Opioids and Antagonists

Question 1

Endogenous opioid peptides

Answer 1

Enkephalins, beta-endorphin, dynorphin

Question 2

Beta-endorphins

Answer 2

decrease pain transmission in spinal cord, facilitate dopamine in reward system→ euphoria

Question 3

Enkephalins

Answer 3

decrease pain transmission in the spinal cord

Question 4

Dynorphins

Answer 4

bind to kappa receptors→ analgesia & dysphoria

Question 5

Opioid receptors

Answer 5

Mu, kappa, delta

Question 6

All opioid receptors MOA

Answer 6

coupled to Gi/o –> decrease cAMP;

close voltage-gated Ca2+ channels on presynp; Mu receptors open K+ channels

Question 7

Effects of mu

Answer 7

analgesia, euphoria, sedation, side effects

Question 8

Effects of kappa

Answer 8

Analgesia in some, dysphoria in others

Question 9

Effects of delta

Answer 9

Dysphoria

Question 10

Decreasing glutamate release in the dorsal horn__

Answer 10

Reduces activation of the ascending pathway

Question 11

Inhibiting GABA release from inhibitory neurons __

Answer 11

Activates of the descending pathway that inhibits pain transmission

Question 12

Effects of opioid

Answer 12

Analgesia; sedation/mental clouding; euphoria; dysphoria; emesis; antitussive; respiratory depression; elevation intracranial pressure; miosis; truncal rigidity; bradycardia; CONSTIPATION; increase sphincter tone (hard to urinate)

Question 13

Commonly used for cough

Answer 13

codeine and dextromethorphan

Question 14

Not an analgesic

Answer 14

Dextromethorphan

Question 15

No antitussive property

Answer 15

Meperidine

Question 16

Opioids may be useful for ___ due to its respiratory depression effect

Answer 16

Pulmonary edema

Question 17

Do not use opioids if pt w/

Answer 17

pulmonary dz; head trauma

Question 18

Opioid that causes mydriasis

Answer 18

Meperidine

Question 19

SE of Truncal rigidity is seen commonly in

Answer 19

IV fentanyl - highly lipid soluble drugs (inject slowly to prevent)

Question 20

Opioid that causes tachycardia

Answer 20

Meperidine

Question 21

Pt taking opioids can have flushing, itching, sweating due to __ and most common with

Answer 21

release of histamine, morphine injection

Question 22

Tolerance effects of opioid

Answer 22

Analgesia, sedation, euphoria, N/V, respiratory depression

Question 23

Non-tolerated effects of opioid

Answer 23

Miosis, constipation, seizures

Question 24

Hyperalgesia occurs when

Answer 24

long-term opioid use due to decrease in NMDA receptor antagonists

Question 25

Addiction ___ dopamine receptors

Answer 25

lower

Question 26

Reduce withdrawal sxs of opioid

Answer 26

clonidine or another opioid (methadone)

Question 27

Overdose triad

Answer 27

CNS depression, respiratory depression, pin point pupils

Question 28

Overdose treatment

Answer 28

Support respiration (ABCs), Naloxone

Question 29

Opioid clinical uses

Answer 29

Analgesic, acute pulmonary edema, relief of cough, tx of diarrhea, anesthesia

Question 30

Opioid and sedative hypnotics

Answer 30

increased CNS and respiratory depression

Question 31

Opioid and antipsych

Answer 31

Sedation

Question 32

Opioid and MAO inhibitor

Answer 32

Inhibit serotonin reuptake to some degree (Merperidine, dexytromethorphan)

Question 33

CYP2D6 require to convert to active compound (recommended to avoid acetaminophen)

Answer 33

Codeine, oxycodone, hydrocodone

Question 34

Opioid contraindication

Answer 34

Use of partial agonist w/ full agonist; head injuries; pregnancy; impaired pulmonary fxn; impaired hepatic or renal fxn; some endocrine dz

Question 35

Opioid precaution for seizure

Answer 35

Meperidine

Question 36

Administration of an antagonist or partial agonist may cause

Answer 36

withdrawal

Question 37

Relapse of withdrawal prevented with

Answer 37

Buprenorphine or methadone

Question 38

Morphine metabolized by

Answer 38

CYP2D6

Question 39

Commonly used in long-term control of pain

Answer 39

Methadone

Question 40

High abuse potential that is commonly used in short surgical procedures; available in transdermal patches or lollipops; metabolized by CYP3A4

Answer 40

Fentanyl

Question 41

Common route for codeine

Answer 41

oral

Question 42

Causes dysphoria due to kappa

Answer 42

Pentazocine/naloxone

Question 43

Tramadol w/ MAOIs, TCAs, SSRIs causes

Answer 43

Serotonin syndrome

Question 44

Tramadol w/ antidepressant causes

Answer 44

seizures

Question 45

Route for naloxone

Answer 45

Injected or intransaal

Question 46

Opioid antagonist that causes liver toxicity when used chronically

Answer 46

Naltrexone

Question 47

Shorter duration: naloxone or naltrexone?

Answer 47

Naloxone

Question 48

Robotripping caused by which drug? (dumb teens are the reason why i am scared of having babies)

Answer 48

Dextromethorphan