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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
t/f: taking morphine with alcohol will have adverse effects due to inhibition of phase 2
true. morphine will not get metabolised -> liver toxicity
26
urinary excretion of morphine can be increase with what?
ammonium chloride
27
what is the oral:IV ratio of absorption for morphine
6:1
28
what is the oral:IV ratio of absorption for codeine
1.5:1
29
t/f: codeine has a high first-pass hepatic metabolism
false. LOW first pass
30
t/f: codeine is an analgesic and antitussive
true
31
t/f: morphine has better BBB diffusion than codeine
false. codeine has better BBB diffusion
32
t/f: both morphine and codeine are metabolised by phase 2 into their active metabolite
false. morphine is phase 2. codeine is phase 1 (phase 2 is inactive metabolite)
33
codeine is metabolised into morphine by which enzyme
CYP 2D6
34
t/f: only 25% of original codeine is metabolised into morphine
false. only 10%
35
t/f: there is genetic polymorphisms of CYP 2D6, so not everyone metabolises codeine well
true
36
t/f: tylenol with codeine no. 4 does NOT have caffeine
true
37
t/f: methadone has a long half life compared to other opioids like morphine
true
38
t/f: methadone has a slower onset and longer duration than morphine
true
39
t/f: methadone can be used to treat opioid use disorder and chronic pain
true
40
t/f: methadone keeps pt in "normal" range, whereas heroin causes oscillations between sick and high
true
41
t/f: fentanyl is 80 times more potent than morphine
true
42
t/f: fentanyl can be administered orally
false. usually IV or transdermal
43
t/f: loperamide is an analgesic opioid
false. it is NON-ANALGESIC
44
t/f: loperamide and diphenoxylate are used for the treatment of constipation
false. treatment of DIARRHEA
45
t/f: oxycodone is only adminitered orally
true
46
100 mg of morphine is equivalent to
- 100mg hydrocodone - 25 mg hydromorphone - 65mg oxycodone - 37mg/hr fentanyl
47
t/f: dosage at or above 50 MME/day increase risk for OD by at least 2x the risk of <20MME/day
true
48
t/f: naloxone is an opioid agonist
false. ANTAGONIST
49
t/f: naloxone has a long half life
false. very short (only 1h)
50
t/f: naloxone has a high affinity for the M opioid receptor
true
51
t/f: naloxone has a low first-pass metabolism
false. HIGH
52
naloxone is used in the tx of
opioid overdose
53
signs of an overdose
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
t/f: if someone is having an overdose, you should administer naloxone orally
false. break the ampoule, pull it into a needle, and inject into a large muscle
55
t/f: naltrexone is an opioid antagonist
true
56
t/f: naltrexone has a short half life
false. it has a LONG half life
57
naltrexone is used to tx __
- opioid addiction | - alcoholism
58
t/f: naltrexone can be used for acute OD
false. naloxone is used for acute OD. naltrexone is used for addiction
59
AE of naltrexone
dose-dependent hepatocellular liver injury
60
t/f: buprenorphine is a partial opioid agonist that binds to the M receptor
true
61
how does buprenorphine reduce the efficacy of morphine and heroin
competes for receptor binding
62
buprenorphine tx
- pain | - opioid use disorder
63
buprenorphine + naloxone (sublingual) tx
opioid use disorder

Pharmacology (17 decks)

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