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C81ADD > Opioids > Flashcards

Opioids Flashcards

1
Q

What are the 3 opiates?

A

Codeine, morphine and thebaine.

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2
Q

What is an opioid?

A

A natural or synthetic exogenous drug that mimics morphine.

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3
Q

What is the only semi-synthetic exogenous opioid?

A

Heroin.

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4
Q

What are the synthetic exogenous opioids?

A

Methadone and fentonyl.

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5
Q

What are the endogenous opioids?

A

Enkephalins and endorphins.

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6
Q

What are the semisynthetic narcotics that contain morphine?

A

Heroin and hydromorphone.

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7
Q

What are the semisynthetic narcotics that contain thebaine?

A

Oxycodone and etorphine.

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8
Q

What are some totally synthetic narcotics?

A

Pentazocine, meperidine, fentanyl, methadone, LAAM and propoxyphene.

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9
Q

What is the difference between an opioid and an opiate?

A

Opioids are any drug that mimics morphine, opiates are non-synthetic opioids.

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10
Q

How do you make heroin?

A
  1. Grow a papaver somniferum (sleep-inducing poppy)
  2. Wait until the flowers’ petals fall
  3. Slit the egg-shaped seed pod
  4. Collect the milky sap - crude opium!
  5. It thickens and darkens
  6. Boil it in lime, organic detritus sinks
  7. This leaves a white top layer of morphine, which can be modified to create heroin.
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11
Q

Approximately what percentage (by weight) of opium is morphine (McKim, 2003)?

A

10%

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12
Q

Approximately what percentage (by weight) of opium is codeine (McKim, 2003)?

A

0.5%

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13
Q

The pharmacological effects of morphine and heroin are essentially identical because…

A

Heroin is converted into morphine in the brain.

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14
Q

When is heroin more potent than morphine?

A

When injected - the acetyl groups in the molecule make it more lipid soluble and it gets to the brain faster.

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15
Q

Water molecule charge movement causes HOH to ionize, becoming…

A

H+ OH-

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16
Q

Where morphine has an two OHs (hydroxyls), heroin has…

A

CH3COO - acetyl/ethyls

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17
Q

Why does fat solubility increase heroin’s potency?

A

Because blood-brain barrier has a bilayered phospholipid membrane which is impenetrable to ionised molecules (morphine), but not for non-ionised molecules (heroin).

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18
Q

What do exogenous opioids do in the CNS?

A

They hijack the endogenous system (for endorphins etc.), affecting mu, kappa and delta receptors.

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19
Q

What is nociception?

A

Pain perception.

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20
Q

What is the pre-thalamic destination of nociception?

A

The dorsal horn of the spine. Then goes to the thalamus.

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21
Q

What is the cortical destination of nociception?

A

The somatosensory cortex.

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22
Q

What is the path for peripheral to central sensation for vision?

A

Optic chiasm, LGN (thalamus), visual cortex.

23
Q

What is the path for peripheral to central sensation for audition?

A

Cochlear nucleus and inferior colliculus, medial geniculate nucleus (thalamus), auditory cortex.

24
Q

How do opioids affect the nociception pathway?

A

Fibres from the periaqueductal grey (midbrain) descend onto the dorsal horn and turn down nociception sensitivity.

25
Q

Where has evidence of opium use been found?

A
  • Ceramic bowls in Brittany
  • Paleobotanical evidence from Neolithic sites in Southern Spain (4200 BC)
  • The Odyssey - mixed with wine by Helen to cheer up Telemachus.
  • Galen prescribed it
  • Paracelsus referred to it in 1520.
26
Q

Who popularised Laudanum use in Britain?

A

Thomas Sydenham (1924-1689), mixed with wine.

27
Q

Who isolated morphine, and when?

A

German pharmacist Friedrich Sertuerner in 1803. Named it after morpheus, Greek god of dreams.

28
Q

Who isolated codeine?

A

French chemist Pierre Robiquet in 1821.

29
Q

What is codeine also known as?

A

Methoxymorphine.

30
Q

Why are over the counter pain drugs containing morphine illegal in some countries, such as Greece?

A

Because of how addictive they are.

31
Q

Who produced diacetylmorphine?

A

English chemist C R Alder Wright in 1874. Cooked with acetic acid.
Also discovered by Hoffman and Dresser in 1898.

32
Q

What is diacetylmorphine?

A

Heroin.

33
Q

What company produced heroin, and when and why did they stop?

A

Bayer. In 1913 when it became apparent that it was in fact addictive.

34
Q

What did Siegel et al (1982) do?

A

Divided rats into 3 groups - similarly tested, differently tested and control only - and gave them injections of heroin (dextrose for control only) in either the same or a different room to the test injection.

35
Q

What did Siegel et al (1982) find?

A

Mortality rates were 32%, 64% and 96% respectively.
Therefore: slow does increase before test improves prospects, showing that some tolerance/adaptation occurs. Also, some of these are psychological - the environment is the CS which signals heroin.

36
Q

What did Siegel (1978) do?

A

3 groups of rats again, two boxes, morphine and saline. Temperature first increased in response to morphine then developed tolerance. When sal-room condition given morphine in the room they usually had saline, they became hyperthermic - environment.

37
Q

What bodily systems do opiates primarily affect?

A

The intestines and the CNS.

38
Q

What follows an acute effect?

A

An opposing effect.

39
Q

The initial effect of analgesia is followed by…

A

Pain

40
Q

The subsequent effect of yawning is preceded by…

A

Respiratory depression

41
Q

Opiate-induced euphoria is followed by…

A

Dysphoria

42
Q

The acute effects of opiates include lowered BP and pupil constriction, which is later followed by…

A

Increased BP and pupil dilation

43
Q

Flushed, warm skin immediately after taking opioids is followed by…

A

Goosebumps.

44
Q

What is the term for pupil constriction?

A

Miosis

45
Q

What is the term for pupil dilation?

A

Mydriasis

46
Q

What changes in terms of the net effect of morphine after many injections?

A

The initial effect remains the same, but the opponent effect starts sooner and counteracts it, meaning that the net effect is a lower initial spike.

47
Q

What happens to the effect graph of taking a larger dose of morphine having developed tolerance to a lower dose?

A

Although the opponent effect starts earlier, the net effect spike is as high as a normal dose without tolerance.

48
Q

What hedonic assumption do theories of action-outcome learning (Thorndike, 1911) make?

A

Actions that obtain favourable outcomes are more likely to be repeated.

49
Q

According to action-outcome learning, when might drug-related actions become more likely to re-occur?

A

When taken during opposing effect - e.g. dysphoria is -100, drug increases to +100 is a very large hedonic change.

50
Q

What type of receptors does methodone affect?

A

It’s a mu-receptor agonist.

51
Q

How is methodone usually taken?

A

Orally

52
Q

How does methodone work in relieving heroin addiction?

A

It reduces craving, and thus relapse, whilst not giving extreme effects.

53
Q

What are the long-term effects of methodone?

A

No organ damage, patient capable of working, but does produce problems with libido and excessive sweating.

C81ADD (13 decks)

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