Opiate Analgesic Drugs

Question 1

Strong Opiate Agonists

Answer 1

Morphine
Fentanyl
Methadone
Meperidine
Oxycodone
Sufentanil
Heroin-Purdrug

Question 2

Moderate Opiate Agnoists

Answer 2

Codeine
Hydrocodone
Propoxyphene

Question 3

Opioid Antagonists

Answer 3

Naloxone
Naltrexone

Question 4

Prototype U agnoist

Answer 4

Morphine

Question 5

Strong lipophilic u agnoists

Answer 5

Fentanyl

Question 6

Long duration, also used for opiate addiction

Answer 6

Methadone

Question 7

Active metabolite can be toxic

Answer 7

Meperidine

Question 8

Used for breakthrough pain (postsurgical pain)

Answer 8

Oxycodone

Question 9

Strong lipophilic u agnoist

Answer 9

Sufentanil

Question 10

(Diacetylmorphine; not approved for medical use in the US)
P-450 inhibitors can induce withdrawal in opiate addicts

Answer 10

Heroin-Prodrug

Question 11

(Prodrug methylmorphine)
USed to treat mild-moderate pain

Answer 11

Codeine

Question 12

Combined with acetaminophen or NSAIDs

Answer 12

Hydrocodone

Question 13

Deadly if mixed with ETOH

Answer 13

Propoxyphene

Question 14

Parenternal

Answer 14

Naloxone

Question 15

Oral

Answer 15

Naltrexone

Question 16

Opioid analgesics are used how?

Answer 16

Relieve moderate to severe pain

Question 17

What happens when endogenous opioid peptides are released from nerve endings?

Answer 17

They interact with opioid receptors in the CNS, and the primary afferent neurons to modulate pain transmission

Question 18

Major opioid receptor subtypes?

Answer 18

Mu
Delta
Kappa

Question 19

All three receptors are couple to what?

Answer 19

G proteins (GPCR)

Question 20

When opioid receptor subtypes are coupled with G proteins what happens?

Answer 20

Activates phospholipase C (PLC) or inhibits adenylyl cyclase (AC)

Question 21

Medical term for ‘pain’

Answer 21

Nociception

Question 22

Pain can be defined as..

Answer 22

Physical suffering caused by illness or injury
It can impact QOL and the ability to carry out daily tasks

Question 23

Why is management of pain a challenege?

Answer 23

Pain is subjective

Question 24

Clinicians rely on what?

Answer 24

Patients perception and description of pain

Question 25

Acute pain

Answer 25

Temporarily in nature Usually goes away when the cause of pain has been removed

Question 26

Chronic pain

Answer 26

As neuropathic pain resulting from nerve damage lasts for months

Question 27

Parimily produce pain relief

Answer 27

Opiates which are mu recepros agaonists in the CNS

Question 28

What are opiates that are mu receptors agonists primarily used for?

Answer 28

Treat moderate to severe acute and chronic pain

Question 29

Pain stimuli are carried to the CNS

Answer 29

Nociceptive fibers

Question 30

Once the nociceptive impulse arrives in the dorsal horn of the SC, what occurs?

Answer 30

Secondary afferent neuron carries the information across the ventral white commissure to the contralateral side where the axon ascends to the brain, resulting in the feeling of pain

Question 31

Opioids exert what effect?

Answer 31

Analgesic

Question 32

Once opioids exert analgesic effects...

Answer 32

Decreasing the ascending (afferent) pain transmission and activating the descending (efferent) pathways that reduce pain.

Question 33

Descending Pain-Inhibitory System

Answer 33

Comprised of descending serotonergic and noradrenergic nerve fibers that synapse upon and inhibit nociceptive input to the SC

Question 34

The analgesic efficacy of opiates can be facilitated by the simultaneous use of _________ to enhance the synaptic activity of 5-HT and/or NE in the dorsal horn of the SC

Answer 34

adjunctive analgesics (ex: tricyclic antidepressants

Question 35

How do antidepressants such as amitriptyline produce analgesics (for treating neuropathic pain)?

Answer 35

Inhibiting spinal NE and 5-HT uptake, these drugs enhance the action of the descending pain-inhibitory pathway By increasing NE and 5-HT in the spinal dorsal horn, these drugs decrease the release of nocicepetive neurotransmitters like substance P and glutamate