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Medical Pharmacology Exam 2 > Pain Opioids I > Flashcards

Pain Opioids I Flashcards

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USMLE® Step 1 flashcards
1
Q

The absence of pain without loss of consciousness is _

A

Analgesia

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2
Q

Pain is transmitted by _ types of fibers. (2)

A

A delta

C

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3
Q

True or false, pain intensity is indirectly related

to stimulus intensity

A

This is a false statement. The relation is direct

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4
Q

What is the effect of analgesic drugs on the sensitized state (hyperalgesia)?

A

Analgesics should reduce the sensitization

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5
Q

Pain consists of two components, the sensory discriminative component and the motivational-affective component. Which of these 2 are opioids most effective against?

A

The motivational affective component

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6
Q

Majority of opioids used for pain relief target which opioid receptor? Are these drugs agonists or antagonists?

A

Mu

Agonists

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7
Q

What are the 4 endogenous opioid peptides? What are their target receptors? Where are they made?

A 
Endomorphins (mu)
Endorphins (mu, delta)
Enkephalins (delta)
Dynorphins (kappa)
CNS and PNS
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8
Q

Identify the opioid receptor. Found in brain, spinal cord, peripheral sensory neurons and intestinal tract. Involved in physical dependence, respiratory depression, GI motility and euphoria.

A

Mu receptor

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9
Q

Identify the opioid receptor. Found in brain spinal cord and peripheral sensory neurons. Involved in dissociative and delirium, diuresis, anticonvulsant effects and dysphoria.

A

Kappa receptor

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10
Q

Identify the opioid receptor. Found in the brain only. Has antidepressant and convulsant effects.

A

Delta

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11
Q

What is the net effect of opioids presynaptically? Postsynaptically? What is the mechanism?

A

Pre - Reduces depolarization
Post - Causes hyperpolarization
Blocks Ca++ influx and increases K+ efflux

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12
Q

Vomiting, euphoria, seizures, reduced sex hormone release and itching are all side effects of what class of drug ?

A

Opioids

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13
Q

Orthostatic hypotension, bradycardia and peripheral vasodialtion are all effects of _ on the cardiovascular system

A

Opioids

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14
Q

What are the components of the acute opioid intoxication triad?

A

Sedation/stupor/coma
miosis (pin point pupils)
respiratory depression

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15
Q

What drug is indicated for reversing acute opioid intoxication?

A

Naloxone

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16
Q

While tolerance to opioids manifests in most organ systems, what 2 systems are exempt?

A

Occular

GI

17
Q

There is no maximum dose of morphine for

malignant pain management. This is because of what phenomenon? How long before tolerance occurs?

A

Tolerance

As short as days

18
Q

What are 2 reasons why pain management if harder following tolerance?

A

Tolerant patient more sensitized to pain

Drug in tolerant patient not as effective

19
Q

What are 2 ways that withdrawal symptoms from opioids can be caused? How can this be prevented?

A

Abrupt cessation
Opioid antagonist
Gradual tapering of the dose

20
Q

What is physical dependence? What is a common cause?

A

Withdrawal symptoms upon stopping use of the drug.

Prolonged use of drug

21
Q

What is psychological dependence? What is the brain pathway associated wit its development

A

Impaired control over drug use for the reinforcement it provides
Mesolimbic dopamine system

22
Q

A primary, chronic, neurobiologic disease,
with genetic, psychosocial, and environmental factors
influencing its development and manifestations. This is the definition of _

A

Addiction

23
Q

True or false. Even with appropriate medical treatment of acute pain, addiction is a common result.

A

False, addiction produced by appropriate medical treatment of acute pain is uncommon

24
Q

The drug of choice for the treatment of acute post op pain and cancer pain is _

A

Opioids

25
Q

The drug of choice for the treatment of chronic non malignant pain is _

A

NOT opioids, still under investigation

26
Q

True or false: Opioids are great for the treatment of pain with activity.
True or false: Opioids will usually be used to completely eliminate pain

A

False

False

27
Q

Placebo effect is mediated by _

A

Release of endogenous opioids

28
Q

A patient with spinal cord transection can feel pain. True or false?

A

False, not pain because the information never reaches the cortex

29
Q

restlessness, perspiration, abdominal
cramps, hot and cold flashes, insomnia, nausea,
vomiting, diarrhea, tachypnea, hypertension,
hypotension, tachycardia are all signs of _

A

Tolerance (Think autonomic signs)

Medical Pharmacology Exam 2 (16 decks)

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