Opioid Analgesics

Question 0

How do opiates and opioids differ?

Answer 0

And opiate is derived from the poppy while an opioid is a general term that refers to things that bind opioid receptors

Question 1

Where is the periaqueductal gray?

Answer 1

The midbrain

Question 2

What is a Narcotic?

Answer 2

A legal term
Technically means sleep inducing
Opioids

Question 3

What is the primary receptor for analgesia?

Answer 3

Mu (u)

Question 4

What are some effects of Mu stimulation?

Answer 4

Analgesia
Respiratory depression
Constipation
Physical dependance

Question 5

What is the kappa receptor?

Answer 5

Another opioid receptor
Analgesia
Sedation
Constipation

Question 6

What receptor is responsible for modulating Mu activity?

Answer 6

Delta receptor

Question 7

What triggers Mu receptors?

Answer 7

Endorphins

Endomorphins

Question 8

What receptor do enkephalins trigger?

Answer 8

Delta receptors

Question 9

What do dynorphins trigger?

Answer 9

Kappa receptors

Question 10

What are opioid receptors coupled to?

Answer 10

G coupled receptors

Question 11

What are two important outcomes of opioid receptor activation?

Answer 11

Inhibited calcium channels

Increased K channels efflux

Question 12

What do opioids eventually do?

Answer 12

Inhibits presynaptic and post synaptic transmission

Question 13

What is inhibited by opioids in the presynaptic neuron?

Answer 13

Calcium channels thereby blocking release of glutamate and substance p

Question 14

What other pain meds act at calcium channels?

Answer 14

Gabapentin - blocks calcium channels

Question 15

How do opioids inhibit the postsynaptic neuron?

Answer 15

By increase K concentration causing hyperpolarization

Question 16

Where is the primary area for opioid action?

Answer 16

Spinal cord but also in the thalamus and periphery

Question 17

What is main area of inhibition by opioids in the descending pathway?

Answer 17

The interneuron

Question 18

What does opioid receptor activation do to the interneuron in the descending pathway?

Answer 18

Opioid activation blocks release of GABA

Indirect activation of the descending pathway

Question 19

What does GABA do?

Answer 19

Inhibits the descending pathway

Question 20

What are some examples of opioid receptor agonists?

Answer 20

Morphine (Mu and Kappa)
Methadone
Oxycodone
Heroin

Question 21

What are some opioid receptor antagonists by competition?

Answer 21

Naloxone

Naltrexone

Question 22

What are some examples of opioid r partial agonist?

Answer 22

Codeine

By Mu

Question 23

What does Pentazocine do?

Answer 23

Agonist at kappa

Antagonist at Mu

Question 24

What does Buprenophine do?

Answer 24

Partial Mu agonist and antagonist of the others | Often used with naloxone

Question 25

What is the bad part of oral opioids?

Answer 25

First pass metabolism

Question 26

What is a common buccal drug?

Answer 26

Fentanyl lollipop

Question 27

What oral opioid is not affect much by first pass metabolism?

Answer 27

Methadone

Question 28

What is most lipid soluble opioid?

Answer 28

Heroin

Question 29

What area is associated with opioid euphoria?

Answer 29

Cortex

Question 30

What area of the brain is associated with opioid respiratory depression, nusea, and bad thermoregulation?

Answer 30

The medulla

Question 31

What do opioids affect when they give bradycardia and increased GI tone?

Answer 31

The vagus nerve

Question 32

What does Imodium do?

Answer 32

Does not cross the BBB so it just relieves diarrhea

Question 33

What are some side effects of opioids?

Answer 33

``` Prolongs labor Constipation Bronchial constriction Histamine release Difficult urinating ```

Question 34

What can be used for opioid overdose?

Answer 34

Naloxone Short duration Can relapse Injection to avoid first pass

Question 35

What is used for opioid addiction?

Answer 35

Naltrexone Also alcohol addiction

Question 36

Why can't you give a patient more opioids when there is a tolerance?

Answer 36

Risk of respiratory depression

Question 37

What is a treatment for addiction?

Answer 37

Methadone | Buprenophine + naloxone = suboxone

Question 38

Is withdrawal life threatening?

Answer 38

No