Pharmacology II

Question 1

What is the mechanism of action of Tramadol?

Answer 1

Very weak opioid agonist that also inhibits serotonin and NE reuptake by working on multiple NTs (p.450)

Question 2

Name eight opioid analgesics.

Answer 2

Morphine, fentanyl, codeine, heroin, methadone, meperidine, dextromethorphan, diphenoxylate (p.449)

Question 3

At what opioid receptor does morphine act as an agonist?

Answer 3

Mu (p.449)

Question 4

At what opioid receptor do enkephalins act as agonists?

Answer 4

Delta (p.449)

Question 5

At what opioid receptor do dynorphins act as agonists?

Answer 5

Kappa (p.449)

Question 6

Name five clinical uses of opoid analgesics.

Answer 6

Pain, cough suppression (dextromethorphan), diarrhea (loperamide, diphenoxylate), acute pulmonary edema, maintance programs of addicts (methadone) (p.449)

Question 7

What is the clinical use of Butorphanol?

Answer 7

Severe pain (migraine, labour, etc) (p.449)

Question 8

What is the clinical use of Tramadol?

Answer 8

Chronic pain (p.450)

Question 9

What toxicites are associated with opiod analgesics?

Answer 9

Addiction, respiratory depression, constipation, miosis (pinpoint pupils), additive CNS depression with other drugs (p.449)

Question 10

What toxicites are associated with Butorphanol?

Answer 10

Opiod withdrawal symptoms if the patient is also taking full opiod agonists (competition for opioid receptors); overdose not easily reversed with naloxone (p.449)

Question 11

What toxicites are associated with Tramadol?

Answer 11

Similar to opoid toxicities; decreases seizure threshold (p.450)

Question 12

Which opiod analgesic is used in cough suppression?

Answer 12

Dextromethorphan (p.449)

Question 13

Which opiod analgesics are used in treatment of diarrhea?

Answer 13

Loperamide, diphenoxylate (p.449)

Question 14

Which opiod analgesic is used in maintenance programs for addicts?

Answer 14

Methadone (p.449)

Question 15

Tolerance to which opioid analgesic toxities can not be attained?

Answer 15

Miosis and constipation (p.449)

Question 16

How is opiod analgesic toxicity treated?

Answer 16

Naloxone or naltrexone (opiod receptor antagonist) (p.449)

Question 17

Name one advantage to using Butorphanol over opioid analgesics.

Answer 17

Butorphanol causes less respiratory depression than full opioid agonists (p.449)

Question 18

Name eight drugs that can be used for both partial (focal) seizures and generalized seizures.

Answer 18

Phenytoin, Carbamazepine, Lamotrigine, Gabapentin, Topiramate, Phenobarbital, Valproic acid, Levetiracetam (p.451)

Question 19

Name two drugs that are only suitable for partial (focal) seizures.

Answer 19

Tigabine, Vagabatrin (p.451)

Question 20

What types of seizures is Phenytoin used to treat?

Answer 20

Simple and complex partial seizures; tonic clonic seizures; status epilepticus (also a class Ib antiarrythmatic) (p.451)

Question 21

In what seizure conditions is Phenytoin used as a first line agent?

Answer 21

Tonic-clonic seizures; prophylaxis against status epilepticus (p.451)

Question 22

What types of seizures is Carbamazepine used to treat?

Answer 22

First line agent for simple and complex partial seizures; first line for tonic-clonic seizures (p.451)

Question 23

What types of seizures is Lamotrigine used to treat?

Answer 23

Simple and complex partial seizures; tonic clonic seizures (p.451)

Question 24

What types of seizures is Gabapentin used to treat?

Answer 24

Simple and complex partial seizures; tonic clonic seizures (p.451)

Question 25

What types of seizures is Topiramate used to treat?

Answer 25

Simple and complex partial seizures; tonic clonic seizures (p.451)