Opioids

Front 1

Where in the brain are mu receptors located?

Back 1

Dorsal spinal cord, PAG, thalamus, cortex, limbic areas

Front 2

Where in the brain are kappa receptors located?

Back 2

Ventral spinal cord, PAG, thalamus, cortex, limbic areas

Front 3

Where in the brain are delta receptors located?

Back 3

Dorsal and ventral spinal cord, PAG, thalamus, cortex, limbic areas

Front 4

What receptor is responsible for respiratory depression?

Back 4

Mu

Front 5

How does respiratory depression occur?

Back 5

Mu receptors decrease the breathing rate and the body's response to CO2 build-up.

Front 6

What effect do mu receptors have on dopamine levels?

Back 6

Mu receptors block GABA interneurons, INCREASING dopamine

Front 7

What receptor is responsible for dysphoria?

Back 7

Kappa

Front 8

How does dysphoria occur?

Back 8

Kappa receptors directly on the dopamine neuron inhibit dopamine

Front 9

What receptors are responsible for miosis?

Back 9

Mu and kappa (increased parasympathetic activity)

Front 10

What receptors are responsible for sedation?

Back 10

Mu and kappa (both decrease NE levels)

Front 11

What receptors are responsible for muscular rigidity?

Back 11

Mu, kappa and delta (inhibition of dopamine neurons in the nigrostriatal tract)

Front 12

What receptors are responsible for cough suppression?

Back 12

None (naloxone insensitive)

Front 13

What receptor is responsible for nausea?

Back 13

Mu receptor in the CTZ in the area postrema

Front 14

How do opiates affect hormone levels?

Back 14

Mu receptors in the hypothalamus decrease testosterone and estrogen

Front 15

What protein are opioid receptors coupled to?

Back 15

Gi

Front 16

What effects do opioids have on the molecular level?

Back 16

Inhibit cAMP, open K+ channels, decrease Ca2+ channels

Front 17

What effect do enkephalin neurons have?

Back 17

Decrease the release of Substance P

Front 18

What effects do dynorphin neurons have?

Back 18

Increase K+ conductance, cause hyperpolarization, slow pain impulses

Front 19

What effect does blocking opioid receptors in the thalamus have?

Back 19

Blocks the impulses to the cortex and limbic system, blunting the emotional response to pain

Front 20

What receptor is responsible for constipation?

Back 20

Mu (decreases motility and secretions, increases tone)

Front 21

What receptors affect smooth muscle?

Back 21

Mu and delta

Front 22

What receptors affect the immune system?

Back 22

Mu and delta (suppress lymphocytes, esp. T-Killer cells)

Front 23

What is the primary type of metabolism opiates undergo in the liver?

Back 23

Glucuronidation

Front 24

What are the contraindications for opioids?

Back 24

Head injury, resp. depression, pregnancy, allergies/asthma, impaired liver/kidney function

Front 25

What happens when you combine opioids with anything that increases NE or 5HT?

Back 25

Increased activation of enkephalin and dynorphin neurons

Front 26

What happens when you combine opioids with CNS depressants?

Back 26

Increased sedation

Front 27

What happens when you combine opioids with antihistamines?

Back 27

Increased analgesia and some sedation

Front 28

What happens when you combine opioids with NSAIDs?

Back 28

Increased analgesia

Front 29

What classes of drugs increase NE and 5HT?

Back 29

TCAs, SSRIs, NSRIs, stimulants, MAO inhibitors

Front 30

What is the opiate "overdose triad"?

Back 30

Stupor, respiratory depression, pinpoint pupils

Front 31

What drug do you give to counteract an opioid overdose?

Back 31

Naloxone (non-selective opioid antagonist)

Front 32

What is the active metabolite of morphine?

Back 32

Morphine-6-glucuronidate

Front 33

What is the active metabolite of heroin?

Back 33

Morphine

Front 34

Which opioid may be a little safer in babies?

Back 34

Meperidine

Front 35

Which opioid may be a SSRI?

Back 35

Meperidine

Front 36

Which enzyme converts codeine to morphine?

Back 36

CYP2D6

Front 37

Dextromethophan is a stereoisomer of what drug?

Back 37

Levorphanol

Front 38

What opioid receptors does pentazocine interact with?

Back 38

Partial mu, full kappa agonist

Front 39

What opioid receptors does nalbuphine interact with?

Back 39

Mu antagonist, full kappa agonist

Front 40

What opioid receptors does butorphanol interact with?

Back 40

Partial mu, full kappa agonist

Front 41

What opioid receptors does buprenorphine interact with?

Back 41

Partial mu, full kappa antagonist

Front 42

What opioid receptors does buprenorphine interact with?

Back 42

Partial mu agonist

Front 43

What opioid receptors does spiradoline interact with?

Back 43

Selective kappa agonist

Front 44

What opioid receptors does nalmefene interact with?

Back 44

Pure mu antagonist