Opioid Pharmacology

Question 1

mechanism of action of opioids presynaptically and postsynaptically

Answer 1

presynaptically they lower calcium influx. Postsynaptically they increase potassium transport into the cell.

Question 2

what does oxycodone break down into

Answer 2

oxymorphone and hydrocodone, and hydrocodone breaks down into dihydrocodeine and hydromorphone

Question 3

lipid solubility and onset

Answer 3

more lipid soluble = faster onset

Question 4

what are the 2 natural opioids

Answer 4

morphine and codeine

Question 5

mechanism of methadone

Answer 5

Opioid agonist, serotonin-norepinephrine reuptake inhibitor, NMDA antagonist

Question 6

what are the 3 endogenous opioids

Answer 6

enkephalin, endorphin, dynorphin

Question 7

relationship between pka and onset

Answer 7

the lower the pka, the faster the onset

Question 8

what are the 4 fully synthetic opioids

Answer 8

fentanyl, methadone, tramadol, dextropropoxyphene

Question 9

which opioid receptors cause physical dependence

Answer 9

mu2

Question 10

what does hydrocodone break down into

Answer 10

dihydrocodeine and hydromorphone

Question 11

Suboxone =

Answer 11

buprenorphine + naloxone

Question 12

what 2 drugs break down into hydrocodone

Answer 12

codeine and oxycodone

Question 13

which opioid receptors result in analgeis

Answer 13

mu1, delta, kappa

Question 14

which endogenous opioid has the highest affinity for opioid receptors

Answer 14

endorphin

Question 15

what are the 2 main opioid antagonists

Answer 15

naloxone and naltrexone

Question 16

what does morphine break down into

Answer 16

hydromorphone

Question 17

what do opioids activate that results in nausea and vomiting

Answer 17

the chemoreceptor trigger zone

Question 18

what opioid receptors cause psychomimetic effects

Answer 18

kappa

Question 19

what are the 4 mixed opioid agonist-antagonists

Answer 19

buprenorphine, pentazocine, butorphanol, nalbuphine

Question 20

What condition is morphine contraindicated with

Answer 20

renal failure

Question 21

mechanism of pentazocine, butorphanol, nalbuphine

Answer 21

Opioid agonist-antagonist

Question 22

most and least lipid soluble opioids

Answer 22

most = fentanyl
least = oxycodone

Question 23

cautionary note of methadone

Answer 23

may cause QT prolongation

Question 24

what are the 2 opioid contraindicated with MAOIs

Answer 24

tramadol and meperidine

Question 25

what is tramadol contraindicated with

Answer 25

MAOIs or SSRIs

Question 26

what does codeine break down into

Answer 26

hydrocodone and morphine, which break up into hydromorphone and dihydrocodeine

Question 27

which opioid receptors cause respiratory depression

Answer 27

mu2 and kappa

Question 28

which opioid medication is the only one that has high affinity for delta receptors

Answer 28

methadone

Question 29

Heroin is aka

Answer 29

diamorphine

Question 30

mechanism of buprenorphine

Answer 30

Opioid antagonist and partial opioid agonist

Question 31

mechanism of tramadol

Answer 31

weak mu agonist and weak serotonin-norepinephrine reuptake inhibitor

Question 32

what does heroin break down into

Answer 32

6-monoacetyl morphine, which breaks down into morphine, which breaks down into hydromorphone

Question 33

mechanism of codeine

Answer 33

weak opioid agonist

Question 34

what is the parent drugs of hydromorphone

Answer 34

hydrocodone and morphine