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Pharm > Opioids Exam 4 > Flashcards

Opioids Exam 4 Flashcards

1
Q

endogenous ligands released when

A

pain, pain expected, excited, orgasm, love, exercise, foods

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2
Q

types of endogenous ligands

A

endorphins, enkephalins, dynorphins

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3
Q

relay neurons do what

A

relay signals to other parts of the CNS

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4
Q

what is the excitatory neurotransmitter

A

glutamate

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5
Q

circuit neurons are __ and ___

A

local and control based

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6
Q

circuit neurons are ___ feed-forward/feedback

A

negative

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7
Q

inhibitory neurotransmitters (2) with circuit neurons

A

GABA and glycine

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8
Q

what is axoaxonic?

A

nerve synapse between two different axons

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9
Q

what type of neuron is axoaxonic associated with?

A

circuit neurons

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10
Q

Monoamine neurotransmitters (3)

A

NE, dopa, 5-HT

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11
Q

monoamine neurotransmission is associated with __ conduction and ____ activation

A

slower, diffuse

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12
Q

diffuse activation used what type of synapses?

A

en passant

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13
Q

where is dopamine produced?

A

substantia nigra and ventral tegmental area

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14
Q

where is NE produced

A

locus coeruleus

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15
Q

where is serotonin produced in the brain

A

raphe nuclei

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16
Q

what is ACh linked to (3)

A

learning/memory, sleep wake cycle, arousal/sensory info

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17
Q

what disease may be linked to deterioration of ACh system?

A

alzheimers

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18
Q

two components of pain

A

sensory and emotionsl

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19
Q

pain stimuli description (3)

A

noxious chemical, thermal, mechanical

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20
Q

slow burning pain with what fiber

A

C fiber

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21
Q

sharp pain, reflex response

A

a delta fiber

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22
Q

mechanical stimuli

A

a beta fiber

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23
Q

gates can be ___ and they can ___ or ____ pain sensation

A

adjusted
increase, decrease

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24
Q

opioids suppress pain by ___ pathway

A

blocking

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25
Q

anti-inflammatories ____ nociceptor signaling

A

suppress

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26
Q

Small fibers do what

A

readily transmit pain through gate

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27
Q

large fibers do what

A

suppress pain signaling (close gates)

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28
Q

tissue damage uses what noxious chemical

A

bradykinin

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29
Q

receptors for bradykinins

A

B1 inflammatory
B2 constitutive

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30
Q

AA cascade contains what pathways and what are created

A

COX and LOX pathways, prostaglandins created

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31
Q

mu receptor full agonist

A

morphine and fentanyl

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32
Q

mu receptor partial agonist

A

codeine, oxycodone

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33
Q

mu receptor antagonist

A

naloxone (narcan
)

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34
Q

3 types of opioid receptor

A

mu, delta, kappa

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35
Q

MOA of opioid

A

bind to receptor in brain and spinal cord

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36
Q

overall receptor effects of opioids

A

reduce neurotransmitter release of glutamate, ACh, NE, serotonin, substance P, hyperpolarize postsynaptic neurons

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37
Q

Mu receptor effects

A

analgesia, euphoria, respiratory depression, dependence

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38
Q

delta receptor effects

A

analgesia, enhance mu effects

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39
Q

kappa receptor effects

A

analgesia, enhance mu effects

40
Q

CNS effects of opioids

A

analgesia, euphoria, sedation, resp. depression, cough suppression, miosis

41
Q

what is the marker for opioid use

A

miosis

42
Q

CV effects

A

bradycardia

43
Q

meperidine causes what CV effect

A

demerol

44
Q

GI effects

A

constipation

45
Q

ABCB1 agonist

A

loperamide

46
Q

what happens when loperamide is given with quinidine

A

systemic absorption, resp. depression

47
Q

analgesia can be sever, constant, sharp or intermittent

A

yes

48
Q

can opioids treat renal or biliary colic?

A

yes

49
Q

ACS opioid treatment anagram

A

MONA, morphine, oxygen, nitro, aspirin

50
Q

acute pulmonary edema MOA with opioids

A

reduced anxiety, reduced preload, reduced afterload

51
Q

other uses for opiods

A

cough, diarrhea, shivering, anesthesiq

52
Q

toxicity of opioids

A

dysphoric reactions, resp depression, N/V, ICP, postural HoTN, constipation, urinary retention, itch

53
Q

tolerance of opioids is fairly ___

A

rapid

54
Q

withdrawal symptoms

A

rhinorrhea, lacrimation, yawning, chills, hyperventilation, hyperthermia, mydriasis, muscle aches, N/V/D, anxiety, hostility

55
Q

OIH stands for

A

opioid induced hyperalgesia

56
Q

symptom associated with OIH

A

increased pain sensation that is distinct from original pain complaint

57
Q

__% of chronic use pts experience OIH

A

30

58
Q

MOA of OIH

A

sensitized mu receptors, MOR-1K contributes to increased cAMP in cell

59
Q

treatment of OIH

A

taper off opioids, switch to GABA analogs

60
Q

drug overdose treatment

A

naloxone

61
Q

alcohol withdrawal treatment

A

naltrexone

62
Q

with head injuries what lethal issue can be enhanced with opioids

A

resp depression

63
Q

opioid issue with pregnancy

A

fetal dependence

64
Q

3 structures w opioids

A

phenanthrenes, phenylheptylamines, phenylpiperidines

65
Q

strong agonist phenanthrenes

A

morphine, hydromorphone, heroin

66
Q

strong agonists phenylheptylamines

A

methadone

67
Q

when is methadone used

A

chronic pain when there is morphine tolerance

68
Q

half life of methadone

A

25-50 hours

69
Q

strong agonists with phenylpiperidine

A

fentanyl, meperidine

70
Q

meperidine (demerol_ can treat what

A

antimuscarinic effects (tachycardia), serotonin syndrome, negative inotrope, seizures, post-op shivering

71
Q

Post- op shivering can be caused by

A

cold Or, Iv fluids, anesthesia

72
Q

shivering increases ___ consumption by 500%

A

O2

73
Q

treatment for post-opshivering

A

meperidine, ondansetron

74
Q

moderate agonists with phenanthrenes

A

codeine, oxycodone

75
Q

percocet equals

A

oxy and acetaminophen

76
Q

moderate agonists with phenylheptylamines

A

propoxyphene

77
Q

moderate agonists with phenylpiperidines

A

tramadol

78
Q

tramadol is given as a ____ mixture

A

racemic

79
Q

2 partial agonists

A

buprenex and stadol

80
Q

antitussive med

A

dextromethorphan

81
Q

derivatives of morphine that are opioid antagonists

A

naloxone, naltrexone, naloxegol

82
Q

how quickly do opioid antagonists work

A

1-3 minutes

83
Q

what opioid antagonists has a short duration

A

naloxone

84
Q

Mu receptors found where in the brain

A

periaqueductal grey area

85
Q

what is the primary pathwat

A

spinothalamic

86
Q

what is the emotional pathway

A

spinoreticular

87
Q

most common receptor

A

mu

88
Q

kappa is associated with what effects

A

psychomimetics

89
Q

opiate receptors also ____ the cell with K to stop signals from being sent

A

hyperpolarize

90
Q

desensiitization can be __ dependent and ___ independent

A

GPCR

91
Q

independent signaling can result in affecting other ___

A

receptors

92
Q

primary signaling is through ____ of cAMP

A

inhibition

93
Q

addiction utilizes what dopamine pathway

A

mesolimbic

94
Q

dilaudid is how many times more potent than morphine

A

7-10

95
Q

methadone utilizes what pathway

A

CYP3A4

96
Q

carfentanil is what transquilizer

A

elephant

97
Q

meperidine can increase

A

kappa opioid receptor agonism

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