Opioid 1 and 2

Question 1

what are the two components of pain?

Answer 1

1. specific sensation (physical)
2. reaction to the sensation (psych)

Question 2

what are the two types of analgesics?

Answer 2

narcotic and non-narcotic

Question 3

opioid analgesics ____ the threshold for pain perception and alter the affective response.

Answer 3

raise

Question 4

name the 4 sites of opioid actions

Answer 4

thalamus, limbic system, brain stem, spinal cord

Question 5

_____ or _____ opioids produce analgesia.

Answer 5

intrathecal (CSF) or epidural

Question 6

what does analgesia mean?

Answer 6

inability to feel pain

Question 6

endogenous opioids have the same properties as _____ opioids

Answer 6

exogenous

Question 7

what is blocked by naloxone?

Answer 7

endogenous opioids, acting on the receptor

Question 8

opioids are synthesized from 3 precursors

Answer 8

enkephalins, endorphins, dynorphins

Question 9

mu, kappa, and delta are examples of what?

Answer 9

opioid receptors

Question 10

general principles of opioids such as morphine are

Answer 10

1. tolerance and cross tolerance
2. physical dependence
3. withdrawal or abstinence syndrome
4. specific antagonists are available such as naloxone

Question 11

what are the pharmacological effects of morphine on body systems?

Answer 11

1. mood changes leading to euphoria and mental clouding
2. nausea and vomiting (stimulates the CTZ)
3. respiratory depression
4. antitussive (cough reflex)
5. miosis (pinpoint pupil)
6. urinary retention
7. inhibits gonadotropin release
8. cardiovascular disease
9. constipative and antidiarrheal

Question 12

morphine ____ the response of brains the respiratory neurons to CO2

Answer 12

decreases

Question 13

morphine causes the release of ____ causing bronchoconstriction

Answer 13

histamine

Question 14

opioids decrease ____ and ____ release (sex hormones)

Answer 14

LH and FSH

Question 15

what are cardiovascular effects of morphine?

Answer 15

Dilation may produce HYPOtension as a result of histamine release and depressed vasomotor and adrenergic tones

Question 16

pharmokinetics of morphine

Answer 16

1. orally and parenterally
2. low lipid solubility (little enters brain)

Question 17

what are examples of lipid soluble opioids that cross BBB faster?

Answer 17

heroin, fentanyl, codeine

Question 18

what is the major metabolism pathway for morphine? morphine is also excrete in urine this way

Answer 18

glucuronide conjuction

Question 19

true/false: all tolerance to opioids is pharmacodynamic; there is NO metabolic tolerance

Answer 19

true

Question 20

is opioid withdrawal life threatening?

Answer 20

no

Question 21

onset of syndrome for morphine

Answer 21

first symptoms in 8-12 hours after last dose and will peak at 36-72 hours

• some are long lasting and will come later with less severe effects*

Question 22

what are some withdrawal symptoms of morphine?

Answer 22

diarrhea, vomiting, chills, lacrimation, tremors, kicking of legs

Question 23

what drug is used to decrease opioid withdrawal symptoms?

Answer 23

clonidine

Question 24

example of naturally occurring opioids

Answer 24

morphine and codeine

Question 25

examples of partially synthetic opioids

Answer 25

heroin, naloxone

Question 26

codeine is a ____

Answer 26

agonist

Question 26

examples of synthetic opioids

Answer 26

levorphanol, methadone, meperidine

Question 26

shorter duration of action than morphine and is used for shorter analgesia

Answer 26

merperidine

Question 26

codeine is used as an antitussant, analgesic, and has a ______ potency of morphine

Answer 26

1/10th (lower)

Question 27

meperidine is a _____ opioid and a common name is ____

Answer 27

synthetic, demerol

Question 27

what is the half life for fentanyl?

Answer 27

20 minutes

Question 27

what has a higher oral activity than morphine but has the same effects and potency?

Answer 27

oxycodone

Question 28

what is orally active but used for IV anesthesia and is 80x more potent than morphine?

Answer 28

fentanyl

Question 29

what is the major termination of action for fentanyl?

Answer 29

redistribution (very lipid soluble)

Question 30

what is fentanyl used for?

Answer 30

anesthetic induction, cardiac surgeries, neuroleptic state

Question 31

what drug has a half life of 15 hours, orally active, and has same potency as morphine?

Answer 31

methadone

Question 32

how long is the duration of action for naloxone

Answer 32

1-4 hours

Question 33

naloxone is a _____ ____ antagonist at all opioid receptors with no opioid agonist activity

Answer 33

pure competitive

Question 34

what drug is a pure competitive opioid antagonist with a 24 hour duration of action

Answer 34

naltrexone

Question 35

what drug is only available in oral form

Answer 35

naltrexone

Question 36

what are the uses of pure antagonists?

Answer 36

1. treatment of opioid overdose 2. diagnose addiction 3. treatment of compulsive use

Question 37

naltrexone and naloxone are

Answer 37

antagonists

Question 38

what is used as an analgesic for mild to moderate pain?

Answer 38

pentazocine (talwin)

Question 39

what is a weak Mu antagonist?

Answer 39

pentazocine- induces opioid withdrawal and does not block respiratory depression

Question 40

what is an agonist at kappa and sigma receptors?

Answer 40

pentazocine

Question 41

what drug can you experience dysphoria and hallucinations esp with repeated high doses?

Answer 41

pentazocine

Question 42

all the kappa agonist effects of pentazocine are blocked by

Answer 42

naloxone

Question 43

both ____ and ____ are 1. analgesic for moderate to severe pain 2. mu antagonists 3. kappa agonists 4. antagonized by naloxone

Answer 43

nalbuphine and butophanol

Question 44

what drug is an analgesic for moderate to severe pain, partial agonist at mu receptors, minor respiratory depression, euphoria, miosis, and mild morphine abstinence syndrome?

Answer 44

buprenorphine

Question 45

kappa antagonist, antagonized by naloxone, and a potential useful replacement for methadone

Answer 45

buprenorphine