2.1.1

Question 1

which receptors are responsible for analgesia

Answer 1

mu kappa and delta on multiple levels in CNS

Question 2

which receptor agonists mediate cough

Answer 2

mu

Question 3

which receptors mediate muscle rigidity

Answer 3

mu kappa and delta in nigrastriatal tract

Question 4

which receptors mediate sedation

Answer 4

mu and kappa inhibits locus ceruleus

Question 5

which receptors agonists decrease gastric secretion and greatly impair gastric motility and slow voiding

Answer 5

mu agonists

Question 6

respiratory depression is caused by ___ agonists in the _____

Answer 6

mu medulla

inhibits medulla CO2 feedback control and results in toxic buildup of CO2 in blood

Question 7

activation of ___ and ___ receptors in the ____ inhibits (inhibitory) GABA interneurons causing increase in dopamine

Answer 7

mu and delta

Question 8

___ agonists inhibit DA neurons, causing dysphoria

Answer 8

kappa

Question 9

miosis mediated by activation of ___ and ___ receptors in Edinger-Westphal nucleus

Answer 9

mu and kappa

Question 10

___ agonists may induce nausea and vomiting through direct and indirect menas

Answer 10

mu

Question 11

activation of ___ receptors produce seizures via disinhibition of inhibitory motoneurons in brain stem

Answer 11

delta

Question 12

no direct CV effect but indirect effect mediated through increased ____ release which indirectly causes peripheral vasodilation, which exacerbated shock and results in fainting

Answer 12

histamine

Question 13

smooth muscle contraction is mediated by ___ and ____ receptors, but indirectly by _____

happens in GI but increases constriction in bronchi, closing airway and lungs (worsens asthma)

Answer 13

mu and delta

Question 14

___ receptors directly ___ bladder voiding and __ increase tone and release of ACTH

Answer 14

increase increase

Question 15

___ agonists in the uterus inhibit the effects of oxytocin, prolonging labor

Answer 15

mu

Question 16

2 patient complaint

Answer 16

itching

Question 17

___ receptors in hypothalamus inhibit gonadotropins, growing may worsen

Answer 17

mu

Question 18

the reduction in response to an opioid after repeated admin

Answer 18

tolerance

Question 19

a state that develops due to adaptive responses in the organism to repeated opioid admin, a person in this adapted state requires increased continued opioid admin to maintain normal function

Answer 19

physical dependence

Question 20

the only actual evidence of physical dependence; occurring when opioid admin in a physically dependent organism is abruptly d/c

Answer 20

withdrawl syndrome

Question 21

withdrawal symptoms start ___ after last dose of opioid

Answer 21

3-5hrs

Question 22

early stage of opioid withdrawal

Answer 22

good-like flesh, piloerection, muscles spasms, pupil dilation, insomnia, growing anxiety, yanwning, escalating (uncontrollable craving for opioids)

Question 23

24-72 hours (late stage)

Answer 23

nausea, severe cramps, aching joints, severe dysphoria, massive anxiety, increased blood pressure (indirect effect), tachycardia (indirect effect)

Question 24

7 days after last dose

Answer 24

physical symptoms somewhat better, but may persist depending on patient and history of use, psychological craving for opioids persists

Question 25

abuse liability seems to correlate with ___ solubility

Answer 25

lipid fentanyl > heroin > morphine > methadone

Question 26

5 anatomical levels of opioid analgesia

Answer 26

dorsal root ganglion, spinal cord dorsal horn, spinal cord ventral horn, thalamus, activation of descending inhibitory pain pathway

Question 27

c6 -c8 modifications (in hydromorphone) _____

Answer 27

increase potency 4-6

Question 28

c14 hydroxy (in oxymorphone) significantly ___

Answer 28

increases mu opioid receptor affinity