Opioid

Question 1

Mnemonic
Monkeys Play Tennis Make Beautiful Noises, Never Fear

Answer 1

Monkeys: morphine
play :pethidine
Tennis :Tramadol.
Make : Methadone
Beautiful: Bueprinorphine
Noises : Nalaxon
Never : Naltoxan
Fear : Fentynl

Question 2

Mention weak opoid.

Answer 2

Propoxyphene

Question 3

parial agonist

Answer 3

Bupernorphine

Question 4

Actions of Morphine

Answer 4

Morphine mnemonic

M: mu agonist Kappa + delta

0: opiod agonist

R: Reduce pain preception

P: Sedation

H: Hind release of NT (substance p)

I: inhibit Ascending pain pathway

N: numb pain sensation

E: Enhance pain tolerance

Question 5

Morphine indication?

Answer 5

MORPHINE mnemonic

M : moderate: Sever pain

0: opiod analgesic for acute pain

R: Respiratory distress in pallitive case

P: post-operative pain mangement. H: Hospital, end of Life care

I : ischemic chest pain (angina)

E: Emergency pain control (burns, Traum)

Question 6

Morphine Adverse effects.

Answer 6

• Miosis no tolerance

• Constipation
can’t tolerated.

Respiratory Depression

physical dependance

Hypo tension

Itching -puritis

Nause and vomiting

Euphoria and sedation

Question 7

Drug Treat Acute Morphine Toxicity

Answer 7

Naloxone

Question 8

Contra indications of Morphine.

Answer 8

M: Mythenia gravis

O: Obstructive Sleep Apnea

R: Respiratory depression

p: pregnancy (neonatorum asphyxia )

H: Head injury ↑ ICP

I: Intestinal obstruction

N: Not in Liver, kidney diseases

E: Elder people (Hypothyrodism)

Question 9

indication of Pethidine (Mepridine)

Answer 9

• Acute moderat: sever pain
  Not more than 48 hr

2- Labour pain

3- Colic pain.

Safe in Labour (√ Asphyxia neonatorum) Less Constipation

Question 10

Advese effects of pethidine

Answer 10

↑ convlusions: Toxic norpethidin XX > 48 hr.

Serotonergic effect (1 Seretonin) Don’t use with MAOI

Question 11

Two drugs
Not used with MAOI
(seretonin)
Both decrease constipation, Respiratory distress , dependance!

Answer 11

Play Tennis

• Pethidine ( seretongic effect)

-Tramadol Seretonin syndrom.

Question 12

uses of Tramado L

Answer 12

1- chronic moderate pain

2- Neuropathic pain.

Question 13

which drug antagonise Tramadol.

Answer 13

partially by Naloxone

Question 14

Methadone indications.

Answer 14

1- opoid addicts (Replace) Less withdrawal symptoms oral-active, Long acting → Less Craving sensation علاج الدمنین .

2- Chronic pain severe

Question 15

why Methadone Cause Arrythmia?

Answer 15

↑ QT interval

MI

Time From Ventricular contraction to Relaxation

Question 16

Buprenorphine (partial agonist) indication?

Answer 16

1- Methadon replacement بديل في علاج المدمنين
D.t
Sublingal long activing less Craving and sedation

2- Severe pain.

Question 17

Respiratory distress and Buprenorphine

Answer 17

Doesn’t increase with Increasing The dose (ceiling)

But if it happened, can’t reserved (High affinity to receptors)

Question 18

indications of Naloxone

Answer 18

1- Acute opiod Toxicity short acting-repeated”

2- Asphyxia neonatorum

3- Antagonise Tramadol.

4- Antagonize Respiratory depression of Morphine

Question 19

indications of Naltrexone.

Answer 19

1-opiod abuse (after Full detoxification by

Plethidine or Burponorphine

2- Alcohol abuse

maintenance
Euphoria block & craving in alcholol addictics

Question 20

indications of Fentanyl.

Answer 20

1- Anesthesia

2- pre anethestic medication

3- Conscious Sedation + Midazolam-

4-Neuro lept analgesia + Droperidol

5-Neuroleptane thesia O2+N20

Question 21

drugs used in Conscious Sedatation

Answer 21

1- Fentany L

2- Midazolam

Question 22

drugs used in Neurolept analgesia

Answer 22

1- Fentanyl

2- Droperidol

Question 23

drugs used in Neurolept anethesia

Answer 23

Fentanyl + N2O + CO2