Exam 3 - Opiates

Question 1

What was Cari’s drug of choice?

Answer 1

heroin

Question 2

What is opium?

Answer 2

• comes from a species of the poppy plant
• powerful analgesic, also a cough suppressant, and antidiarrheal

Question 3

Opiate history

Answer 3

• readily available in the 19th century in europe and the US
• F.W. Serturner figured out how to separate morphine from opium
• heroin became the drug of choice in the 20th century, and use has dramatically increased

Question 4

What are the classifications of opioids?

Answer 4

• natural substances: straight from the plant, opium, morhpine, codeine
• semisynthetic narcotics: altered natural substances, heroin, oxy
• synthetic products: completely made in labs, demerol
• endogenous opioids: naturally made in body, endorphins

Question 5

Pharmacokinetics: Absorption

Answer 5

• absorbed in the GI tract, nasal mucosa and lungs, IM and IV

Question 6

Opioids are distributed into the bloodstream, what type of opium more readily crosses the BBB? What does excretion of opiates look like?

Answer 6

• heroin crosses more readily than morphine
• excretion by liver is rapid, with 90% excretion w/n 24 hours

Question 7

What are the 3 types of opioids?

Answer 7

• full agonist: completely binds, morphine like effect (heroin, oxy, meth)
• partial agonist: partially activates, lesser morphine like effects w/ strong receptor affinity (buprenorphine)
• antagonist: blocks receptor (naloxone, naltrexone)

Question 8

What does the Mu2 opiate receptor do? What areas does it influence?

Answer 8

• constipation, respiratory depression
• medial thalamus, periaqueductual gray, median raphe (pain control)

Question 9

What does the delta opiate receptor do? What areas does it influence?

Answer 9

• may be involved in spinal and suprasinal analgesia
• substantia nigra, nucleus accumbens

Question 10

What does the kappa opiate receptor do? What areas does it infuence?

Answer 10

• spinal analgesia, hallucinations, dysphoria
• striatum, amygdala, hypothalamus, pituitary

Question 11

Is heroin dissolvable in water?

Answer 11

yes

Question 12

What are some opiate effects?

Answer 12

• analgesia
• euphoria
• sedation and anxiolysis
• depression of respiration
• suppression of cough
• pupillary constriction
• nausea and vomiting
• GI symptoms
• endocrine effects - release histamine, makes you itch

Question 13

How soon does heroin dependency develop?

Answer 13

within weeks

Question 14

What are the stages of opium withdrawal?

Answer 14

• early: anxiety, perspiration, yawning, runny nose
• mid: fever, chills, sweat, leg and ABD cramps, bone pain
• late: vomiting, diarrhea, hyperventilation, insomnia
• withdrawal is not lethal

Question 15

What areas of the brain are involved in environmental cues that influence heroin use?

Answer 15

amygdala and anterior cingualte

Question 16

What are some medial complications involved in opioid addiction?

Answer 16

• infections like HIV, Hep B and C, endocarditis, meningitis, TB
• neuropathy, menstrual irregularity
• imapired immune function
• hepatic and renal toxicity

Question 17

Methadone

Answer 17

• detox method for heroin
• decreases dangerous injections

Question 18

LAAM

Answer 18

• detox method for heroin
• oral opioid analgesic with long and slow onset (72 hours)

Question 19

What are the two opioid antagonists?

Answer 19

naloxone and naltrexone

Question 20

Krokodil/desomorphine

Answer 20

• lighter fluid/gasoline + codeine
• extremely potent and toxic, causes infections and eventually gangrene

Question 21

Describe the withdrawal syndrome associated with opiate abuse

Question 22

What are 2 methods used to determine neurobiology of opiate reinforcement?

Question 23

What brain areas contribute to opioid withdrawal?

Question 24

What role do environmental cues have in tolerance, drug abuse and relapse?