Opioid Analgesics and Drug Abuse

Question 1

I-STOP/PMP

Answer 1

Internet System for Tracking Over-Prescribing/Prescription Monitoring Program

Question 2

T/F: Ibuprofen-APAP (which are NSAIDs) combined may be more effective analgesic than many currently available opioid-containing formulations.

Answer 2

True

Question 3

Ibuprofen-APAP combined provided greater pain relief than did Ibuprofen or APAP alone after third molar extractions.

Answer 3

True

Question 4

The third most commonly prescribed drug in 2015.

Answer 4

Hydrocodone/APAP (97m)

Question 5

What is a schedule II drug?

Answer 5

One that may lead to abuse and dependence.

Question 6

Any drug containing Hydrocodone is what schedule?

Answer 6

II

Question 7

Prescriptions for which Schedule drugs CANNOT be refilled?

Answer 7

II

Question 8

An addictive narcotic drug consisting of the dried juice of the opium poppy.

Answer 8

Opium

Question 9

Any natural preparation or derivative of opium

Answer 9

Opiate

Question 10

Opioid

Answer 10

Any narcotic analgesic

Question 11

Raw dried opium contains _____% morphine and ___% codeine.

Answer 11

12 ; 1

Question 12

The poppy seed has _________ and _________.

Answer 12

Morphine; Codeine

Question 13

This opioid receptor is the principal mediator of opioid-induced:

Analgesia
Resp depression
Miosis
Reduced GI motility
Physical dependence

Answer 13

Mu Receptor

Question 14

This substance is released as part of the pleasure center or the reward process.

Answer 14

Dopamine

Question 15

This NT is inhibited when opioids bind to the mu receptor.

Answer 15

GABA

Question 16

What happens when opioids binding to the mu receptor inhibit GABA?

Answer 16

More Dopamine is released.

Question 17

Tendency of the body to adapt to the presence of opioids, making it necessary to use ever-increasing doses to achieve the same effects.

Answer 17

Tolerance

Question 18

Tolerance develops to these things, but not to these things.

Answer 18

Analgesia, euphoria, respiratory depression;

Constipation and miosis

Question 19

The psychological attachment to the euphoric effects of opioids.

Answer 19

Addiction

Question 20

The body has an unpleasant withdrawal syndrome if opioids are abruptly discontinued.

Answer 20

Dependence

Question 21

2-4h: sense of intense fear
8-16h: Increased SNS activity: nervousness, sweating, increased anxiety and fear, mydriasis
36h: skeletal muscle fasciculation, cramps, gooseflesh, increased respiration, blood sugar, metabolic rate.
48-72h: peaks and subsides over 10 days.

Answer 21

Opioid Withdrawal Syndrome

Question 22

The inability to feel pain.

Caused by activation of mu receptors.

Answer 22

Analgesia

Question 23

What are the respiratory depressant effects of opioids?

Answer 23

Carbon dioxide retention and secondary elevation of cerebrospinal fluid pressure.

Question 24

The most dangerous side effect of opioids.

Answer 24

Respiratory depression.

Question 25

Characteristic sign of morphine use as well as other opioid drugs: heroin, methadone, and fentanyl (but not meperidine/Demerol).

Answer 25

Miosis - pinpoint pupils

Question 26

Miosis

Answer 26

pinpoint pupils

Question 27

A narcotic analgesic agonist of opiate receptors that causes the following: - Inhibits ascending pain pathways - Alters brain response to pain, producing analgesia. - Products sedation and respiratory depression.

Answer 27

Morphine

Question 28

Adverse effects of Morphine.

Answer 28

Respiratory depression, hypotension, sedation, temperature decrease, constipation, strong potential for addiction.

Question 29

Advantages of IV administration of Morphine.

Answer 29

- Effect is more immediate. | - Analgesia can be titrated to the pain.

Question 30

This opioid is broken down to morphine and is less potent than morphine.

Answer 30

Codeine

Question 31

Tylenol #3 contains:

Answer 31

30 mg Codeine | 300 mg Acetaminophen

Question 32

Used for oral conscious sedation in pediatric dentistry.

Answer 32

Meperidine

Question 33

Tramadol MOA

Answer 33

1) Centrally acting weak opioid mu agonist | 2) Weakly inhibits the reuptake of Serotonin and NE.

Question 34

This drug is used as an alternative when NSAIDs and codeine-acetaminophen combos are contraindicated.

Answer 34

Tramadol

Question 35

This opioid is a Schedule 4 controlled substance.

Answer 35

Tramadol

Question 36

Combo of Hydrocodone and Acetaminophen

Answer 36

Lortab | Vicodin

Question 37

Hydrocodone + Ibuprofen

Answer 37

Vicoprofen

Question 38

How many hydrocodone-only products are FDA-approved?

Answer 38

Two: Zohydro and Hysingla

Question 39

Oxycontin

Answer 39

Oxycodone alone

Question 40

Percodan

Answer 40

Oxycodone + Aspirin

Question 41

Percocet

Answer 41

Oxycodone + Acetaminophen

Question 42

Used for serious pain caused by surgery, broken bones, or cancer.

Answer 42

Hydromorphone

Question 43

This drug is highly lipid soluble, allowing for significant penetration into the brain, creating a more exaggerated euphoria.

Answer 43

Heroin

Question 44

Why is Heroin a schedule I drug?

Answer 44

BC it has no medical use.

Question 45

What is heroin a form of?

Answer 45

Morphine

Question 46

Used in the controlled withdrawal of dependent abusers from heroin and morphine.

Answer 46

Methadone

Question 47

Orally-active liquid concentrate whose elimination half-life is 24 hours.

Answer 47

Methadone

Question 48

T/F: Methadone and other opioids suppress salivary secretion through disordered peripheral signaling at parasympathetic muscarinic receptors and centrally at primary salivary centers.

Answer 48

True

Question 49

Has 80 to 100-fold the analgesic potency of morphine.

Answer 49

Fentanyl

Question 50

Suppresses withdrawal symptoms and cravings for opioids, does not cause euphoria in the opioid-dependent patient, and blocks the effects of other opioids for 24 hrs.

Answer 50

Buprenorphine

Question 51

Buprenorphine + Naloxone

Answer 51

Suboxone

Question 52

A competitive antagonist at opioid receptors and reverses the depressive actions, including the respiratory depression and hypotension of opioid overdose.

Answer 52

Naloxone

Question 53

Tmax of Naloxone

Answer 53

20-30 mins

Question 54

Half-life of Naloxone

Answer 54

60-90 mins