FB - Opioid Analgesics

Question 1

What is the pharmacodynamic characteristics of codeine?

Answer 1

Weak opioid agonist

Question 2

Why is early control of pain important?

Answer 2

When pain becomes severe, it is less responsive to treatment

Question 3

How do opioids inhibit pain signal propagation?

Answer 3

By blocking opioid receptors and inhibiting propagation of pain signals

Question 4

Name the major types of opioid receptors.

Answer 4

µ (Mu), δ (Delta), κ (Kappa)

Question 5

What is the role of µ (Mu) receptors in opioid analgesia?

Answer 5

Supraspinal and spinal analgesia, respiratory depression, euphoria

Question 6

What effects are associated with κ (Kappa) receptors?

Answer 6

Peripheral analgesia, dysphoria, and sedation

Question 7

How do individual differences affect opioid dosing?

Answer 7

Factors like age and type of pain (neuropathic vs nociceptive) influence dosing requirements

Question 8

What is the principle of ‘dosing to effect’ in opioid therapy?

Answer 8

Starting with a low dose and titrating until adequate analgesia is achieved or until side effects necessitates termination

Question 9

What a clinical uses for codeine?

Answer 9

cough suppression

Question 10

What is a common adverse effect of opioids related to the gastrointestinal system?

Answer 10

Constipation due to reduced GI motility

Question 11

What are the risks associated with opioid overdose?

Answer 11

Respiratory depression, potential lethality, especially in combination with other CNS depressants

Question 12

What is the primary use of opioid antagonists like naloxone?

Answer 12

To counteract opioid overdose

Question 13

Why must opioid antagonists be used cautiously in patients with opiate dependency?

Answer 13

They can precipitate a potentially fatal withdrawal syndrome

Question 14

How do opioids like morphine affect driving or operating machinery?

Answer 14

They cause drowsiness, requiring caution

Question 15

What is the impact of long-term opioid use on the immune system?

Answer 15

It may have an immunosuppressant effect

Question 16

How do opioids potentially affect patients with asthma?

Answer 16

Morphine can trigger histamine release, causing bronchoconstriction

Question 17

What characterizes opioid tolerance?

Answer 17

Reduced effectiveness over time, requiring dose escalation

Question 18

Define opioid addiction.

Answer 18

Psychological craving, compulsive use, and loss of control over use

Question 19

What happens during physical dependence on opioids?

Answer 19

Stopping the drug leads to physical withdrawal symptoms

Question 20

What are signs of opioid withdrawal?

Answer 20

Anxiety, irritability, chills, nausea, vomiting, abdominal cramps

Question 21

Why is morphine considered a strong opioid agonist?

Answer 21

High affinity to opioid mu receptors, highanalgesic efficacy and liability for addiction/abuse

Question 22

What distinguishes methadone and fentanyl among strong opioid agonists?

Answer 22

Methadone is long-acting; Fentanyl is short-acting and thus often used as an anaesthetic adjuvant

Question 23

What are the characteristics of moderate opioid agonists like codeine?

Answer 23

Weak opioid receptor agonist, low analgesic efficacy, moderate liability for addiction/abuse

Question 24

How does pethidine (Meperidine) differ from morphine?

Answer 24

Shorter duration of action, produces restlessness rather than sedation

Question 25

What are contraindications for using opioid analgesics?

Answer 25

Known hypersensitivity to opioids, severe respiratory depression, acute or severe bronchial asthma, gastrointestinal obstruction

Question 26

How do opioids interact with other CNS depressants?

Answer 26

They can potentiate the effects of other CNS depressants leading to increased sedation or respiratory depression

Question 27

What is the key clinical indication for using strong opioids like morphine?

Answer 27

Management of moderate to severe neuropathic pain, especially in cancer-related pain

Question 28

Why are opioids used in anesthesia?

Answer 28

To supplement the effects of anesthetics by providing analgesia

Question 29

What is the impact of opioids on the cardiovascular system?

Answer 29

They can cause bradycardia and hypotension, especially in high doses or rapid administration

Question 30

How do opioids affect urinary function?

Answer 30

They can increase bladder sphincter tone and lead to urinary retention

Question 31

What is the concern with using opioids in elderly patients?

Answer 31

Increased sensitivity and risk of side effects like falls due to sedation and dizziness

Question 32

Why must opioids be used cautiously in patients with hepatic impairment?

Answer 32

Impaired metabolism can lead to increased effects and toxicity

Question 33

How do opioids affect gastrointestinal motility?

Answer 33

They decrease gastrointestinal motility leading to constipation

Question 34

How are opioid-induced itching and sweating managed?

Answer 34

Often treated with antihistamines or reducing the opioid dose