C. Opioid Tolerance

Question 1

Define tolerance

Answer 1

The need to increase the dose to maintain a given effect

Question 2

Define dependance

Answer 2

Physical and psychological dependance

Question 3

Cross Tolerance

Answer 3

One drug causes tolerance to a different drug due to same pharmacological class

Question 4

What are the symptoms of opioid withdrawal ?

Answer 4

Severe influenza-like symptoms:

• Restlessness
• Yawning
• Pupillary dilation
• Fever
• Sweating
  -Piloerection
  -Nausea
  Diarrhoea
  -Insomnia
• Involuntary leg movement
  -Goose pimples

Question 5

When do the symptoms disappear?

Answer 5

10 DAYS AND MAXIMAL SYMPTOMS AROUND DAY 2

Question 6

How are opioid induced symptoms reversed ?

Answer 6

Re-administration of opioid agonist

Question 7

What can be used to treat acute opioid toxicity ?

Answer 7

Naloxone as it locks opioid receptors

Question 8

What are opioid withdrawal symptoms treated with?

Answer 8

Loperamide 
Mebeverine 
Paracetamol 
Metoclopramide 
short acting benzodiazepide 
Clonidine

Question 9

What can be given as substitution therapy to reduce craving for heroin?

Answer 9

Methadone

Buprenorphine

Question 10

Methadone properties

Answer 10

An opioid with longer half life

Taken by mouth under supervision

Less likely to produce heroin like highs

Danger of respiratory depression in overdose