Opioids

Question 1

define analgesia

Answer 1

no pain felt even though there is painful stimuli

Question 2

what are the neurotrans released by descending pain inhibitory tracts

Answer 2

serotonin
enkephalin
NE

Question 3

endgenenous opioid peptides

Answer 3

enkaphlins
endorphins
dynorphins

Question 4

what are the opioid receptors

Answer 4

mu receptor
kappa receptor
delta receptor

Question 5

what binds to the mu receptor endogenously

Answer 5

enkaphlins, beta endorphins

Question 6

what does binding of ligand to the mu, kappa, and delta receptors cause?

Answer 6

activation of Gi, which inhibits adenylate cyclase, decreasing cAMP—net result is decreased release of neurotransmitters

Question 7

where are opioid receptors found?

Answer 7

periaquaductal gray
dorsal horns of sp cord
medulla
hypothalamus
GI
heart

Question 8

what receptors and in what location may be involved in drug dependence

Answer 8

mu and delta receptors in limbic areas

Question 9

what receptors and in what location may be involved in dysphoria

Answer 9

kappa receptors in limbic areas

Question 10

definition of narcotic

Answer 10

morphine like drugs and other abused substances

induce sleep like state and could or could not be analgesic

Question 11

opioid metabolism

Answer 11

by liver

Question 12

analgesic effect-compare among opioids

Answer 12

full agonists equally effective, except codeine and propxyphene

Question 13

what effects do opioids have

Answer 13

analgesic

cough supression: codeine, dextromethorphan. Dextromethorphan doesn’t bind to opioid receptors

antidiarrheal, constipation (mu receptors on GI nerves)

euphoria, followed by sedation

respiratory depression (due to reduced sensitivity of brainstem chemoreceptors to CO2)

nausea (through activating chemoreceptor trigger zone in area postrema)

endocrine: reduces LH release (mu), increases ADH production (mu), decreases ADH secretion (kappa)

miosis (activates Edinger Westphal nucleus)

tolerance

physical dependence

Question 14

tolerance in opioids rapidly, more gradually, and doesn’t develop for what?

Answer 14

rapidly: nausea and vomiting
gradually: analgesia, euphoria, respiratory depression, endocrine effects

no tolerance develops for: miosis, constipation

Question 15

cross tolerance for opioids develops with what?

Answer 15

other mu agonists

Question 16

symptoms of morphine withdrawal

Answer 16

6-12 hr: drug seeking, restlessness, lacrimation, sweating
12-24 hr: restless sleep, tremor, gooseflesh, anorexia
24-72 hr: greater intensity of above, depression, nausea, vomiting, diarrhea, increased HR and BP, involuntary movements, pain

Question 17

opioid abuse is a problem for

Answer 17

prescription opioids

Question 18

treatment of opioid abuse

Answer 18

methadone
subuxone (buprenorphine/naloxone sublingual)
naltrexone

behavioral