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CHEM 183 > Pain-Anesthesia > Flashcards

Pain-Anesthesia Flashcards

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1
Q

Where did the first information on opioids come from?

A

Ancient Mesopotamia

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2
Q

Where is opium extracted from?

A

Resin of the poppy bud

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3
Q

Who first noticed that opium could put people to sleep?

A

Paracelsus, 1493-1541

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4
Q

What did Paracelsus observe?

A

By combining alcohol and opium, the painkilling effect increases

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5
Q

Who first isolated morphine from opium?

A

1806, Friedrich Wilhelm Serturner

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6
Q

What was significant about Friedrich Serturner’s discovery of morphine?

A

He isolated morphine into a pure white powder, which allowed for determining accurate dosage

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7
Q

How did Friedrich Serturner name morphine?

A

After the Greek god of dreams “Morpheus”

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8
Q

What is the therapeutic window of morphine?

A

It is very narrow, meaning the difference between a dose that relieves pain and one that causes death is small.

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9
Q

When did the British introduce opium to China?

A

In the 1800s, during British rule over India.

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10
Q

What was China’s initial response to British opium exports?

A

China resisted due to the addictive nature of opium and did not want to open opium dens.

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11
Q

What wars were caused by China’s resistance to the British opium exports?

A

The First Opium War (1839-1842) and the Second Opium War (1856-1860).

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12
Q

What was the result of the Opium Wars for China?

A

China lost, leading to widespread opium addiction in the country.

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13
Q

What was another issue during the time after the Opium Wars?

A

Patent medicines: they contained active ingredients but the dosage was unknown to consumers, leading to addiction

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14
Q

When was the issue of patent drugs addressed?

A

In 1906, when the US introduced the first ever Food and Drug Act. (It concerned labeling but was not super strict yet)

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15
Q

What are endorphins? What do they do?

A

Endorphins are proteins that relieve pain and create feelings of pleasure, such as those during laughter, orgasms, and the high after exercising.

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16
Q

How does morphine relieve pain?

A

Morphine resembles endorphins, the body’s natural pain relievers, and fits into the same receptors that endorphins do, blocking pain signals.

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17
Q

What neurotransmitter causes pain, and how does morphine affect it?

A

Substance P causes pain, and morphine blocks Substance P to reduce pain.

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18
Q

What type of addiction does morphine cause?

A

It causes physical addiction because the body needs more and more of it over time, and withdrawal symptoms occur when it’s not in the body’s system

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19
Q

What is the double-edged sword of opioids?

A

It is used in medicine for good, like pain relief, but can also cause some bad, like addiction

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20
Q

Who synthesized heroin (diacetyl morphine) from morphine?

A

In 1874, Charles Romley Wright

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21
Q

What was the initial view on heroin?

A

Thought to be a better painkiller and less addictive, and was compared to aspirin, but they are very different

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22
Q

How addictive is heroin?

A

One single injection can lead to addiction. It takes less less heroin to get someone addicted than morphine

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23
Q

Where is heroin used?

A

It is not used in any medicines or hospitals

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24
Q

How is morphine converted to heroin?

A

It is very easy: a slight change in molecular structure, just attach two acetyl groups to morphine.

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25
Q

Who is credited with the development of aspirin?

A

Felix Hoffmann

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26
Q

What substance is found in the bark of the willow tree?

A

Salicin

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27
Q

What happens to salicin when you swallow it?

A

It gets converted into salicylic acid

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28
Q

How was aspirin first made?

A

Salicylic acid + acetic acid = acetyl salicylic acid or ASA (aspirin)

Aspirin is made from something found in the bark of the willow tree

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29
Q

Who won the Nobel Prize for discovering how aspirin works?

A

In 1982, Sir John Vane

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30
Q

How does aspirin work?

A

Aspirin blocks the enzyme, cyclooxyrgenase, stopping the formation of prostaglandins that cause inflammation, swelling, pain, and fever.

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31
Q

How does aspirin cause negative effects?

A

It interferes with the production of prostaglandins, which protect the stomach lining, decreasing stomach acid production and help the gut release more protective mucus.

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32
Q

Who found oxycodone? And how?

A

Martin Freund and Edmund Speyer found it from thebaine, a compound in opium, when they played around with the structure of morphine

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33
Q

How is oxycodone created from morphine?

A

By treating morphine with an oxidizing agent.

34
Q

How and when was dilaudid or hydromorphone made?

A

In 1962, when a little change was done to morphine

35
Q

What is dilaudid like?

A

It is less addictive, but also a less effective painkiller. It is still used as a common painkiller in hospitals

36
Q

When and how was demerol made?

A

In 1932. A significant change in the molecular structure of morphine.

37
Q

How does demerol work as a painkiller (as is other painkillers)?

A

Its molecular structure twists and folds in such a way that it fits into a morphine receptor to block the pain. In this way, a painkiller doesn’t have to be similar to the molecular structure of morphine in order to work as a painkiller.

38
Q

What connection does Hitler have with oxycodone?

A

Hitler was prescribed oxycodone and became addicted to it.

39
Q

What two common pain relievers were developed in 1953?

A

Acetaminophen (Tylenol)

40
Q

What are some characteristics about Acetaminophen (Tylenol)?

A
  • It doesn’t have blood clouting effect.
  • It relieves pain and reduces fever.
  • But the studies on its pain relieving effect are inconsistent.
  • May be a cyclooxyrgenase inhibitor, like aspirin
41
Q

Can certain pain-relieving drugs be taken together for enhanced effect?

A

Yes, some drugs like Vicodin can be combined to enhance pain relief.

42
Q

What is an opioid?

A

Any substance that behaves like morphine, whether it comes from opium or not, is called an opioid.

43
Q

Who founded Purdue Pharma, and what was their first product?

A

Drs. Raymond, Arthur, and Mortimer Sackler founded Purdue Pharma, and their first product was morphine.

44
Q

What was MS Contin, and how did it work?

A

MS Contin was a continuous-release form of morphine sulfate, designed to slowly release morphine for prolonged pain relief.

45
Q

What was OxyContin, and how was it marketed? Was it accurate?

A

OxyContin was oxycodone with a continuous-release mechanism. It was marketed as a 12-hour, less addictive painkiller with the low risk of 1% of people getting addicted. Purdue’s claims were all false.

46
Q

What was Purdue’s response to their marketing mistake of OxyContin?

A

Purdue introduced OxyNeo, a gel formulation of oxycodone, to prevent misuse, but it was enough to fix their mistake.

47
Q

What is the main criticism of Purdue Pharma’s actions?

A

The shame lies not in creating OxyContin but in promoting it with false claims, leading to widespread addiction.

48
Q

Is OxyContin a bad drug?

A

No, OxyContin is not a bad drug when used properly for legitimate medical reasons. However, most addicts had not been prescribed it for medical reasons.

49
Q

How does fentanyl work as a painkiller?

A

It has the shape that fits into a receptor despite not resembling morphine

49
Q

What are the natures of fentanyl?

A

It is highly addictive and strictly regulated because of this

50
Q

How do underground chemists bypass fentanyl regulations?

A

They alter its molecular structure to create variants like alphamethyl-fentanyl or 3-methyl-fentanyl, which aren’t illegal since they are not yet a known drug yet

51
Q

What is the opioid antagonist that reverses the effects of opioids by displacing them from their receptor sites?

A

In 1961, Naloxone

52
Q

What makes naloxone?

A

A slight change in the molecular structure of morphine

53
Q

What is Advil, and what are its side effects?

A

Advil is a pain reliever that inhibits prostaglandins, but it can cause stomach issues, including gastrointestinal bleeding.

54
Q

What year was Advil introduced?

A

1969

55
Q

Who discovered Stadol, and what is it used for?

A

Bernard Belleau at McGill University discovered Stadol, which is used for migraines and is available as a nasal spray.

56
Q

Is Stadol highly effective?

A

No, Stadol is not highly effective but is still used today.

57
Q

Tramadol

A

Tramadol was introduced in 1977 as a synthetic opiate.

58
Q

What are side effects all opioids have?

A

All opioids can cause constipation and slow breathing, among other side effects.

59
Q

Who discovered nitrous oxide?

A

In 1777, Joseph Priestley

60
Q

How was nitrous oxide discovered?

A

By heating ammonium nitrate, which produced nitrous oxide gas

61
Q

Who described the effects of nitrous oxide?

A

In the 1800s, Humphry Davy, noting that it caused people to laugh - “laughing gas”

62
Q

How was nitrous oxide popularized?

A

Nitrous oxide was used at performances and parties where people inhaled it, becoming giddy and laughing, which made it widely known to the public.

63
Q

Who was the dentist who observed something about nitrous oxide? What did he observe?

A

Horace Wells. A man fall off a stage and had a gash on his leg while under the influence of nitrous oxide, yet felt no pain and continued to dance

64
Q

How did Horace Wells test nitrous oxide for dental use?

A

Wells tested nitrous oxide on his assistant and then on himself, successfully pulling out his own teeth without feeling pain.

65
Q

Where did Horace Wells demonstrate the effects of nitrous oxide?

A

Massachusetts General Hospital

66
Q

What happened with Horace Wells demonstration?

A

Wells’ demonstration failed because he didn’t allow enough time for the nitrous oxide to take full effect in the patient before performing the procedure.

67
Q

What happened to Horace Wells?

A

He committed suicide

68
Q

Who continued the study on nitrous oxide after Horace Wells?

A

Wells’ fellow dentist, William Mortan

69
Q

What did William Morton?

A

He continued experimenting and consulted chemist Charles Jackson, who suggested using ether. Morton tested ether, which successfully put patients to sleep.

70
Q

What device William Morton make with ether?

A

He made an inhaler with sponges soaked with ether in them

71
Q

When and where did the first successful anesthesia demonstration using ether occur?

A

The first successful demonstration using ether occurred on October 16, 1846, at Massachusetts General Hospital in a room later called the “ether dome.”

72
Q

How did the world first hear of anesthesia?

A

Magician Robert Houdin heard about anesthesia in Boston and incorporated ether into his magic act, joking that it could defy gravity, making people think they might float.

73
Q

Who was the guy who never came out to report on his findings of ether before William Horton?

A

In 1842, Crawford Long, a Georgia physician

74
Q

Who are considered the possible “fathers of anesthesia”?

A

The battle over the title of “father of anesthesia” includes William Morton, Charles Jackson, and Horace Wells, and maybe even Paracelsus.

75
Q

Who discovered chloroform as an anesthetic and what was his significant contribution?

A

In 1847, James Simpson. Introduced its use for childbirth.

76
Q

What was the opposition to the use of chloroform for childbirth?

A

The Church opposed chloroform for childbirth, citing the Bible’s command that women should experience pain in childbirth.

77
Q

How was the use of chloroform defended against Church opposition?

A

James Simpson argued that God was the first anesthetist, as He put Adam to sleep before creating Eve.

78
Q

How many major surgeries are performed under anesthesia worldwide today?

A

An estimated 230 million major surgical procedures are carried out under anesthesia worldwide each year.

79
Q

What is waste anesthetic gases?

A

Anesthetic gases that are leaked or exhaled from a patient after inhaling during surgery

80
Q

What are the three problems with waste anesthetic gases?

A

Ozone destruction, greenhouse effect, and occupational hazard

81
Q
A

CHEM 183 (1 decks)

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