Opioids

Question 1

✓ Natural and from phenanthrene group

Answer 1

Morphine, codeine, and thebaine

Question 2

✓ Natural and from benzylisoquinoline

Answer 2

Papaverine, noscapine, and narcein.

Question 3

-Semisynthetic
-More potent than morphine
-Rapid onset and shorter duration
-Not used clinically bec they are highly addictive

Answer 3

Heroin( diacetylmorphine) and hydromorphone

Question 4

Synthetic and they are agonist

Answer 4

✓ Meperidine family
✓ Methadone family
✓ Tramadol

Question 5

Synthetic and they are mixed agonist antagonist

Answer 5

Nalorphine
Nalbuphine
Pentazocine
Butorphanol
Bupernorphine

Question 6

Synthetic and they are antagonist

Answer 6

Naloxone
Naltrexone

Question 7

Bioavailability is 60%

Answer 7

Codein

Question 8

Analgesic potency is 10-20%

Answer 8

Codeine

Question 9

More potent cough suppressant

Answer 9

Codeine

Question 10

Little euphoria effect

Answer 10

Codeine

Question 11

Methylmorphine is a demethylation of morphine

Answer 11

Codeine

Question 12

Analgesic for mild to moderate pain usually combine with paracetamol

Answer 12

Codeine

Question 13

Used as central antitussive

Answer 13

Codeine

Question 14

Adverse effect less than morphine

Answer 14

Codeine

Question 15

Adverse effects:
✓ constipation
✓ RC depression

Answer 15

Codeine

Question 16

• Synthetic and full agonist with
• Better absorbed orally and has greater bioavailability than morphine

Answer 16

Meperidine ( pethidine)

Question 17

Analgesic potency is 10% of morphy

Answer 17

Meperidine (pethidine)

Question 18

Used as analgesic in the following cases:
✓ Inferior myocardial infarction bec the patient has bradycardia
✓ during labour bec it is shorter in Duration and doesn’t prolong labour

Answer 18

Meperidine (pethidine)

Question 19

✓ addiction liability but less than morphine

Answer 19

Codeine and Meperidine ( pethidine)

Question 20

Cause histamine release and bronchoconstriction

Answer 20

Meperidine

Question 21

Has weak atropine like actions ( dry mouth, tachycardia )

Answer 21

Meperidine

Question 22

No GIT
NO antitussive
NO vagal stimulant effects

Answer 22

Meperidine

Question 23

Synthetic derivatives of Meperidine

Answer 23

Fentanyl and alfentanil

Question 24

The most potent and the shortest duration opioid agonists

Answer 24

Fentanyl and alfentanil

Question 25

Analgesic in severe pain as long acting transdermal skin patch

Answer 25

Fentanyl and alfentanil

Question 26

12 microgram patch =~ 30mg oral morphine daily

Answer 26

Fentanyl

Question 27

Analgesic effect equal to morphine

Answer 27

Methadone

Question 28

Longer duration than of morphine ( t 1/2 ) is 24h

Answer 28

Methadone

Question 29

Used in treatment of chronic opiate and heroin users

Answer 29

Methadone

Question 30

Can satisfy the craving need of the patient with less addictive features

Answer 30

Methadone

Question 31

Has withdrawal symptoms less than the other opioids

Answer 31

Methadone

Question 32

Has two different mechanisms ✓ Binds to the mu opioid receptor ✓ inhibits the re-uptake of serotonin and NA

Answer 32

Tramadol

Question 33

Used as analgesic for moderate to severe pain ( especially musculo- skeletal pain )

Answer 33

Tramadol

Question 34

Has relatively fewer side effects than most opioid but addiction can occur

Answer 34

Tramadol

Question 35

May induce seizures in epileptic patients

Answer 35

Tramadol

Question 36

Have agonist activity on kappa receptors

Answer 36

Nalbuphine, pentazocine, and Butorphanol

Question 37

Have antagonist or partially agonist activity on mu receptors

Answer 37

Nalbuphine, pentazocine, and Butorphanol

Question 38

Their analgesic activity and respiratory depression are less marked than morphine

Answer 38

Nalbuphine, pentazocine, and Butorphanol

Question 39

Increase systemic and pulmonary vascular resistance lead to high cardiac load so they are contraindicated in acute myocardial infarction

Answer 39

Pentazocine and Butorphanol

Question 40

Competitive blockers of all opioid receptors

Answer 40

Naloxone and naltrexone

Question 41

Is given I.V and has short t 1/2 ( ~1h )

Answer 41

Naloxone

Question 42

Could be administered orally and has longer ( t 1/2 ) 48h

Answer 42

Naltrexone

Question 43

Can precipitate severe withdrawal syndrome if administered to opioid-addict patient

Answer 43

Naloxone and naltrexone

Question 44

Used in treatment of acute opioid toxicity ( the adverse respiratory and CVS effects of opioids are reversed within 1-2 min and lasts for 1-2hrs

Answer 44

Naloxone

Question 45

Is given during labour to mothers, who received opioids, to prevent neonatal respiratory depression or it can be given to the neonate via the umbilical vein

Answer 45

Naloxone