Exam 2; Narcotic Analgesics (Opiates)

Question 1

These are the very best analgesics which were drastically changed with the invention of the hypodermic syringe

Answer 1

opiates

Question 2

What is the analgesic effect of opioids on the CNS

Answer 2

decrease the perception of pain and the response to the pain

some sedation

Question 3

How do opioids affect mood

Answer 3

they elevate mood; even induce euphoria

Question 4

opioids have a direct effect on the chemoreceptor trigger zone in the CNS causing what

Answer 4

nausea

Question 5

opioids have an effect on the brain respiration center which can lead to what

Answer 5

decreased respiration; typically dying of an OD is in conjunction with ethanol and they “just forget to breathe”

Question 6

opioids stimulate the nucleus of the oculomotor nerve cause what

Answer 6

pupil constriction; “pin-point-pupils”

hyperthermia

Question 7

What is the effects of opioids on the GI system

Answer 7

they cause random contraction leading to constipation

Question 8

What are three effects of opioids

Answer 8

vasodilation
orthostatic hypotension
increased CSF pressure
increased release of histamine; bronchconstriction and itching

Question 9

All of the opioids can pass what

Answer 9

the placenta

baby will be born with high levels and will go through withdrawal

Question 10

opioids act on what

Answer 10

specific opioid receptors

Question 11

opioids look a lot like what three things

Answer 11

endogenous opiate-like peptides
enkephalines
endorphins
dynorphins

Question 12

What is the most significant opioid receptor

Answer 12

μ; mu

Question 13

What are five symptoms of opioids on the μ receptor

Answer 13

pain
euphoria
cough
respiration depression
gut motility

Question 14

The activation of opioid receptors leads to a decrease in this

Answer 14

cAMP

Question 15

This is related both to the pleasure of the addictive experience and the dear of the consequence of withdrawal

Answer 15

addiction

Question 16

This is when you need more of something to satisfy your need; continuously increase the dose to get the desired effect

Answer 16

tolerance

Question 17

This is the adaptation to the presence of the drug therefore the effects of stopping the drug are the opposite of the drug itself

Answer 17

withdrawal

Question 18

What are four symptoms of opioid withdrawal

Answer 18

skin; severe vasoconstriction “cold turkey”

GI; extremely active, cramping, diarrhea, nausea

Question 19

What are the two treatment for opioid withdrawal

Answer 19

“cold turkey” no treatment

ultra-rapid withdrawal; ovoid blocker under general anesthesia

Question 20

This is a natural analog opiate agonist usually given parentally because it undergoes first pass metabolism

Answer 20

morphine

Question 21

This is a natural analog opiate partial agonist with low anti-nociceptive effects; great anti-tussive effect

Answer 21

codeine

Question 22

This is a semisynthetic opiate agonist which is 5x more potent than morphine

Answer 22

heroin

Question 23

This is a semisynthetic opiate agonist which is 10x more potent than morphine

Answer 23

hydromorphone

Question 24

This is a semisynthetic opiate agonist that is 0.5% less potent than morphine and is available in oral form

Answer 24

oxycodone

Question 25

This is a synthetic opiate agonist that is 80-100x more potent that morphine

Answer 25

fentanyl

Question 26

What are five synthetic opiate agonists

Answer 26

``` sufentanil (500-600x more potent than morphine) alfentanil remifentanil oxymorphone levorphanol ```

Question 27

This synthetic opiate agonist is 0.5 less potent than morphine but there is no pupil constriction

Answer 27

meperidine

Question 28

This synthetic opiate agonist is orally effective due to giving in it a liquid form that is harder to abuse

Answer 28

methadone

Question 29

These are three opiate receptor blockers used in emergencies

Answer 29

naloxene naltrexone methyltrexone

Question 30

These are two agents that work as a combination of opiate activity and SSRIs

Answer 30

tramadol | tapentadol

Question 31

When should opiates be used

Answer 31

in the control of PAIN in cancer, burn patines, trauma, allowing them to lead normal lives addiction is rare in patients that need the pain control to function

Question 32

Opiates analogs without CNS effects can be used to treat what

Answer 32

diarrhea and cough

Question 33

What are the four things that opiates should never be used for

Answer 33

undiagnosed pain head injury; increase intracranial pressure convulsive disorder; may increase seizures respiratory difficulties