Neuropharm of Opiates

Question 1

___ is a fast acting opiate antagonist which can be used to treat overdose. It is active __ only

Answer 1

Naloxone; parenterally (IV)

Question 2

The kappa receptor subtype binds the endogenous ligand ____

Answer 2

dynorphin

Question 3

Both ___ (A-fiber) and ____ (C-fiber) pain are alleviated by opioids

Answer 3

somatic; visceral

Question 4

Opioid pain is still ___ but the patients don’t ___

Answer 4

felt; care

Question 5

__ ___ a CNS effect, is the cause of death in opioid overdose

Answer 5

respiratory depression

Question 6

Some opioid users feel ___, a negative CNS side effect

Answer 6

dysphoria

Question 7

Another CNS effect is ___-____, or cough suppresent

Answer 7

anti-tussive

Question 8

Two obvious CNS effects are ____ (pain) and ____ for sleep

Answer 8

analgesia; sedation

Question 9

A positive CV side effect of opioids is ______, which is important for CHF. A negative CV side effect is _____

Answer 9

vasodilation; bradycardia

Question 10

The eye effect of opioids is pupillary _____

Answer 10

constriction

Question 11

Two skin effects are ____ (sweating) and ____ (itching)

Answer 11

anhydrosis; pruritus

Question 12

The GI symptom of opioids is __

Answer 12

constipation

Question 13

Morphine onset is ____ and it lasts ___ hours

Answer 13

rapid; 3-4

Question 14

Oral doses of morphine are much ___ due to the first pass effect

Answer 14

higher

Question 15

Delta receptors modulate pain in the ___ ___, specifically the __ ___ __

Answer 15

spinal cord; dorsal root ganglion

Question 16

Mu receptors modulate pain in both the ___ ___ and the ___ ___ area (thalamus, PAG, sensory cortex)

Answer 16

spinal cord; supra-spinal area

Question 17

Mu receptors do the ___ (amount) of the pain relief in the ___ structures

Answer 17

majority; cortical

Question 18

Euphoria by opioids is produced in the ___

Answer 18

VTA

Question 19

__ is produced in the chemoreceptor trigger zone in the medulla

Answer 19

Nausea

Question 20

____ depression is produced in the ___ __

Answer 20

respiratory; brainstem

Question 21

High levels of PCO2 due to opioids can lead to increased ____, so use with caution during a head injury

Answer 21

ICP

Question 22

Antitussive action is done in the ___

Answer 22

medulla

Question 23

Mu opioid receptors sit on ____ interneurons and stop them from inhibiting ____ neurons, and they also ___ the signal in the NA and the PFC

Answer 23

GABA; dopaminergic; amplify

Question 24

Patients with ___ ___ should be given opioids with caution because opioids can cause the loss of ____ of the biliary tract

Answer 24

gallstones; contraction

Question 25

Opioids decrease action of the ___ protein and ultimately decrease ___ ____

Answer 25

CREB; gene transcription

Question 26

Pharmacodynamic tolerance is less/more relevant in opioid addiction than pharmacokinetic tolerance

Answer 26

more

Question 27

The phosphorylation of opioid receptors causes a switch in chronic opioid users from G_ to G_

Answer 27

Gi to Gs

Question 28

___ (process) of the Mu receptor causes it to be internalized and may be responsible for tolerance

Answer 28

phosphorylation

Question 29

Chronic morphine use causes loss of ____ ____ on neurons

Answer 29

dendritic spines

Question 30

___ neurogenesis is also caused by chronic morphine use

Answer 30

hippocampal

Question 31

Although withdrawal symptoms are mild for opioids, ___ are what cause people to relapse and ____ can trigger them

Answer 31

cravings; cues

Question 32

Suboxone is naloxone plus ____ which is a partial agonist so addicts can’t abuse this drug

Answer 32

buprenorphine

Question 33

The _ allele SNP has lower levels of the __ receptor; they have a ___ response to an agonist and a __ response to an antagonist. They have a strong positive response to ____

Answer 33

G; mu; hypo; hyper; alcohol