Opioids

Question 1

Which parts of the brain are most involved in presence of acute pain?

Answer 1

Anterior cingulate, Insula, Basal Ganglia, Thalamu

Question 2

Whicih part of the brain plays a role in the anticipation and perception of pain?

Answer 2

brainstem

Question 3

Which are of the brain increases in activation with chronic pain?

Answer 3

Prefrontal Cortex

Question 4

How does the sensation of pain travel?

Answer 4

Nociceptors -> action potential -> dorsal horns in spine ->spinothalamic tract-> thalamus and higher centers of brain

Question 5

What are hte 2 types of pain?

Answer 5

Acute pain

Chronic Pain

Question 6

How do opioids work?

Answer 6

Bind to opioid receptors

Question 7

What are the receptor types for opioid receptors?

Answer 7

Delta (d1,d2): OP1
Kappa : OP2
Mu :OP3
Nociceptin: OP4

Question 8

How do opioids relieve pain?

Answer 8

Induce analgesia by reducing the amount of inflammation -> reduce elaboration of pain -> reduce sensation of pain

Question 9

How do opiods reduce pain transmission at the presynaptic level?

Answer 9

Activate presynaptic opioid receptors -> dec cAMP -> dec Ca2+ influx-> inhibit release of excitatory NT

Question 10

How do opioids reduce pain transmission at the postsynpatic level?

Answer 10

Binding -> hyperpolarizaiton of membrane ->dec chance of action potential

Question 11

What are the CNS effects of opioids

Answer 11

Euphoria
SEdation
Cough Suppression
Miosis
Temperature Changes: via k receptor
REspiratory Depression: MOST IMPORTANT

Question 12

What are the strong opioids?

Answer 12

Morphine
Methadone
Meperidine

Question 13

What are hte moderately strong opioids?

Answer 13

Codeine

Oxycodone

Question 14

What are the antagonists to opioids

Answer 14

Naloxone

Question 15

What is the prototypical opioid?

Answer 15

Morphine

Question 16

What are the side effects of morphine?

Answer 16

Constipation, Addiction, Tolerance,

Question 17

What is Meperidine used for?

Answer 17

Analgesic to relieve moderate/severe pain
Biliary Spasm
Renal Colic

Question 18

What are the side effects to Meperidine?

Answer 18

Serotonin Syndrome
Seizure
Dysphoria
Tremor

*Cannot be countered with NAloxone

Question 19

What is hydrocodone?

Answer 19

Opioid similar ot morphine that targets mu and delta receptors

Moderately strong

Question 20

What is hydrocodone used for?

Answer 20

Treat moderate to severe pain

Anti-tussive: suppress coughing

Question 21

What are the side effects of hydrocodone?

Answer 21

GI problems, anxiety, miosis, REspiratory problems

Question 22

What are the toxicities of hydrocodone?

Answer 22

LOC, Muscular seizure, sleeping problems

Question 23

What is the mechanism for euphoria?

Answer 23

Morphine binds mu receptor -> inhibit GABA secretion -> no GABA inhibition -> large release of dopamine -> euphoria due to inhibition of inhibitor of dopamine

Question 24

What is codeine

Answer 24

Moderately strong opioid used for mild/moderate pain as well as cough, diarrhea, IBS, narcolepsy

Question 25

What are the side effects of codeine?

Answer 25

Euphoria, itching, urinary retention, depression, constipation

Question 26

What is pentazocine

Answer 26

Agonist/Antagonist analgesic for mild/moderae pain, especially dental extraction

Question 27

What are hte side effects of pentazocine?

Answer 27

WEak antagonization of analgesic effects of morphine/meperidine Hallucinations

Question 28

What is naloxone

Answer 28

opiate antagonist that is used to prevent/reverse effects of opioids, especiialy respiratory depression, sedation, and hypotension

Question 29

How does naloxone affect a normal person?

Answer 29

No effect

Question 30

What are hte signs of opioid overdose?

Answer 30

Blue lips, unresponsive to pain stimuli

Question 31

What happens in opioid overdose?

Answer 31

BP drops due to increased blood vessel size Lungs suppresssed and slows down Stomach has decreased GI activity SExual organs messed up

Question 32

What is methadone?

Answer 32

Strong opioid analgesic | Agonist of mu and delta receptors and glutamate and Ach receptors

Question 33

What is methadone used for?

Answer 33

Treatment of opiate drug dependence as it binds to receptors and prevents binding of other opioids -> decrease desire for further opioid intake -> decreases craving but may be dependent on methadone