narcotic analgesics

Question 1

how does opioid analgesia work on endogenous mechanisms?

Answer 1

inhibit the propagation of pain signals
alter the emotional perception of pain
elevate the pain threshold

Question 2

sites of opioid receptors regulating pain (3)

Answer 2

peripheral nociceptive terminals (peripheral analgesia)
spine (spinal analgesia)
brain (supra spinal analgesia)

Question 3

3 major opioid receptor types

Answer 3

Mu
Delta
Kappa

Question 4

elderly patients usually require a ___ dose to achieve effective pain relief than younger patients

Answer 4

lower

Question 5

neuropathic pain usually requires a ____ dose than nociceptive pain

Answer 5

higher

Question 6

_____ doses are usually required for continuous maintenance of pain relief

Answer 6

lower

Question 7

drugs for analgesia (3)

Answer 7

codeine morphine pethidine

Question 8

drugs for anaesthetic adjuvant

Answer 8

fentanyl

Question 9

drugs for cough suppression

Answer 9

codeine

Question 10

antidiarrhoeal drug

Answer 10

diphenoxylate

Question 11

name the 4 strong opioid agonists

Answer 11

morphine
methadone
fentanyl
pethidine

Question 12

caution when using morphine, methadone and fentanyl

Answer 12

high addiction potential

Question 13

methadone is a __-acting while fentanyl is ____ acting

Answer 13

long, short

Question 14

Name 2 moderate opioid agonists

Answer 14

Codeine

Tramadol

Question 15

Codeine is a weak __ and __ agonist

Answer 15

Mu and delta

Question 16

Tramadol is a….

Answer 16

Weak inhibitor of 5-HT and NA reuptake

Question 17

How does respiratory depression occur

Answer 17

Actions in the nucleus tracts solitarius and nucleus ambiguus reduce responses to CO2 and H+ And suppress voluntary breathing

Question 18

8 common ADR of opioids

Answer 18

Nausea
Vomiting 
Drowsiness 
Constipation 
Miosis 
Urinary retention 
Postural hypotension 
Immunosuppressant in long term use

Question 19

Morphine specific ADR

Answer 19

Histamine release

• urticaria and itching
• brinchiconstriction
• hypotension due to vasodilation

Use with caution in asthmatics

Question 20

Opioid antagonist (3)

Answer 20

Naloxone
Naltrexone
Nalmefene

Question 21

Naloxone is ___ acting (usually administered___)

Answer 21

Short

IV

Question 22

Naltrexone is ___ acting usually administered ____

Answer 22

Long

Orally

Question 23

Nalmefene is __ acting and usually administered ___

Answer 23

Long

IV