Opioid Agonists and Antagonists (M3)

Question 1

What are all compounds that work at opiod receptors (agonists, partial agonists, and antagonists) called?

Answer 1

opioid

Question 2

What are naturally occurring alkaloids (morphine, codeine, thebaine, papaverine) called?

Answer 2

opiates

Question 3

What are sleep-inducing medications called?

Answer 3

narcotics

Question 4

What are the three opioid receptor types?

Answer 4

1. mu
2. delta
3. kappa

Question 5

What are the three families of endogenous opioid peptides?

Answer 5

1. endorphins
2. enkephalins
3. dynorphins

Question 6

Where can opioids accumulate?

Answer 6

muscle and fat

Question 7

Where is heroin metabolized?

Answer 7

plasma

Question 8

What is the mechanism of opioids?

Answer 8

bind G-protein-coupled receptors in brain and spinal cord involved in transmission and modulation of pain

Question 9

What is the cellular mechanism of opioids?

Answer 9

1. close voltage gated Ca2+ channels on presynaptic nerve terminal, reducing NT release
2. open K+ channels and hyperpolarize, inhibiting postynaptically

Question 10

What are the unique functions of mu receptors? 1. What is the relative affinity for the peptides? 2

Answer 10

1. sedation, inhibition of resp, slow GI transit, modulate hormone and NT release
2. endorphins > enkephalins > dynorphins

Question 11

What are the unique functions of delta receptors? 1. What is the relative affinity for the peptides? 2

Answer 11

1. modulation of hormone ant NT release

2. enkephalins > endorphins > dynorphins

Question 12

What are the unique functions of kappa receptors? 1. What is the relative affinity for the peptides? 2

Answer 12

1. psychotomimetic effects, slowed GI transit

2. dynorphins&raquo_space; endorphins and enkephalins

Question 13

What peptide do most opioid analgesics act on?

Answer 13

mu receptor

Question 14

What peptide do most endogenous opioids act on?

Answer 14

delta and kappa

Question 15

What pathways do opioids act on?

Answer 15

1. ascending pain pathways

2. descending (modulatory) pathways

Question 16

What is it called when with long-term administrtion, opioid analgesics increase the sensation of pain?

Answer 16

hyperalgesia

Question 17

What is the CNS effect of opioids that relieves sensory pain?

Answer 17

analgesic

Question 18

What is the CNS effect of opioids that provide a pleasant floating snesation, lessened anxiety and distress, and possible dysphoria?

Answer 18

euphoria

Question 19

What are the CNS effects of opioids?

Answer 19

1. analgesia
2. euphoria
3. sedation
4. respiratory depression
5. cough suppression
6. miosis
7. truncal rigidity
8. nausea and vomiting
9. varying body temp

Question 20

What do opioids do to the liver?

Answer 20

decrease renal plasma flow

Question 21

What do opioids do to the uterus?

Answer 21

prolong labor

Question 22

What do opioids do to the endocrine systems?

Answer 22

1. stimulate ADH, prolactin and somatotropin release
2. effects of hypothalamus
3. low testosterone
4. amenorrhea

Question 23

What are the associated numbers for the Numeric Rating Scale (NRS)?

Answer 23

1. mild: 1-3
2. moderate: 4-6
3. severe: 7-10

Question 24

What is the scale for pain that uses the facial expressions of the patient?

Answer 24

Wong-Baker scale

Question 25

Which opioid analgesics can be given by rectal suppositories?

Answer 25

1. morphine | 2. hydromophone

Question 26

Which opioid analgesics can be given by transdermal patch?

Answer 26

1. fentanyl | 2. buprenorphine

Question 27

Which opioid can there be tolerance within hours of taking it?

Answer 27

remifentanil

Question 28

Which actions of opioids is there no tolerance for?

Answer 28

1. miotic 2. convulsant 3. constipating

Question 29

When are the peak effects of morphine dependence displayed? 1. meperidine effects? 2. Methadone effects? 3

Answer 29

1. 36-48 hours 2. 24 hours 3. 2 weeks

Question 30

What is it called when opioid antagonist is given to determine withdrawal signs and symptoms?

Answer 30

Antagonist-precipitated withdrawal

Question 31

What is marked by the inability to abstain from use, impairment of behavioral control, and diminished recognition of problems in behavior and relationships?

Answer 31

addiction

Question 32

What is the community-based overdose education and naloxone distribution program?

Answer 32

Project DAWN

Question 33

What are the drug types that cannot be taken with opioids?

Answer 33

1. sedative-hypnotics 2. antipsychotic agents 3. monoamine oxidase inhibitors