opioids

Question 1

opioids have more affinity for what isomer?

Answer 1

L- isomer

Question 2

opioid receptors are primarily responsive to 3 endogenous ligands…

Answer 2

• endorphins
• dynorphins
• enkephalins

Question 3

opioids…(what form attached to receptor?)

Answer 3

ionized

Question 4

potency correlates with…

Answer 4

receptor affinity

Question 5

opioid receptors primarily located on…

Answer 5

• the peripheral ends of primary sensory (sensory afferent dorsal) neurons
• substantia gelatinosa
• rexed lamina II and III

Question 6

opiod receptor activation… (1, 2)

Answer 6

1. decreases neurotransmission

2. inhibits the release of excitatory neurotransmitters (ACh, Dopa, NE, substance P)

Question 7

G-protein coupled receptors

Answer 7

• mu
• delta
• kappa

(decrease cAMP)

Question 8

epidural space (between ligamentum flavum and dura) contains…

Answer 8

• fat, veins, spinal nerve roots

- 20ml

Question 9

SA space (spinal space) contains…

Answer 9

• spinal cords, CSF, spinal nerve roots

- >1ml will increase ICP

Question 10

cephalad spread depends on…

Answer 10

lipid solubility

Question 11

classic 4 opioid SE

Answer 11

• pruritis
• urinary retention
• ventilatory depression
• sedation

Question 12

Morphine and N2O

Answer 12

CV depression

Question 13

miosis d/t

Answer 13

excitatory response to opioids in the ANS component of the Edinger-Westphal (CN III) nucleus

Question 14

treatment of biliary spasm d/t opioids

Answer 14

• glucagon 1-2mg
• naloxone 0.01mg
• nitroglycerine 25mcg

Question 15

CTZ (NV)

Answer 15

• area post rems

- floor 4th ventricle