opioids

Question 1

Mnemonic Monkeys Play Tennis Make Beautiful Noises, Never Fear

Answer 1

Monkeys: morphineplay :pethidine Tennis :Tramadol.Make : MethadoneBeautiful: BueprinorphineNoises : NalaxonNever : Naltoxan Fear : Fentynl

Question 2

Mention weak opoid.

Answer 2

Propoxyphene

Question 3

parial agonist

Answer 3

Bupernorphine

Question 4

Actions of Morphine

Answer 4

Morphine mnemonic M: mu agonist Kappa + delta0: opiod agonistR: Reduce pain preceptionP: SedationH: Hind release of NT (substance p)I: inhibit Ascending pain pathwayN: numb pain sensationE: Enhance pain tolerance

Question 5

Morphine indication?

Answer 5

MORPHINE mnemonic M : moderate: Sever pain0: opiod analgesic for acute painR: Respiratory distress in pallitive caseP: post-operative pain mangement. H: Hospital, end of Life care I : ischemic chest pain (angina)E: Emergency pain control (burns, Traum)

Question 6

Morphine Adverse effects.

Answer 6

• Miosis no tolerance • Constipation can’t tolerated.Respiratory Depressionphysical dependanceHypo tensionItching -puritisNause and vomitingEuphoria and sedation

Question 7

Drug Treat Acute Morphine Toxicity

Answer 7

Naloxone

Question 8

Contra indications of Morphine.

Answer 8

M: Mythenia gravisO: Obstructive Sleep ApneaR: Respiratory depressionp: pregnancy (neonatorum asphyxia )H: Head injury ↑ ICPI: Intestinal obstructionN: Not in Liver, kidney diseasesE: Elder people (Hypothyrodism)

Question 9

indication of Pethidine (Mepridine)

Answer 9

• Acute moderat: sever painNot more than 48 hr2- Labour pain3- Colic pain.Safe in Labour (√ Asphyxia neonatorum) Less Constipation

Question 10

Advese effects of pethidine

Answer 10

↑ convlusions: Toxic norpethidin XX > 48 hr.Serotonergic effect (1 Seretonin) Don’t use with MAOI

Question 11

Two drugsNot used with MAOI(seretonin)Both decrease constipation, Respiratory distress , dependance!

Answer 11

Play Tennis- Pethidine ( seretongic effect)-Tramadol Seretonin syndrom.

Question 12

uses of Tramado L

Answer 12

1- chronic moderate pain2- Neuropathic pain.

Question 13

which drug antagonise Tramadol.

Answer 13

partially by Naloxone

Question 14

Methadone indications.

Answer 14

1- opoid addicts (Replace) Less withdrawal symptoms oral-active, Long acting → Less Craving sensation علاج الدمنین .2- Chronic pain severe

Question 15

why Methadone Cause Arrythmia?

Answer 15

↑ QT intervalMITime From Ventricular contraction to Relaxation

Question 16

Buprenorphine (partial agonist) indication?

Answer 16

1- Methadon replacement بديل في علاج المدمنينD.t Sublingal long activing less Craving and sedation2- Severe pain.

Question 17

Respiratory distress and Buprenorphine

Answer 17

Doesn’t increase with Increasing The dose (ceiling)But if it happened, can’t reserved (High affinity to receptors)

Question 18

indications of Naloxone

Answer 18

1- Acute opiod Toxicity short acting-repeated”2- Asphyxia neonatorum3- Antagonise Tramadol.4- Antagonize Respiratory depression of Morphine

Question 19

indications of Naltrexone.

Answer 19

1-opiod abuse (after Full detoxification by Plethidine or Burponorphine2- Alcohol abusemaintenance Euphoria block & craving in alcholol addictics

Question 20

indications of Fentanyl.

Answer 20

1- Anesthesia2- pre anethestic medication3- Conscious Sedation + Midazolam-4-Neuro lept analgesia + Droperidol5-Neuroleptane thesia O2+N20

Question 21

drugs used in Conscious Sedatation

Answer 21

1- Fentany L2- Midazolam

Question 22

drugs used in Neurolept analgesia

Answer 22

1- Fentanyl2- Droperidol

Question 23

drugs used in Neurolept anethesia

Answer 23

Fentanyl + N2O + CO2