Opiates

Question 1

Pure Opioid Antaganists

Answer 1

Naloxone
Naltrexene
Nalmefene

Question 2

Mixed Opioid Agonist-Antagonists

Answer 2

Buprenorphrine - mu agonist, kappa antagonist
Nalbuphine - kappa agonist, mu antagonist

• bumuka
• nakama

Question 3

Opioid Agonists

Answer 3

Morphine
Methadone
Fentanyl
Meperidine

Hydromorphone
Oxycodone
Sufentanil, alfentanil, remifentanil

Question 4

Antitussives

Answer 4

Dextromethorphan

Codeine, Levopropoxyphene

Question 5

Other Analgesics Used in Moderate Pain

Answer 5

Tepentadol

Tramadol

Question 6

Endogenous opioid peptides

Answer 6

Dynorphin
Enkephalin
Endorphin

Question 7

Natural opium alkaloid

Answer 7

Morphine

• prototype opioid agonist, comes from opium which is obtained from the poppy of Papaver somniferous and P.album.
• other naturally occurring alkaloids include:
  Codeine, Thebaine, and papaverine

Question 8

Oldest opioid with mixed receptor actions.

Answer 8

Pentazocine

Question 9

The major analgesic opioid receptr

Answer 9

mu receptor

Question 10

Adverse Effects of opioid analgesics as seen in addicts can lead to:

Answer 10

hyperalgesia

Question 11

Adverse effects with chronic use of opioid analgesics

Answer 11

hypogonadism, immunosuppression, increased feeding, increased growth hormone secretion, withdrawal effets, tolerance, dependence, abuse, addistion, hyperalgesia, impairment while driving

Question 12

Adverse effects with acute use of opioid analgesics

Answer 12

respi depression, N/V, pruritus, urticarial, constripation, urinary retention, delirium, sedation, seizure, myoclonis

Question 13

Tramadol Toxicity

Answer 13

Serotonin Syndrome

inc. seizures, devt serotonin syndrome, nausea, dizziness

Question 14

This occurs when repeated doses of opioids have a diminishing analgesic effect

Answer 14

tolerance

Question 15

Strong agonist opioid assoc with QT- based cardia arrhythmias

Answer 15

methadone

Question 16

Effect of heroin intake by the mother during pregnancy to her baby include

Answer 16

shrill crying, irritability, diarrhea, seizures

Question 17

This over-the-counter opioid containing cold/cough medicine was banned in children below 6 yo because of reports of death

Answer 17

dextromethorphan

Question 18

used in sedating mammals like elephants

Answer 18

Carfentanil (extremely potent analog used in veterinary esp in malalaking animals)

Question 19

tx for post operative ileus ff bowel rsection surgery

Answer 19

alvimopan

Question 20

maintenance drugs for addics in treatment programs

Answer 20

naltrexone

Question 21

tx for constipation in pt with late stage advanced illness

Answer 21

Methylnaltrexone bromide

Question 22

tx for acute opioid overdose

Answer 22

naloxone

Question 23

phenylpiperidine derivative opioid used to control diarrhea due to action on peripheral mu-opioid receptpr and lack of effect on the CNS receptors

Answer 23

loperamide

diphenoxylate also indicated for diarrhea

Question 24

detox of heroin dependent addict

Answer 24

methadone

Question 25

maintenance drugs for addics in treatment programs

Answer 25

naltrexone

Question 26

contraindicated for opiates

Answer 26

increased ICP pregnancy, impaired pumo/hepatic/renal function, endocrine dse, combi use of pure agonist with weak partial agonist

Question 27

opioids inhibit the release of

Answer 27

luteinizing hormone

Question 28

opioid with most pronounced anti-shivering properties | thru alpha-2 adrenoreceptors

Answer 28

meperidine

Question 29

drug group that is relative contraindication to al opioid analgesics because of high incidence of hyperpyrexic coma

Answer 29

monoamine oxidase inhibitors

Question 30

this long acting phenanthrene derivative opioid available in transdermal patch preparations is both a partial mu receptor agonist and an antagonist at the kappa and delta receptors

Answer 30

buprenorphine

Question 31

when starting an opiod therapy... a. start with the highest dose of opioid b. establish a therapeutic goal before starting c. multiple prescribing physicians are recommended d. early refills are beneficial

Answer 31

b

Question 32

tx for pt with dyspnea from pulmonary edema assoc with left ventricular HF

Answer 32

morphine

Question 33

opioid available in nasal formulation

Answer 33

butorphanol