Quiz 3

Question 1

Mu 1 receptor effects

Answer 1

euphoria, supraspinal analgesia, confusion, dizziness, nausea, low addiction potential

Question 2

Mu 2 receptor effects

Answer 2

respiratory depression, CV and GI effects, miosis, urinary retention

Question 3

delta receptor effects

Answer 3

spinal analgesia, CV depression, decreased brain and myocardial oxygen demand

Question 4

kappa receptor effects

Answer 4

spinal analgesia, dysphoria, psychomimetic effects, feed-back inhibition of endorphin system

Question 5

Describe morphine 3

Answer 5

INACTIVE metabolite of morphine- may accumulate and cause seizures

Question 6

Describe morphine 6

Answer 6

ACTIVE metabolite of morphine- can cause ventilatory depression more potent than morphine

Question 7

Does dilaudid have active metabolites?

Answer 7

no

Question 8

Does demerol have an active metabolite?

Answer 8

yes- normeperidine (not good for elderly patients- lowers seizure threshold, produces CNS stim)

Question 9

Does alfentanil have metabolites?

Answer 9

no

Question 10

Demerol is an agonist to what receptor

Answer 10

mu

Question 11

Sufentail is an agonist to what receptor?

Answer 11

mu

Question 12

What do opioid agonist-antagonists bind to?

Answer 12

mu, kappa, and delta receptors

Question 13

What are the advantages of opioid agonist-antagonists?

Answer 13

produce analgesia with limited depression of ventilation and low dependence potential

Question 14

describe Nalbuphine (Nubain)

Answer 14

opioid agonist-antagonist that is chemically related to oxymorphone and narcan- equally as potent as morhpine

Question 15

Where is Nalbuphine most used?

Answer 15

obstetrics

Question 16

describe Butorphanol (Stadol)

Answer 16

opioid agonist-antagonist; agonist effects 20x more than pentazocine and antagonist actions 10-30x pentazocine

Question 17

Describe Narcan

Answer 17

opioid antagonist- used to treat opioid induced depression, overdose, detect physical dependence

Question 18

Describe how you should give Narcan

Answer 18

should be carefully titrated 20-40 mcg IV to avoid produceing severe pain (sudden antagonism of opioid can cause HTN, tachycardia, dysrhythmias, pulmonary edema)

Question 19

What is the duration of action of Narcan?

Answer 19

1-4 hours

Question 20

Name opioid agonists

Answer 20

morphine, demerol, fentanyl (and others), codeine, dilaudid, oxy, methadone, heroin, tramadol

Question 21

Name agonists-antagonists

Answer 21

pentazocine, butorphanol, nalbuphine, buprenorphine, nalorphine, bremazocine, dezocine, meptazinol

Question 22

Name opioid antagonists

Answer 22

naloxone, naltrexone, nalmefene

Question 23

List the opioids from least to most potent

Answer 23

Demerol < morphine < alfentanil < fentanyl < remifentanil < sufentanil

Question 24

Potency of demerol compared to morphine

Answer 24

1/10

Question 25

Potency of alfentanil to morphine

Answer 25

10-20x

Question 26

Relative potency of fentanyl to morphine

Answer 26

100x (10 mg morphine = 100 mcg fentanyl)

Question 27

potency of remifentanil to morphine

Answer 27

250 ( 10 mg morphine= 40 mcg remifentanil??)

Question 28

potency of sufentanil to morphine

Answer 28

500-1000x

Question 29

Relative potency of dilaudid to morphine

Answer 29

0.1 (10 mg morphine=1 mg dilaudid?)

Question 30

Relative potency of meperidine to morphine

Answer 30

7.5 (10 mg morphine = 75 mg Demerol)

Question 31

Schedule 1 drugs

Answer 31

heroin, LSD, cannabis, qualudes, ecstasy (3,4 methylnedioxymethamphetamine)

Question 32

Schedule 2 drugs

Answer 32

cocaine, amphetamines, pentobarbital, etorphine, fentanyl, codeine, other opioids

Question 33

Schedule 3 drugs

Answer 33

barbiturates, hydrocodone, ketamine

Question 34

Schedule 4 drugs

Answer 34

diazepam, phenobarbital, butorphanol, phenobarbital

Question 35

Schedule 5 drugs

Answer 35

buprenorphine, diphenoylate, codeine, cough syrup