Opiates

Question 1

A class of naturally occurring, nitrogen-containing bases

-Ex: morphine, cocaine, caffeine, etc

Answer 1

Alkaloids

Question 2

A naturally occurring opium-derived alkaloid

-Ex: morphine or codeine

Answer 2

Opiate

Question 3

A more inclusive group, it refers to any natural, synthetic, or semi-synthetic compound with morphine like properties

Answer 3

Opioid

Question 4

Most opioid analgesics in the clinic are

Answer 4

Mu-selective agonists

Question 5

Located primarily in the brain where they function as neurotransmitters or neuromodulators

Answer 5

Endogenous Opioid peptides

Question 6

Inhibits adenylyl cyclase-catalyzed formation of cAMP

Answer 6

Opioids such as morphine

Question 7

Decreases the release of neurotransmitters that convey pain perception such as Ach, substance P, and glutamate

Answer 7

Morphine

Question 8

Is an exception to the typical mu-opioids because it produces mydriasis instead of miosis

Answer 8

Meperidine

Question 9

An analgesic used for acute pain from severe injuries, post-surgery, or bone/joint/muscle ailments

Answer 9

Morphine

Question 10

For pulmonary edema, acts as an anxiolytics and vasodilator

Answer 10

Morphine

Question 11

Oral analgesics for moderate, chronic pain

Answer 11

Oxycodone or hydrocodone

Question 12

Used for relief of opioid-induced constipation

Answer 12

Methylnaltrexone

Question 13

Hydrophilic drug, so CNS penetration and exit are slow. Slow onset and long duration

Answer 13

Morphine

Question 14

Morphine is contraindicated in

Answer 14

Head injuries

Question 15

We need to use caution with morphine use in patients with

Answer 15

Renal dysfunction

Question 16

A more lipophilic prodrug of morphine that exhibits faster CNS penetration

Answer 16

Heroin (diamorphine)

Question 17

Lipophilic drug, so very fast CNS penetration

-80-100 times more powerful than morphine

Answer 17

Fentanyl

Question 18

Increase pain tolerance and decrease perception and reaction to pain

Answer 18

Opioids

Question 19

Sometimes useful for pain caused by tissue/nerve inflammation (e.g. herpes zoster, shingles)

Answer 19

Opioids

Question 20

More effective for prolonged, dull pain than sharp pain

Answer 20

Opioids

Question 21

Opioids elicit euphoria by

Answer 21

Decreasing release of GABA and increasing release of dopamine

Question 22

Opioids are generally contraindicated in cases of

Answer 22

Head injury

Question 23

Tend to increase ICP and thus can exacerbate damage to the respiratory center in the brain

Answer 23

Opioids

Question 24

opioids cause a decreased response to CO2 in the

Answer 24

Brainstem respiratory center

Question 25

The resultant increase in arterial CO2 causes cerebral vasodilation and

Answer 25

Increased ICP

Question 26

To treat this increased CO2, we give

Answer 26

Naloxone, NOT O2

Question 27

Opioids also depress the cough centers in the

Answer 27

Medulla

Question 28

Cause miosis by stimulating the E-W nucleus of the occulomotor nerve

Answer 28

Opioids (except Meperidine)

Question 29

Opioid stimulation of the chemoreceptors trigger zone (CTZ) in the area postrema activates the

Answer 29

Vomiting center

Question 30

The emetic effects of opioids are caused by stimulation of the vestibular apparatus. Thus, patients who are most likely to vomit are

Answer 30

Ambulatory patients

Question 31

Large IV doses of fentanyl can cause

Answer 31

Muscle rigidity

Question 32

Full agonist opioids can cause non-immunologic release of

-Induces vasodilation and hypotension

Answer 32

Histamine

Question 33

Decreases peristalsis in the small and large bowels, which can lead to

Answer 33

Constipation or cramping

Question 34

Can induce spasmodic effects on smooth muscle along the biliary tree

-Results in Sphincter of Oddi Dysfunction (SOD)

Answer 34

Opioids

Question 35

Tolerance to analgesia, respiratory depression, and euphoria develops gradually over

Answer 35

2-3 weeks of daily dosing

Question 36

We can occasionally see seizures do to the CNS effects of metabolites of

Answer 36

Meperidine

Question 37

A major cause of hospital admissions for drug abuse

Answer 37

Methadone

Question 38

Agonist of all opioid receptors that is prescribed to patients AFTER opioid detoxification to prevent relapse

Answer 38

Naltrexone

Question 39

Pure competitive antagonist at all opioid receptors and is widely used for emergency opioid overdose/intoxication

Answer 39

Naloxone

Question 40

Provides immediate relief from acute respiratory depression, but can induce severe withdrawal symptoms

Answer 40

Naloxone

Question 41

Act as kappa agonists to produce analgesia and mu antagonists

Answer 41

Mixed agonist-antagonists