AGENTS, CONTROLLING THE FUNCTIONS OF THE CENTRAL NERVOUS SYSTEM - Narcotic analgesics Flashcards
Narcotics analgesics should
Relieve severe pain
Second-order pain is
Dull, burning pain
Chemical mediators in the nociceptive pathway are
- Kinins
- Prostaglandins
- Substance P
Chemical mediators in the nociceptive pathway are not
Enkephalins
Indicate the chemical mediator in the antinociceptive descending pathways
- BETA-endorphin
- Met- and leu-enkephalin
- Dynorphin
Which mediators is found mainly in long descending pathways from the midbrain to the dorsal horn?
Enkephalin
Select the brain and spinal cord regions, which are involved in the transmission of pain?
- The limbic system, including the amygdaloidal nucleus and the hypothalamus
- The ventral and medial parts of the thalamus
- The substantia gelatinosa
Mu (μ) receptors are associated with
Analgesia, euphoria, respiratory depression, physical dependence
Which opioid receptor types is responsible for euphoria and respiratory depression?
Mu (μ) receptors
Indicate the opioid receptor type, which is responsible for dysphoria and vasomotor stimulation
Kappa-receptors
Kappa and delta agonists
Close a voltage-gated Ca2+ channels on presynaptic nerve terminals
Which supraspinal structures is implicated in pain-modulating descending pathways?
The midbrain periaqueductal gray
Indicate the neurons, which are located in the locus ceruleus or the lateral tegmental area of the reticular formation
Nonadrenergic
Which analgesics is a phenanthrene derivative?
Morphine
Tick narcotic analgesic, which is a phenylpiperidine derivative
Fentanyl
Which opioid analgesics is a strong mu receptor agonist?
Morphine
Indicate the narcotic analgesic, which is a natural agonist
Morphine
Select the narcotic analgesic, which is an antagonist or partial mu receptor agonist
Pentazocine
Which agents is a full antagonist of opioid receptors?
Naloxone
The principal central nervous system effect of the opioid analgesics with affinity for a mu receptor is
- Analgesia
- Respiratory depression
- Euphoria
Which opioid analgesics can produce dysphoria, anxiety and hallucinations?
Pentazocine
Indicate the opioid analgesic, which has 80 times analgesic potency and respiratory depressant properties of morphine, and is more effective than morphine in maintaining hemodynamic stability?
Fentanyl
Which opioid analgesics is used in combination with droperidol in neuroleptanalgesia?
Fentanyl
Fentanyl can produce significant respiratory depression by
- Suppression of the cough reflex leading to airway obstruction
- Development of truncal rigidity
Most strong mu receptor agonists cause
Cerebral vasodilatation, causing an increase in intracranial pressure
Which opioid analgesics can produce an increase in the pulmonary arterial pressure and myocardial work?
Pentazocine
Morphine causes
- Constipation
- Urinary retention
- Bronchiolar constriction
Morphine do not causes
Dilatation of the biliary duct
Therapeutic doses of the opioid analgesics
Decrease body temperature
Which opioid analgesics is used in obstetric labor?
Meperidine
Indicate the opioid analgesic, which is used for relieving the acute, severe pain of renal colic
Meperidine
Which opioid analgesics is used in the treatment of acute pulmonary edema?
Morphine
The relief produced by intravenous morphine in dyspnea from pulmonary edema is associated with reduced
- Perception of shortness of breath
- Patient anxiety
- Cardiac preload (reduced venous tone) and afterload (decreased peripheral resistance)
Rhinorrhea, lacrimation, chills, gooseflesh, hyperventilation, hyperthermia, mydriasis, muscular aches, vomiting, diarrhea, anxiety, and hostility are effects of
Abstinence syndrome
The diagnostic triad of opioid overdosage is
Coma, depressed respiration and miosis
Which opioid agents is used in the treatment of acute opioid overdose?
Naloxone
Indicate the pure opioid antagonist, which has a half-life of 10 hours
Naltrexone
In contrast to morphine, methadone
- Causes tolerance and physical dependence more slowly
- Is more effective orally
- Withdrawal is less severe, although more prolonged
Which opioid analgesics is a partial mu receptor agonist?
Buprenorphine
Indicate a partial mu receptor agonist, which has 20-60 times analgesic potency of morphine, and a longer duration of action
Buprenorphine
Which opioid analgesics is a strong kappa receptor agonist and a mu receptor antagonist?
Nalbuphine
Which drugs has weak mu agonist effects and inhibitory action on norepinephrine and serotonin reuptake in the CNS?
Tramadol
