Lecture 4

Question 1

What is Heroin

Answer 1

A semi-synthetic derivative of morphine, NOT a natural substance

Question 2

Opiate

Answer 2

Any drug derived from opium that has morphine-like effects. Natural and Semi-sythetitc

Question 3

Opioid

Answer 3

Any drug natural or synthetic that has morphine-like effects, can include endorphins

Question 4

Narcotic

Answer 4

Any drug of abuse

Question 5

Analgesia

Answer 5

Raising of pain threshold or lowering of pain

Question 6

Hyperalgesia

Answer 6

Lowering of pain thresholds, increasing of pain (opposite of analgesia)

Question 7

Allodynia

Answer 7

Painful response to non painful stimulus (a blanket resting on you can hurt you)

Question 8

Anesthesia

Answer 8

Analgesia, loss of consciousness and memory

Question 9

Hyperkatifiea

Answer 9

Lowering of emotional pain thresholds, increasing emotional pain (Koobs made up)

Question 10

Medical uses of Opiods

Answer 10

Constipated (block diarrhea) blocks coughs, used pre or post-surgery to block pain

Question 11

Describe two opioids used for diarrhea

Answer 11

Imodium and Lomotil - Imodium can’t cross the blood brain barrier and Lomotil crosses the blood brain barrier but atropine prevents abuse, and these drugs do NOT produce analgesia. All analgesic opioids have abuse potential

Question 12

Which are the two most potent opioids?

Answer 12

Dialaudid and Sublimaze (most potent)

Question 13

Effects of Opioids on pain

Answer 13

Raises the pain threshold, lowers the pain, but does not affect other sensory modalities, touch vibration visions and hearing all remain the same

Question 14

Effects of Opioids on different types of pain

Answer 14

Continuous dull pain is relieved more effectively than sharp intermittnet pain

Question 15

What did the FDA change in 2011

Answer 15

Originally thought that acetaminophen was safer than the opiate, this was changed because the acetaminophen was more toxic to the body

Question 16

What does high doses of acetaminophen cause?

Answer 16

Causes NAPQI which leads to depletion of GSH and liver damage. Alcohol use can make this worst

Question 17

What is the dose limit for all opioids

Answer 17

325 mg per pill

Question 18

Outpatient management with opioids

Answer 18

Oral (pill) and patch-transdermal

Question 19

Inpatient management with opioids

Answer 19

IV - titration is possible and patient controlled analgesia, allows for self-administered opioid

Question 20

What is used for relief of pain during brith

Answer 20

Sublimaze

Question 21

What is the drug of choice for anesthesia?

Answer 21

Fentanyl and its derivatives, acts as an adjunct and is 80x more potent than morphine

Question 22

General Anesthesia (Parenteral)

Answer 22

Induction and maintenance

Question 23

Propofol

Answer 23

Used for induction and maintenance of anethesia NOT analegsic

Question 24

Desflurane

Answer 24

Inhaled anesthetics maintenance

Question 25

Opioids used for cough

Answer 25

Dextromethorphan and Codeine

Question 26

Side effects of opioid medication

Answer 26

Respiratory depression, constipation, loss of memory (mental clouding), itching, and nausea

Question 27

Opiate Antagonists

Answer 27

Drug that blocks effects of opiate but has no effect on its own Ex. Narcan (IV) and Depede (Oral)

Question 28

What are the 3 natural ingredients of opium poppy

Answer 28

Morphine, Codeine, and Thebaine

Question 29

Desomorphine (Krokodil)

Answer 29

Analgesic, less nausea and less respiratory depression, however, it has impurities in its preparation and causes gangrene in users