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Pharm Final > Opioids > Flashcards

Opioids Flashcards

1
Q

Opioids

a. propoxyphene antagonises the analgesic effects of paracetamol

A

a) False. Paracetamol potentiates the analgesic effects of opioids

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2
Q

Opioids

b. naloxone reverses the respiratory depressant effects of morphine

A

b) True, naloxone is an opioid antagonist

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3
Q

Opioids

c. codeine is a more potent analgesic than fentanyl

A

c) False, fentanyl is more potent than codeine

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4
Q

Opioids

d. tolerance develops to euphoria before miosis

A

d) False, tolerance develops to all central nervous system effect

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5
Q

Opioids

e. tramadol blocks the reuptake of serotonin

A

e) True. Tramadol is a centrally acting synthetic opioid analgesic and SNRI (serotonin/norepinephrine reuptake-inhibitor)

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6
Q

Adverse-effects associated with morphine

a. insomnia

A

a) False, opioids cause sedation

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7
Q

Adverse-effects associated with morphine

b. urine voiding

A

b) False, urine retention

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8
Q

Adverse-effects associated with morphine

c. pruritus

A

c) True

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9
Q

Adverse-effects associated with morphine

d. emesis

A

d) True, nausea and vomiting

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10
Q

Adverse-effects associated with morphine

e. diarrhoea

A

e) False, constipation

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11
Q

Adverse effects of morphine include

a. urine retention

A

A. True

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12
Q

Adverse effects of morphine include

b. hypotension

A

B. False, No significant direct effects on the heart and, other than bradycardia, no major effects on cardiac rhythm

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13
Q

Adverse effects of morphine include

c. biliary colic

A

C. True, The opioids contract biliary smooth muscle- can result in biliary colic

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14
Q

Adverse effects of morphine include

d. insomnia

A

D. False, cause sedation

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15
Q

Adverse effects of morphine include

e. diarrhoea

A

E. False, constipation

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16
Q

Opioids

a. codeine is a mu-opioid receptor agonist

A

A. True

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17
Q

Opioids

b. fentanyl is less cardiotoxic than morphine

A

B. False

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18
Q

Opioids

c. morphine is metabolised by plasma cholinesterase

A

C. False, Morphine is 90% metabolized by glucuronidation

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19
Q

Opioids

d. naloxone reverses morphine-induced respiratory depression

A

D. True

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20
Q

Opioids

e. loperamide is used in the treatment of constipation

A

E. False, loperamide is indicated for for the control and symptomatic relief of acute nonspecific diarrhoea and of chronic diarrhoea

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21
Q

Opioids

a. codeine is a mu-opioid receptor antagonist

A

A. False, mu-opioid receptor agonist

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22
Q

Opioids

b. remifentanyl has a longer duration of action than fentanyl

A

B. False, remifentanil has a short duration of action

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23
Q

Opioids

c. analgesic effects are reversed by naloxone

A

C. True, naloxone is an opioid antagonist and will reverse all effects caused by opioids

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24
Q

Opioids

d. pethidine is safe to use in patients taking a monoamine oxidase inhibitor

A

D. False, can cause serotonin syndrome if used with MAO inhibitors & SSRIs

25
Q

Opioids

e. opioids cross the placenta

A

E. True, can cause fetal dependency

26
Q

Adverse effects of morphine include

a. mydriasis

A

A. False, miosis

27
Q

Adverse effects of morphine include

b. respiratory depression

28
Q

Adverse effects of morphine include

c. urine voiding

A

C. False, urine retention

29
Q

Adverse effects of morphine include

d. diarrhoea

A

D. False, constipation

30
Q

Adverse effects of morphine include

e. sedation

31
Q

Opioids

a. morphine is a mu-opioid receptor antagonist

A

a) False, morphine is a mu receptor agonist

32
Q

Opioids

b. pethidine is preferred to morphine during labour

A

b) True, low dose pethidine is used during labour

33
Q

Opioids

c. tramadol induces less histamine release than morphine

A

c) True, in contrast to morphine, tramadol has not been shown to cause histamine release. At therapeutic doses, tramadol has no effect on heart rate, left-ventricular function or cardiac index.

34
Q

Opioids

d. naloxone reverses morphine-induced respiratory depression

A

d) True, naloxone is an opioid antagonist and will reverse all effects caused by opioids

35
Q

Opioids

e. patients tolerant to morphine will respond to the analgesic effect of pethidine morphine

A

e) True, pethidine has more affinity for the kappa-receptor than morphine.

36
Q

The following are adverse effects of morphine

a. mydriasis

A

a. False, miosis

37
Q

The following are adverse effects of morphine

b. biliary colic

38
Q

The following are adverse effects of morphine

c. respiratory depression

39
Q

The following are adverse effects of morphine

d. insomnia

A

d. False, sedation

40
Q

The following are adverse effects of morphine

e. vomiting

41
Q

Tramadol

a. causes more respiratory depression than morphine

A

a. False, tramadol is generally considered a lower-risk opioid option for the treatment of moderate to severe pain

42
Q

Tramadol

b. inhibits the reuptake of serotonin in the CNS

A

b. True, Tramadol is a centrally acting μ-opioid receptor agonist and SNRI

43
Q

Tramadol

c. causes seizures as an adverse effect

44
Q

Tramadol

d. has greater affinity for mu-opioid receptors than morphine

A

d. False, has about 1/10th of the potency of morphine.

45
Q

Tramadol

e. causes dizziness as an adverse effect

46
Q

Opioids

a. tolerance to the analgesic effects of opioids develops more rapidly than tolerance to constipation

A

a. True, tolerance develops to central nervous system effects

47
Q

Opioids

b. pethidine increases the risk of seizures in patients with kidney failure

A

b. True, Patients with impaired renal function are at higher risk of accumulation of norpethidine and may increase CNS excitation (seizures)

48
Q

Opioids

c. naloxone antagonises the effects of fentanyl at mu-opioid receptors

A

c. True, naloxone has a high affinity for μ-opioid receptors, where it acts as an inverse agonist, causing the rapid removal of any other drugs bound to these receptors.

49
Q

Opioids

d. codeine is an antagonist at mu-opioid receptors

A

d. False, agonist

50
Q

Opioids

e. pethidine is safe to use concurrently with irreversible monoamine oxidase inhibitors

A

e. False, It can block neuronal uptake of 5HT3 –can cause serotonin syndrome if used with MAO inhibitors & SSRIs

51
Q

Opioids

a. morphine is an antagonist at postsynaptic mu opioid receptors

A

a. False, agonist

52
Q

Opioids

b. naloxone is an agonist at kappa-opioid receptors

A

b. False, opioid receptor antagonist

53
Q

Opioids

c. remifentanil has a shorter duration of action than fentanyl

54
Q

Opioids

d. tramadol causes more respiratory depression than morphine

A

d. False, tramadol has fewer side effect

55
Q

Opioids

e. dextromethorphan suppresses the cough reflex

A

e. True, antitussive

56
Q 
A 60-year-old man with a history of moderate chronic obstructive pulmonary disease presents
to the emergency department with a broken femur suffered in an automobile accident. He is in severe pain. He undergoes emergency surgery. Which agent from the list above would provide the highest potency for the use as an intraoperative analgesic?
1.	Alfentanil
2.	Codeine
3.	Dextromethorphan
4.	Fentanyl
5.	Morphine
6.	Naloxone
7.	Pethidine 
8.	Remifentanil
9.	Tramadol
57
Q

A 45 year old man is undergoing elective surgery. He had severe muscle rigidity
during a previous surgical procedure due to adjunct opioid used. Which agent from
the above list would provide potent intra-opera6ve analgesia, is 20 fold more potent
than morphine, and would be broken down in the patient’s plasma?
1. Alfentanil
2. Codeine
3. Dextromethorphan
4. Fentanyl
5. Morphine
6. Naloxone
7. Pethidine
8. Remifentanil
9. Tramadol

A

Alfentanil

58
Q

Opioids A 33- year old women with known history of peptic ulcers and mild hypotension requires an analgesic for moderate pain relief following a minor car accident. Considering the medical background which ONE of the following
drugs would promote central pain control and would not worsen her hypotension at analgesic doses
a. pethidine
b. morphine
c. codeine
d. tramadol

Pharm Final (25 decks)

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