Exam 2 Important "Groupings"

Question 1

drugs that go through the first pass effect in the liver

Answer 1

meperidine
naloxone
morphine PO

Question 2

drugs that go through the first pass effect in the lungs

Answer 2

fentanyl
sufentanyl
lidocaine
propofol

Question 3

don’t give this drug to impaired liver patients

Answer 3

thiopental

Question 4

don’t give these drugs to impaired renal patients

Answer 4

morphine
meperidine
sufentanil
toradol
NSAIDS

Question 5

these drugs are known for placental transfer

Answer 5

morphine
meperidine
fentanyl analogues
diazepam

Question 6

these drugs are dependent on hepatic BF

Answer 6

fentanyl 
sufentanil
ketamine
morphine
lidocaine
diltiazem

Question 7

these drugs are responsible for a large histamine release

Answer 7

atracurium
codeine IV
meperidine
morphine

Question 8

these drugs are responsible for porphyrias

Answer 8

barbiturates

etomidate

Question 9

name these drugs in order of potency: morphine, dilaudid, tramadol, meperidine

Answer 9

dilaudid
morphine
tramadol/meperidine

Question 10

most to least potent fentanyl analogues in order:

Answer 10

sufentanil
fentanyl
remifentanil
alfentanil

Question 11

most to least Vd for fentanyl analogues in order:

Answer 11

fentanyl 4L/kg
sufentanil 2L/kg
alfentanil .6L/kg
remifentanil .39L/kg

Question 12

least to most ionized fentanyl analogues in order:

Answer 12

alfentanil (90% unionized)
remifentanil (58% unionized)
sufentanil (20% unionized)
fentanyl (10% unionized)

Question 13

lowest to highest pKa fentanyl analogues in order:

Answer 13

alfentanil pKa 6.5
remifentanil
sufentanil
fentanyl pKa 8.4

Question 14

drugs that are acids

Answer 14

barbiturates, propofol, NSAIDS

Question 15

synthetic opioids

Answer 15

phenylpiperdines

Question 16

opiates

Answer 16

morphine, codeine

Question 17

opioids do not

Answer 17

block nerve impulses, alter responsiveness of afferent nerve endings to noxious stimulation

Question 18

where are opioid receptors primarily found in the brain

Answer 18

periaqueductal gray, locus coeruleus, rostral ventral medulla

Question 19

where are opioid receptors found in the spinal cord

Answer 19

primary afferent and interneurons of dorsal horn

Question 20

Mu1 receptor effects

Answer 20

analgesia (supra spinal and spinal)
euphoria
miosis
bradycardia
urinary retention

Question 21

Mu2 receptor effects

Answer 21

analgesia (spinal)
depression of ventilation
physical dependence
constipation

Question 22

Kappa receptor effects

Answer 22

analgesia (supra spinal and spinal)
dysphoria, sedation
miosis
diuresis
agonist antagonists usually act on these, less effective for high intensity pain, inhibit calcium release

Question 23

delta receptor effects

Answer 23

analgesia (supra spinal and spinal)
respiratory depression
physical dependence
urinary retention
constipation

Question 24

enkephalins

Answer 24

norepinephrine, dopamine, endorphins

Question 25

reflex coughing is seen most often with

Answer 25

fentanyl, sufentanil, alfentanil