Pharm - Ch 31 - Opioid Analgesics And Antagonists

Front 1

Inhibit synaptic activity of primary afferents and spinal cord pain transmission neurons

Back 1

Ascending pathways

Front 2

Activation of these receptors close Ca2+ ion channels to inhibit neurotransmitter release

Back 2

Presynaptic mu, delta, and kappa receptors

Front 3

Activation of these receptors open K+ ion channels to cause membrane hyperpolarization

Back 3

Postsynaptic Mu receptors

Front 4

All opioids except this agent (which has a muscarinic blocking action) cause pupillary constriction

Back 4

Meperidine

Front 5

SE of these drugs include dependence, withdrawal syndrome, sedation, euphoria, respiratory depression nausea and vomiting, constipation, biliary spasm, increased ureteral and bladder tone, and reduction in uterine tone

Back 5

Opioid Analgesics

Front 6

Opioids used in anesthesia

Back 6

Morphine and fentanyl

Front 7

Opioid used in the management of withdrawal states

Back 7

Methadone

Front 8

Opioid available trans-dermally

Back 8

Fentanyl

Front 9

Opioid that can be given PO, by epidural, and IV, which helps to relieve the dyspnea of pulmonary edema

Back 9

Morphine

Front 10

Use of this opioid with MAOI can lead to hyperpyrexic coma, and with SSRI's can lead to serotonin syndrome

Back 10

Meperidine

Front 11

Moderate opioid agonists

Back 11

Codeine, hydrocodone, and oxycodone

Front 12

Weak opioid agonist, poor analgesic, its overdose can cause severe toxicity including respiratory depression, circulatory collapse, pulmonary edema, and seizures

Back 12

Propoxyphene

Front 13

Partial opioid agonist, considered a strong analgesic, has a long duration of action and is resistant to naloxone reversal

Back 13

Buprenorphine

Front 14

Opioid antagonist that is given IV and had short DOA

Back 14

Naloxone

Front 15

Opioid antagonist that is given orally in alcohol dependency programs

Back 15

Naltrexone

Front 16

These agents are used as antitussive

Back 16

Dextromethorphan, Codeine

Front 17

These agents are used as antidiarrheal

Back 17

Diphenoxylate, Loperamide

Front 18

Oral med for increasing pain in met bone CA pt who is receiving oxycodone + acetominophen?

Back 18

levorphanol (strong agonist)

Front 19

Tolerance doesn't develop to a significant extent with respect to (2)

Back 19

constipation, miosis

Front 20

The ionic mech involved in inhibition of release of NTs

Back 20

decreased influx of Ca ions

Front 21

Over-the-counter opioid with antidiarrheal action

Back 21

loperamide

Front 22

Fentanyl patches used to provide analgesia have caused what SE?

Back 22

respiratory depression

Front 23

Merperidine plus what drug causes a reaction consisting of tachycardia, HTN, hyperpyrexia and seizures?

Back 23

phenelzine (MAOI)

Front 24

Merperidine plus SSRI causes what reaction?

Back 24

serotonin syndrome

Front 25

Genetic polymorphism in drug metab is est to be responsible for variations in analgesic response to what agent?

Back 25

codeine

Front 26

Morphine is contraindicated or to be used with extreme caution in what 4 clinical situations?

Back 26

adrenal insuff, biliary tract surgery, hypothyroidism and late stage labor

Front 27

Most likely cause of the following signs and sx in a heroid addict: chills, muscle aches, diarrhea, vomiting, hypervent and hyperthermia

Back 27

abstinence syndrome

Front 28

Which drug is most effective in alleviating sx of abstinence syndrome?

Back 28

buprenorphine

Front 29

T or F about nalbuphine? activates mu receptors

Back 29

FALSE

Front 30

T or F about nalbuphine? doesn't cause resp depression

Back 30

FALSE; however is less likely than with mu activators

Front 31

T or F about nalbuphine? is nonsedating

Back 31

FALSE

Front 32

T or F about nalbuphine? pain-relieving action is not superior to that of codeine

Back 32

false; superior to codeine but inferior to strong agonists

Front 33

T or F about nalbuphine? response to naloxone in overdose may be unreliable

Back 33

TRUE

Front 34

Which drug doesn't activate opioid receptors and with a single oral dose will block effects of injected heroin for 48 h?

Back 34

Naltrexone

Front 35

T or F about dextromethorphan? activates kappa receptors

Back 35

FALSE; activates mu receptors

Front 36

T or F about dextromethorphan? analgesia equivalent to pentazocine

Back 36

FALSE; has no analgesic activity

Front 37

T or F about dextromethorphan? highly effective antiemetic

Back 37

FALSE

Front 38

T or F about dextromethorphan? less constipation than codeine

Back 38

TRUE

Front 39

T or F about dextromethorphan? no abuse potential

Back 39

FALSE; causes disorientation, hallucinations, seizures and death in large amounts

Front 40

Full agonist drug with good oral bioavail, analgesic activity equivalent to morphine, longer duration of action and milder withdrawal signs:

Back 40

methadone

Front 41

T or F about propoxyphene? analgesia equivalent to oxycodone

Back 41

FALSE; very low analgesic activity

Front 42

T or F about propoxyphene? antagonist a mu receptors

Back 42

FALSE; weak agonist

Front 43

T or F about propoxyphene? causes dose limiting diarrhea

Back 43

FALSE

Front 44

T or F about propoxyphene? highly effective cough suppressant

Back 44

FALSE

Front 45

T or F about propoxyphene? seizures in overdose

Back 45

TRUE; overdose causes seizures, PE, circulatory collapse, resp depression

Front 46

Opioids effect what 3 pain pathways?

Back 46

transmission (ascending), modulation (descending) and reactivity (basal ganglia, hypothalamus, limbic and cortex)

Front 47

Which opioid has muscarinic blocking acton?

Back 47

meperidine

Front 48

strong agonists (6)

Back 48

morphine, fentanyl, heroin, levorphanol, meperidine, methadone

Front 49

weak agonist

Back 49

propoxyphene

Front 50

mixed agonist-antagonists (4)

Back 50

pentazocine, buprenorphine, butorphanol, nalbuphine

Front 51

antagonists (3)

Back 51

naloxone, nalmefene, naltrexone