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Pharmacology > opioids > Flashcards

opioids Flashcards

1
Q

non-endogenous ligands

A
  • morphine
  • heroin
  • etorphine
  • ketocyclazosin
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2
Q

endogenous ligands

A
  • endorphins
  • enkaphalins
  • dynorphins
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3
Q

t/f: morphine, heroin, and endorphins bind to the M receptor

A

true

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4
Q

t/f: all opioid receptors are GiPCR and inhibitory

A

true

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5
Q

t/f: components of the sensory pathway include: spinothalamic tract and thalamus

A

true

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6
Q

t/f: thalamus is part of the modulatory pathway

A

false. the thalamus is part of the sensory pathway. the hypothalamus is part of the modulatory pathway

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7
Q

components of the modulatory pathway are

A
  • hypothalamus
  • midbrain
  • medulla
  • spinal cord
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8
Q

the synapses between the sensory and modulatory pathway are

A
  • midbrain
  • medulla
  • spinal cord
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9
Q

t/f: sensory pathway leads up to which parts of the brain

A
  • cortex
  • frontal
  • somatosensory cortex
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10
Q

opioids work on which pathway

A

modulatory

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11
Q

CNS effects of opioids include

A
  • cough suppression
  • miosis
  • endocrine effects
  • resp and cv depression
  • coma/death
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12
Q

t/f: dextromethorphan is an opioid used for cough suppression

A

true

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13
Q

t/f: dextromethorphan crosses BBB and leads to dependence

A

false. it does not cross BBB, no drug dependence

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14
Q

peripheral effects of opioids

A
  • decrease GI motility
  • constipation
  • urinary retention
  • CV (orthostatic hypotension, flushing, warm sensation)
  • dermatologic (sweating, itching)
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15
Q

t/f: analgesia has a high rate of tolerance

A

true

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16
Q

what effects of opioids have a high rate of tolerance (ie. need more for an effect)

A
  • analgesia
  • euphoria
  • sedation
  • COUGH suppression
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17
Q

t/f: using opioids for cough suppression can lead to a low rate of tolerance

A

false. leads to a HIGH rate of tolerance

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18
Q

t/f: using opioids for constipation has a high rate of tolerance

A

false. VERY LOW rate of tolerance

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19
Q

what effects of opioids have a low rate of tolerance

A
  • constipation
  • miosis
  • convulsions
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20
Q

t/f: opioids with a low rate of tolerance are dose dependent

A

false. they are not dose dependent

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21
Q

t/f: morphine has a low bioavailability when taken orally compared to IV

A

true

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22
Q

t/f: morphine is metabolised by hepatic glucuronidation in phase 1 reaction

A

false. PHASE 2

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23
Q

t/f: the active metabolite of morphine is M3G

A

false. it’s M6G

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24
Q

t/f: M6G is less potent than morphine

A

false. its 2-6 times more potent than morphine

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25
Q

t/f: taking morphine with alcohol will have adverse effects due to inhibition of phase 2

A

true. morphine will not get metabolised -> liver toxicity

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26
Q

urinary excretion of morphine can be increase with what?

A

ammonium chloride

27
Q

what is the oral:IV ratio of absorption for morphine

A

6:1

28
Q

what is the oral:IV ratio of absorption for codeine

A

1.5:1

29
Q

t/f: codeine has a high first-pass hepatic metabolism

A

false. LOW first pass

30
Q

t/f: codeine is an analgesic and antitussive

A

true

31
Q

t/f: morphine has better BBB diffusion than codeine

A

false. codeine has better BBB diffusion

32
Q

t/f: both morphine and codeine are metabolised by phase 2 into their active metabolite

A

false. morphine is phase 2. codeine is phase 1 (phase 2 is inactive metabolite)

33
Q

codeine is metabolised into morphine by which enzyme

A

CYP 2D6

34
Q

t/f: only 25% of original codeine is metabolised into morphine

A

false. only 10%

35
Q

t/f: there is genetic polymorphisms of CYP 2D6, so not everyone metabolises codeine well

A

true

36
Q

t/f: tylenol with codeine no. 4 does NOT have caffeine

A

true

37
Q

t/f: methadone has a long half life compared to other opioids like morphine

A

true

38
Q

t/f: methadone has a slower onset and longer duration than morphine

A

true

39
Q

t/f: methadone can be used to treat opioid use disorder and chronic pain

A

true

40
Q

t/f: methadone keeps pt in “normal” range, whereas heroin causes oscillations between sick and high

A

true

41
Q

t/f: fentanyl is 80 times more potent than morphine

A

true

42
Q

t/f: fentanyl can be administered orally

A

false. usually IV or transdermal

43
Q

t/f: loperamide is an analgesic opioid

A

false. it is NON-ANALGESIC

44
Q

t/f: loperamide and diphenoxylate are used for the treatment of constipation

A

false. treatment of DIARRHEA

45
Q

t/f: oxycodone is only adminitered orally

A

true

46
Q

100 mg of morphine is equivalent to

A
  • 100mg hydrocodone
  • 25 mg hydromorphone
  • 65mg oxycodone
  • 37mg/hr fentanyl
47
Q

t/f: dosage at or above 50 MME/day increase risk for OD by at least 2x the risk of <20MME/day

A

true

48
Q

t/f: naloxone is an opioid agonist

A

false. ANTAGONIST

49
Q

t/f: naloxone has a long half life

A

false. very short (only 1h)

50
Q

t/f: naloxone has a high affinity for the M opioid receptor

A

true

51
Q

t/f: naloxone has a low first-pass metabolism

A

false. HIGH

52
Q

naloxone is used in the tx of

A

opioid overdose

53
Q

signs of an overdose

A
  1. soft/no breath or snoring
  2. small pupils
  3. blue lips, nails, skin
  4. cold, clammy skin
  5. limp body
  6. doesnt respond to shouting
54
Q

t/f: if someone is having an overdose, you should administer naloxone orally

A

false. break the ampoule, pull it into a needle, and inject into a large muscle

55
Q

t/f: naltrexone is an opioid antagonist

A

true

56
Q

t/f: naltrexone has a short half life

A

false. it has a LONG half life

57
Q

naltrexone is used to tx __

A
  • opioid addiction

- alcoholism

58
Q

t/f: naltrexone can be used for acute OD

A

false. naloxone is used for acute OD. naltrexone is used for addiction

59
Q

AE of naltrexone

A

dose-dependent hepatocellular liver injury

60
Q

t/f: buprenorphine is a partial opioid agonist that binds to the M receptor

A

true

61
Q

how does buprenorphine reduce the efficacy of morphine and heroin

A

competes for receptor binding

62
Q

buprenorphine tx

A
  • pain

- opioid use disorder

63
Q

buprenorphine + naloxone (sublingual) tx

A

opioid use disorder

Pharmacology (17 decks)

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