Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Exam 4: Opioid Analgesics-Part 1 > Flashcards

Exam 4: Opioid Analgesics-Part 1 Flashcards

1
Q

Opiates are for _______ to ______ dental pain that cannot be managed effectively with NSAIDS.

A

Moderate to severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the older term derived from Greek word meaning “stupor”?

A

Narcotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What term is used to describe substances from the white liquid extract derived from the seeds of poppy plant? Alkaloids found in opium…

A

Opiates

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the current/correct term used to describe opiates, their antagonists, and the receptors stimulated by opioid drugs?

A

Opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 4 mechanisms of action for opioid theraputics?

A

Agonists, Partial Agonists, Mixed (agoinists + antagoinists) and antagoinists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Opioids bind to receptors in both _____ and spinal cord…Produce altered perception of _____ reaction…Opioid receptors that mediate specific pharmacologic effects and adverse reactions are stimulated to varying ______ by individual opioids.

A

CNS…pain….degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The Analgesic Effect: Produced by _______ stimulation due to activation of a pain-modulating circuit which projects via the _____ to the spinal cord ______ horn.

A

midbrain…medulla..dorsal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is the highest concentration of endogenous opioid?

A

the DESCENDING pain-modulating circuit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What circuit is activated by stress (like running/birth)?

A

the DESCENDING pain-modulating circuit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Opiates produce analgesia by direct action on the _____.

A

CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

The Pain suppression center involves ________ as neurotransmitter and it is partially _______-mediated (endogenous opioids)

A

serotonin…enkephalin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the 3 areas of the CNS where all the Analgesia action takes place?

A

1.periaquaductal grey matter (MIDBRAIN)….2.nucleus raphe magnus (MEDULLA)….3.pain inhibitory neurons (DORSAL horns of the spinal cord)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Projections from the Periaqueductal Gray Matter (PAG) and RVM (rostroventral medulla) are ________ and are highly sensitive to ________.

A

serotonergic…morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Projections from the dorsolateral pons are _________…Application of NE to spinal cord blocks noxious stimuli in ______ horn.

A

noradrenergic….dorsal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 groups of endogenous opioids?

A

1.Endorphins 2.Enkephalins 3.Dynorphins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 3 different receptors that opioids work on? What type of signal transduction?

A

Mu, delta, and kappa….G protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Term “_______” = used synonymously with endogenous opioid peptides

A

endorphins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Endorphins/endogenous opioid peptides are produced by the _______ gland and _________.

A

pituitary gland and the hypothalamus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

You can find endorphins/endogenous opioid peptides? mainly in ______ system and ______ areas
associated with pain reception and certain areas of the _____

A

limbic…brainstem…spinal cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The Endogenous Opioid Peptides: β-Endorphin = expressed in cells in the _______ nucleus of the _______ and in the _______….acts via ____: influences appetite, sexual behavior

A

arcuate…hypothalamus…brainstem..mu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Enkephalin = widely distributed throughout the brain

– acts via ____ and _____

A

mu and delta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Dynorphin = found in the spinal cord and in many parts of the brain, including the hypothalamus
– acts via ______

A

kappa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

More on ENDORPHINS: endogenous morphine is produced from _______ molecules (no I aint about to memorize those)

A

precursor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which group of endogenous opioid is found in the gut (pancreatic islet cells), sympathetic nervous system, adrenal medullary chromaffin cells, CNS?

A

Endorphins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

More on ENDORPHINS: B-endorphin distributed in _____

A

brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Which group of endogenous opioid is involved in blood pressure regulation, temperature regulation and food intake?

A

Endorphins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

More on ENDORPHINS: they act via the ____ receptor to produce the opiate effects.

A

mu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Since the naturally occurring endorphins act via mu receptors in the GI tract, what is a MAJOR side effect when you prescribe opioids? What would you recommend to the Pt along with your Rx?

A

CONSITPATION!!! A stool softener like Colace

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

More on ENKEPHALINS: they are _________ synthesized and isolated from brain.

A

pentapeptides

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

More on ENKEPHALINS: they mimic opiate activity = and are ______ analgesics

A

weak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

More on ENKEPHALINS: May be responsible for producing analgesia in placebo responders and _______.

A

acupuncture

32
Q

More on ENKEPHALINS: act via ___ and _____ receptors.

A

mu and delta

33
Q

More on DYNORPHINS: Found in the spinal cord and in many parts of the brain, including the _________….acit via ______ receptors.

A

hypothalamus…kappa

34
Q

______ and ______ horn of spinal cord have dense concentrations of opiate binding sites

A

PAG (periaqueductal gray matter)….dorsal

35
Q

Opiate receptors are also found in tissues that are NOT involved in analgesia, Accounts for side effects of respiratory ________, pupil _______, decreases in body _______ and decreases in gut ______!!!

A

depression….constriction….temperature…motility

36
Q

What method do scientists use to measure opiate receptor locations? What are the three areas that showed lots of mu activity?

A

PET scan…thalamus, cerebral cortex, and basal ganglia

37
Q

Recognition site of receptor is highly ______!! analgesic action of opioid drugs is stereospecific: ONLY _____-isomers have biological activity

A

specific…LEVO-isomers

38
Q

What are the 5 opioid receptors? (we’ve talked about 3 of them)

A

mu, delta, kappa, epsilon, sigma(aint a receptor no more)

39
Q

Which receptor? Supraspinal analgesia • Euphoria

• Physical dependence

A

Mu 1

40
Q

Which receptor? Respiratory depression

A

Mu 2

41
Q

Must bind to ____ to be physically addicting!

A

Mu

42
Q

Drugs that bind to ___ (___ agonists) exhibit the

BEST analgesic properties!

A

Mu…Mu

43
Q

Downside: always the risk of ______ and risk for respiratory _______

A

addiction…depression

44
Q

If decrease the ______ for Mu (e.g. partial Mu agonist), then decrease the risk for ______, but also decrease the level of _______.

A

affinity…addiction…analgesia

45
Q

Which receptor? – Spinal analgesia – Miosis (pinpoint pupils) -SEDATION

A

Kappa (think soccer ladies)

46
Q

Which receptor? Analgesia – Emotion – Seizures

A

Delta

47
Q

Which receptor? just analgesia….

A

Epsilon

48
Q

Which receptor? – Autonomic stimulation – Dysphoria – Hallucinations – Nightmares – Respiratory stimulation – Vasomotor stimulation (tachycardia) – Anxiety…(not really a receptor…)

A

Sigma

49
Q

Strength of attachment of an opioid drug to its binding site (binding affinity) is proportional to its ______.

A

potency

50
Q

INTERESTING! Opioids cause _________ of nerve cells, inhibition of nerve _____ and presynaptic inhibition of _______ release

A

hyperpolarization…firing…transmitter

51
Q

What are two examples of opium alkaloids?

A

morphine and codiene

52
Q

What are 4 examples of semi-synthetic opioids?

A

heroin, oxy-codone, hydro-codone, hydro-morphone

53
Q

What are 4 examples of fully synthetic opiods?

A

meper-id-ine, metha-done, fentanyl, penta-zo-cine

54
Q

Which type of opioid drug elicits receptor responses of opiate receptors….there are Pure and partial..

A

agoinists

55
Q

Which type of opioid drug has no inherent action after binding to receptor but block any agonist activity?

A

pure Antagonists

56
Q

What is our prime example of a PURE agonist?

A

morphine

57
Q

Which type of opioid? Complete receptor activation, Mu and Kappa activated, Unlimited analgesia..ex-morphine

A

pure agonist

58
Q

What is this phenomenon called? With continued exposure of tissues to high concentrations of opioid agonists, the potency of the drug DECLINES so that progressively HIGHER concentrations are required to produce the same degree of analgesia.

A

Tolerance

59
Q

How many of the opioids exhibit tolerance?

A

ALL of them

60
Q

______-tolerance develops to other opioid analgesics as well

A

Cross

61
Q

What type of opioid am I talkin bout? Drug example: buprenorphine (Buprenex), Partial Mu activation, Weak Kappa antagonist, Good analgesia but limited effect, Not typically used in dentistry, Injection (C-V/III) for moderate to severe pain, Tablets (C-III) – treatment of opioid dependence; chronic pain; investigational for opiate and heroin withdrawal

A

Partial Agonist

62
Q

Partial Agonists: Drug example: _________ (Buprenex)

A

Bu-Pren-or-phine

63
Q

Partial Agonists: Partial ___ activation

A

Mu

64
Q

Partial Agonists: weak _____ ANtagonist

A

kappa

65
Q

Partial Agonists: good ______ but limited effect

A

analgesia

66
Q

Partial Agonists: Not typically used in ______

A

dentistry

67
Q

We use a _____ agonist for the treatment of opioid dependence.

A

partial

68
Q

Agonist/Antagonist mixes are used as a _______ prior to surgery… they are agonists for ____ receptors and antagonists for _____ receptors.

A

sedative…kappa….mu

69
Q

Need to know this drug! What is our PRIME example of a PURE Antagonist?

A

Naloxone (Narcan)

70
Q

A Pure antagonist works by blocking ____ and ___ receptors.

A

mu and kappa

71
Q

______ antagonist, used in dentistry to reduce overdose of opiates (fentanyl and meperidine) used during conscious sedation…Used for complete or partial ______ of opioid depression

A

pure…reversal

72
Q

Kinetics: Ditribution-_______ effect reduces bioavailability

– Passes to ______ = produces ________ depression in fetus if taken by mother

A

first pass…fetus…respiratiory

73
Q

Kinetics: Metabolism-Conjugation with _______ acid in liver

A

glu-cur-on-ic acid

74
Q

Kinetics: Excreted in ______, usually a way of testing for their over use.

A

urine

75
Q

Kinetics: Duration-most opiates produce analgesia for ___-___ hours

A

4-6 hours

Pharmacology (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions