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46 Cards in this Set
- Front
- Back
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You are on your way to take an examination and you suddenly get an attack of diarrhea. If you stop at a nearby drugstore for an over-the-counter opioid with antidiarrheal action, you will be asking for (A) Codeine (B) Dextromethorphan (C) Diphenoxylate (D) Loperamide (E) tramadol
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E |
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Genetic polymorphisms in certain hepatic enzymes involved in drug metabolism are established to be responsible for variationsin analgesic response to (A) Codeine (B) Fentanyl (C) Meperidine (D) Methadone (E) Tramadol |
A |
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Which drug does not activate opioid receptors, has been proposed as a maintenance drug in treatment programs for opioid addicts, and with a single oral dose, will block the effects of injected heroin for up to 48 h? (A) Amphetamine (B) Buprenorphine (C) Naloxone (D) Naltrexone (E) Propoxyphene |
D |
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Which statement about dextromethorphan is accurate? (A) Activates κ receptors (B) Analgesia equivalent to pentazocine (C) Highly effective antiemetic (D) Less constipation than codeine (E) No abuse potential
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D |
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former heroin addict is maintained on methadone, but succumbsto temptation and buys an opioid on the street. He takes it and rapidly goesinto withdrawal. Which opioid did he take?a. Meperidine b. Heroin c. Pentazocine d. Codeine e. Propoxyphene |
C |
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Which of the following opioid agonists is only administered by theparenteral route?a. Morphine b. Codeine c. Fentanyl d. Methadone e. Propoxyphene
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C |
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. A 36-year-old male heroin addict is seen in the ED because he cannotbe aroused from sleep. On examination, he has shallow breathing andpinpoint pupils. Naloxone is administered, and the patient wakes up.Which of the opiate receptor subtypes that binds naloxone is responsiblefor reversing the respiratory depression and miosis?
a. δ b. κ c. µ |
C |
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Which of the following is associated with abuse of opioid analgesics? a. No cross-tolerance develops among opioid analgesics b. Tolerance develops equally to all effects of opioids. c. Opioids reduce pain, aggression, and sexual drives d. The symptoms of acute methadone withdrawal are qualitatively different fromthose of acute heroin withdrawal e. None of the above
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C |
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Morphine may be characterized best by which of the following statements? a. It is classified as a mixed agonist-antagonist drug b. It is used medically to inhibit withdrawal symptoms in persons who are dependenton heroin c. At high doses, it causes death by respiratory depression d. It is a pure opioid antagonist at the µ, κ, and δ receptors e. It has an addiction potential equal to that of codeine
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C |
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Morphine may be characterized best by which of the following statements? a. It is classified as a mixed agonist-antagonist drug b. It is used medically to inhibit withdrawal symptoms in persons who are dependenton heroin c. At high doses, it causes death by respiratory depression d. It is a pure opioid antagonist at the µ, κ, and δ receptors e. It has an addiction potential equal to that of codeine |
C |
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Which of the following is not associated with the development of ahigh degree of tolerance following opiate administration? a. Euphoria b. Analgesia c. Nausea and vomiting d. Respiratory depression e. Constipation |
E |
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Which of the following is not associated with methadone? a. It is useful as an analgesic b. It has greater oral efficacy than morphine c. It possesses opioid antagonist effects d. It produces a milder but more protracted withdrawal syndrome than that associatedwith morphine e. Adverse reactions may include constipation, respiratory depression, and lightheadedness |
C |
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Morphine produces analgesia by acting at (a) Peripheral pain receptors (b) A spinal site (c) Suspraspinal sites (d) Both (b) and (c)
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B |
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Instead of depressing, morphine stimulates (a) Vasomotor centre (b) Edinger westphal nucleus (c) Temperature regulating centre (d) Cough centre |
B |
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Morphine is contraindicated in headinjury because (a) It does not relieve the pain of head injury (b) It can raise intracranial tension (c) It can cause constipation (d) It is liable to cause addiction |
B |
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. In man sedation caused by morphine ischaracterized by (a) Initial excitement (b) Little or no motor incoordination (c) Rise in seizure threshold (d) All of the above. |
B |
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Which of the following opioids is morepotent than morphine ? (a) Pethidine (b) Fentanyl (c) Dextropropoxyphene (d) Tramadol
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B |
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Which of the following opioid analgesicsis similar to codeine in pharmacologicalprofile but is less constipating ? (a) Methadone (b) Buprenorphine (c) Butorphanol (d) Dextropropoxyphene
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D |
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Morphine dependence is characterized by (a) Marked drug seeking behavior (b) Physical dependence without psychicdependence (c) Physical as well as psychic dependence (d) Both (a) and (c)
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D |
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. Which action of morphine is incompletelyreversed by naloxone ? (a) Analgesia (b) Respiratory depression (c) Sedation (d) Miosis
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C |
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Select the analgesic which acts throughopioids as well as additional spinalmonoaminergic mechanisms. (a) Tramadol (b) Ethoheptazine (c) Dextropropoxyphene (d) Alfentanil
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A |
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Mu (μ) receptors are associated with: a) Analgesia, euphoria, respiratory depression, physical dependence b) Spinal analgesia, mydriasis, sedation, physical dependence c) Dysphoria, hallucinations, respiratory and vasomotor stimulation d) Analgesia, euphoria, respiratory stimulation, physical dependence |
A |
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Indicate the opioid receptor type, which is responsible for dysphoria and vasomotor stimulation: a) Kappa-receptors b) Delta-receptors c) Mu-receptors d) All of the above |
A |
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5. Which of the following opioid analgesics is a strong mu receptor agonist? a) Naloxone b) Morphine c) Pentazocine d) Buprenorphine
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B |
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Which of the following opioid analgesics is used in combination with droperidol in neuroleptanalgesia? a) Morphine b) Buprenorphine c) Fentanyl d) Morphine |
C |
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Most strong mu receptor agonists cause: a) Hypertension b) Increasing the pulmonary arterial pressure and myocardial work c) Cerebral vasodilatation, causing an increase in intracranial pressure d) All of the above |
C |
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Which of the following opioid analgesics is used in the treatment of acute pulmonary edema? a) Morphine b) Codeine c) Fentanyl d) Loperamide |
A |
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Indicate a partial mu receptor agonist, which has 20-60 times analgesic potency of morphine, and a longer duration of action: a) Pentazocine . b) Buprenorphine c) Nalbuphine d) Naltrexone |
B |
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Which of the following drugs has weak mu agonist effects and inhibitory action on norepinephrine and serotonin reuptake in the CNS? a) Loperamide b) Tramadol c) Fluoxetine d) Butorphanol |
B |
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The diagnostic triad of opioid overdosage is: a) Mydriasis, coma and hyperventilation b) Coma, depressed respiration and miosis c) Mydriasis, chills and abdominal cramps d) Miosis, tremor and vomiting
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B |
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019. The principal central nervous system effect of the opioid analgesics with affinity for a mu receptor is: a) Analgesia b) Respiratory depression c) Euphoria d) All of the above
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B |
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A young man is brought into the emergency room. He is unconscious, and he has pupillary constriction and depressed respiration. You note needle marks on his legs. You administer naltrexone, and he awakens.This agent was effective because: A. The patient was suffering from an overdose of a benzodiazepine. B. Naltrexone antagonizes opiates at the receptor site. C. Naltrexone is a stimulant of the central nervous system. D. Naltrexone binds to the opioid and inactivates it. E. The patient was was suffering from an overdose of meperidine.
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B |
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A heroin addict has entered a rehabilitation program that requires that she take methadone. Methadone is effective in this situation because it: A. Is an antagonist at the morphine receptors. B. Is a non-narcotic. C. Is longer acting than heroin, conferring milder withdrawal than with the latter drug. D. Does not cause constipation. E. Is nonaddictive.
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C |
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Which of the following statements about morphine is correct? A. It is used therapeutically to relieve pain caused by severe head injury. B. Its withdrawal symptoms can be relieved by naloxone. C. It causes diarrhea. D. It is most effective by oral administration. E. It rapidly enters all body tissues, including the fetus. |
E |
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The pain of a patient with bone cancer has been managed with a morphine pump. However, he has become tolerant to morphine. Which of the followingmight be indicated to ameliorate his pain? A. Meperidine. B. Codeine. C. Fentanyl. D. Methadone. E. Buprenorphine.
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C |
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SECTION 2 |
True or false |
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Dextromethorphan is an opiod used for antitussive purpose |
True |
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Loperamide is an opiod that is used for treatment of diarrhea |
True |
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Ketamine can be used to treat torelence of the opiods |
True |
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Kappa receptor is associated with physical dependance |
False |
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Dysphoria is due to Mu1 receptor |
False |
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SECTION 3 |
CASES |
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A patient was given an analgesic drug after surgery.after few days the patient exprienced chest wall rigidity what was his medication |
Fentanyl |
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From the below case answer the question that follows |
A 63-year-old man is undergoing radiation treatment as an outpatient for metastatic bone cancer. His pain has been treated with a fixed combination of oxycodone plus acetaminophentaken orally. Despite increasing doses of the analgesic combination, the pain is getting worse. |
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1. The most appropriate oral medication for his increasing pain is (A) Buprenorphine (B) Codeine plus aspirin (C) Hydromorphone (D) Pentazocine (E) Tramadol
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C |
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It is possible that this patient will have to increase the dose of the analgesic as his condition progresses as a result of developing tolerance. However, tolerance will not develop to a significant extent with respect to (A) Biliary smooth muscle (B) Emesis (C) Pupillary constriction (D) Sedation (E) Urinary retention
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C |
