S2_L2: Analgesics Flashcards

1
Q

Match the uses for the following drug category.

  1. opioids
  2. NSAIDs
  3. Steroids
  4. Non-opioids

A. Pain
B. Inflammation
C. Both A & B

A
  1. A
  2. C
  3. B
  4. A
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2
Q

Opioids come what which plant?

Name the generic/common and scientific name of the plant.

A

Common Name: Opium Poppy Plant
Scientific Name: “Papaver Somniferum”

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3
Q

This is when an MD needs to adjust the dose/shift to another drug/add another drug on top to produce the same effect. It happened due to chronic use/ intake.

A

Tolerance

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4
Q

This is when an individual experiences symptoms due to sudden discontinuation from chronic use of drugs

A

Withdrawal

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5
Q

determine which brain structure utilizes the following receptor subtype

  1. Hippocampus
  2. globus pallidus
  3. corpus striatum

A. delta
B. mu
C. kappa
D. sigma

A
  1. D
  2. A
  3. A
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6
Q

determine which brain structure utilizes the following receptor subtype

  1. deep layers of cerebral
    cortex
  2. hypothalamus
  3. limbic system

A. delta
B. mu
C. kappa
D. sigma

A
  1. C
  2. B
  3. B
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7
Q

determine which brain structure utilizes the following receptor subtype

  1. periaqueductal gray
  2. Substantia nigra
  3. medial thalamic nuclei

A. delta
B. mu
C. kappa
D. sigma

A
  1. B
  2. A
  3. B
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8
Q

determine which brain structure utilizes the following receptor subtype
1. lamina II
2. substantia gelatinosa
3. dorsal horn of spinal gray matter

A. delta
B. mu
C. kappa
D. sigma

A

All C

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9
Q

determine which response results from the following receptors. answers for each number may be up until 2-3.

  1. Supraspinal analgesia
  2. Spinal analgesia
  3. dysphoria

A. delta
B. mu
C. kappa
D. sigma

A
  1. B
  2. C
  3. D
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10
Q

determine which response results from the following receptors. answers for each number may be up until 2-3.

  1. hallucination
  2. pressed flexors reflexes
  3. euphoria

A. delta
B. mu
C. kappa
D. sigma

A
  1. D
  2. C
  3. A & B
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11
Q

Enumerate the 3 receptors which has a LOW abuse potential.

A
  1. kappa
  2. delta
  3. sigma
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12
Q

The following are common manifestations of the abstinence syndrome, EXCEPT:

A. Runny nose
B. Sneezing
C. Shivering
D. Fever
E. Hypotonicity

A

E. Hypotonicity

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13
Q

Select the letter/s which represents the common manifestations of the abstinence syndrome:

A. Body aches
B. Depression
C. Diarrhea
D. Anorexia
E. Goosebumps

A

A, C, E only

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14
Q

Select the letter/s which represents the common manifestations of the abstinence syndrome:

A. Nausea/vomiting
B. Weakness
C. Uncontrollable yawning
D. Tachycardia
E. Loss of appetite

A

All are manifestations

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15
Q

TRUE OR FALSE: Non-opioids are effective for pain & inflammation management.

A

False

It is only for pain relief

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16
Q

TRUE OR FALSE: Codeine is an antihistamine used for dry, irritating cough.

A

False

It is an antitussive (cough suppressants)

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17
Q

TRUE OR FALSE: The use if opioids requires a prescription from a doctor with a S2 License.

A

True

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18
Q

TRUE OR FALSE: The delta receptor subtype may also target limbic structures

A

True

This is the reason why its activation may also result to euphoria

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19
Q

TRUE OR FALSE: Morphine can be given through oral form, IV injection, and through the subdural
space for pain management

A

False

epidural*

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20
Q

TRUE OR FALSE: The classic receptors drug of morphine is Mu. The classic side effect of opioids is euphoria

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

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21
Q

TRUE OR FALSE: CNS has specific receptors for opioids. This drug is able to bind on both the PNS and CNS

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

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22
Q

TRUE OR FALSE: Among the receptor subtypes, (mu, delta, kappa, sigma), the Mu receptors has the best pain modulation effect. Stimulation of Sigma receptors result in restlessness and agitation

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

Explanation:
1. Mu targets supraspinal areas
2. Dysphoria results when acting on hippocampal areas

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23
Q

What is the active substance obtained from the latex of the poppy plant?

A

Alkaloids

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24
Q

TRUE OR FALSE: Opioids results in pupillary vasoconstriction when overdosed. Another s/sx of overdose from opioids is respiratory depression

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

Miosis = pupillary vasoconstriction

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25
Q

What part of the opium poppy plant is used for opioid analgesics?

A

latex (sap) that comes with scarring the raw bud

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26
Q

what is the gold standard for all opioids?

A

morphine

NOTE: it is the classic
opioid analgesics for acute and chronic pain

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27
Q

This is an illegal drug sold in the black market. It is a mult-dollar business that is highly addicitve and derived from morphine. What is this drug?

A

Heroin

28
Q

TRUE OR FALSE: Opioids causes allergies but suppresses cough reflex

A

True

29
Q

TRUE OR FALSE: Opioid overdose results in hypertension and tachycardia

A

False

It results in orthostatic hypotension & bradycardia

30
Q

TRUE OR FALSE: Opioids may cause drowsiness, nausea, and vomiting

A

True

31
Q

TRUE OR FALSE: Opioids are able to relax the intestinal muscles. Thus, laxatives are given to treat the constipation

A

True

32
Q

TRUE OR FALSE: Non-opioids have a peak blood concentration from half an hour to an hour when taken orally

A

True

33
Q

TRUE OR FALSE: Non-opioids are used for fevers and mild to severe pain.

A

False

Mild to moderate pain only

34
Q

TRUE OR FALSE: Acetaminophen/Paracetamol is not given to treat inflammatory processes

A

True

35
Q

TRUE OR FALSE: Acetaminophen and Paracetamol are the same drug. It is an opioid.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

C. Only the 1st statement is true

It is a non-opioid analgesic

36
Q

The majority of opioid analgesics act at this receptor.

A

Mu (μ) receptor

37
Q

Analgesia, euphoria, respiratory depression and physiological dependence result primarily from opioid analgesic action at this receptor

A

Mu receptor

38
Q

Analgesic effects of opioids are due to ability to inhibit ____________ pain transmission and activate ____________ pain-inhibitory circuits

A
  1. ascending
  2. descending
39
Q

The descending pain inhibitory neuron is inhibited by this NT

A

GABA

40
Q

In patients with impaired renal function, opioids are contraindicated because?

A

half-life is prolonged

41
Q

The analgesic use of opioids is for the treatment of what pain range?

A

moderate to severe pain

42
Q

TRUE OR FALSE: all species of opium
poppy & its parts or substance are prohibited in importation, sale, trading, administration,
dispensation, delivery, distribution and transportation, but not in culinary purposes

A

False

43
Q

TRUE OR FALSE: Opioids are able to stimulate the dorsal horn of the spinal cord for pain modulation & suppression

A

True

44
Q

TRUE OR FALSE: Opioids are able to bind to pain receptors to inhibit neurons involved in the anterior spinothalamic tract.

A

False

it inhibits the LATERAL spinothalamic tract

45
Q

TRUE OR FALSE: Opioids are used for post-surgical pain and cancer pain. It can be used for acute and chronic pain

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

A. Both statements are true

46
Q

TRUE OR FALSE: In the level of the spinal cord, opioids are able to decrease the release of pain mediating substances. It also repolarize the postsynaptic neuron.

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

C. Only the 1st statement is true

Hyperpolarization happens

47
Q

TRUE OR FALSE: In hyperpolization, the neuron is more positive, therefore, enabling transmission of impulse.

A

False

*negative
* not able to transmit AP

48
Q

TRUE OR FALSE: Opioids decreases the excitability if A-Beta, A-Delta, and C fibers on the peripheral nerves.

A

False

It only targets A-Delta and C fibers

49
Q

TRUE OR FALSE: Opioids are recommended for mild pain such as headaches

A

False

50
Q

TRUE OR FALSE: Fentanyl is the latest kind of opioid that is used to treat chronic pain transdermally.

A

True

51
Q

determine which response results from the following receptors. answers for each number may be up until 2-3.

  1. cardiovascular stimulation
  2. sedation
  3. respiratory depression

A. delta
B. mu
C. kappa
D. sigma

A
  1. D
  2. A & C
  3. B
52
Q

Select the letter/s which represents the common manifestations of the abstinence syndrome:

A. Insomnia
B. Irritability
C. Delirium
D. Hypertension
E. Diabetes

A

A & B

53
Q

Select the letter/s which represents the common manifestations of the abstinence syndrome:

A. Stomach cramps
B. Ptosis
C. Edema
D. Sweating
E. Fatigue

A

A, D, E only

54
Q

Choose as many letters appropriate.

  1. derived from alkaloid and manufactured
    in laboratories
  2. semisynthetic

A. Tramadol & Oxycodone
B. Nalbuphine
C. Fentanyl

A

Both A. Tramadol & Oxycodone

55
Q

Choose as many letters appropriate.

  1. Available in IV (intramuscular or subcutaneous use)
  2. Available in injectable form (IV or through epidural space)

A. Tramadol & Oxycodone
B. Nalbuphine
C. Fentanyl

A
  1. B
  2. C
56
Q

Choose as many letters appropriate.

  1. Given post-operatively
  2. Manufactured by color, which signifies the drug dose

A. Tramadol
B. Oxycodone
C. Nalbuphine
D. Fentanyl

A
  1. C & D
  2. B
57
Q

What is the effect of taking opioids for a period of time, but suddenly stopping intake?

A

physical dependence

58
Q

What is the half life of non-opioids?

A

2-3 hours

59
Q

True or False: Acetaminophen/paracetamol is indicated for pts with aspirin allergy.

A

True

60
Q

The following may be adverse effects of Non-opioid intake, EXCEPT:

A. increase in nephrotic enzymes
B. dizziness
C. disorientation
D. excitement
E. none

A

A. increase in nephrotic enzymes

61
Q

The following may be adverse effects of Non-opioid intake, EXCEPT:

A. methemoglobinemia
B. hemolytic anemia
C. acute renal tubular necrosis
D. central lobular necrosis
E. none

A

E. none

62
Q

This was used to be an effective drug but it gave
kidney and liver problems

A

phenacetin

63
Q

Acetaminophen/Paracetamol inhibits what Cox pathway for pain and inflammation?

A

3

NOTE: Nonetheless, this drug dos NOT have a significant anti-inflammatory property

64
Q

TRUE OR FALSE: Opioids are able to decrease breathing rhythm and depth. This results to respiratory depression and eventually apnea

A. Both statements are true
B. Both statements are false
C. Only the 1st statement is true
D. Only the 2nd statement is true

A

D. Only the 2nd statement is true

Decrease rate & depth

65
Q

This is part of the opioid alkaloids that is also used to reverse the side effects of the drug

A

Thebaine

66
Q

Based on the Numeric Pain Scale, in what range can opioids be used?

A

4-10