overdose not easily reversed with naloxone.

Tramadol
MECHANISM

Very weak opioid agonist; also inhibits serotonin and norepinephrine reuptake (works on multiple
neurotransmitterstram it all in with tramadol).

CLINICAL USE

Chronic pain.

TOXICITY

Similar to opioids. Decreases seizure threshold. Serotonin syndrome.

extension legquadriceps femoris M. femoris N.

flexion leg: biceps M. (Common Peroneal N.), sartorius
HIP abduction: tensor foscia lata (superior glutel): hip; (superior glutel
N): flexion thigh:
flexion: psoas(lumbar plexus)iliopsoas, sartorius (femoral N), tensor foscia lata
(superior glutel),
Extension: gluteus maxium (inferior glutal nerve), the inferior portion of adductor
Magnus, hamstring muscle from ischial tuberosity
adduction: (gracilis, adductor Medially rotate thigh longus, adductor brevis, anterior
portion of adductor magnus (Obturator nerve )
medial rotation: anterior muscle+tensor foscia lata
lateral rotation: Piriformis, gemellus superior, obturator internus, gemellus inferior,
quadratus femoris and the obturator externus, sartorius+

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N e u rology
neurologyPharmacology

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