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57 Cards in this Set

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  • Back
  • 3rd side (hint)
Which neurotransmitter binds to the delta receptor
Enkephalin
Which neurotransmitter binds to the kappa receptor
Dynorphin
Which neurotransmitter binds to the mu receptor
Beta-endorphin
What is the mechanism of action of medications that activate presynaptic opioid receptors
Inhibits calcium influx through voltage-gated ion channels thereby inhibiting neurotransmitter release
None
What is the mechanism of action of medications that activate postsynaptic opioid receptors
Increases potassium efflux from cells leading to membrane hyperpolarization and thereby inhibition of neurotransmitter release
None
Opioid receptors are coupled to what type of proteins
Inhibitory G-proteins (inhibits adenylyl cyclase)
Binding of opioids to which receptor type may be responsible for the dysphoria and hallucinations associated with certain opioids
Sigma receptor
What is the prototype opioid analgesic
Morphine
None
Why must caution be taken when using opioids in patients with head injuries
Opioids may increase intracranial pressure
Where in the midbrain are opioid receptors located
Periaqueductal gray region (binding to these receptors leads to activation of descending pathways to the Raphe nuclei thereby decreasing transmission throughout pain pathways)
None
Where in the dorsal horn of the spinal cord are opioid receptors located
Primary afferent fibers (binding to these receptors leads to inhibition of substance P release)
None
Are opioid analgesics better at relieving intermittent or persistent pain
Persistent pain
None
What is the mechanism of morphine-induced hypotension and pruritus
Increased histamine release from mast cells
None
Do opioid analgesics increase or decrease gastrointestinal (GI) peristalsis
Decrease (causes constipation)
None
Which two opioids are used specifically to treat diarrhea
Loperamide
Diphenoxylate
None
Which medication is commonly given in combination with diphenoxylate for the treatment of diarrhea
Atropine
Which opioid analgesic does not increase the tone of the biliary tract, bladder, and ureter
Meperidine (antagonizes muscarinic receptors)
None
Do opioid analgesics increase or decrease uterine contractions during pregnancy
Decrease
None
Do opioid analgesics cause miosis or mydriasis of the pupils
Miosis (common sign of opioid overdose is pinpoint pupils)
None
What is the mechanism of opioid-induced miosis
Increased parasympathetic (cholinergic) activity in the pupilary constrictor muscles
None
Which opioid analgesic does not cause miosis
Meperidine (antagonizes muscarinic receptors)
None
Which two opioids are used specifically to treat cough
Codeine; Dextromethorphan (opioids suppress the cough reflex)
Is dextromethorphan a natural or synthetic opioid
Synthetic
What is the mechanism of opioid-induced urinary retention
Increases antidiuretic hormone (ADH)
None
Do opioid analgesics promote emesis or act an antiemetics
Promote emesis
None
What is the mechanism of opioid-induced emesis
Activation of the chemoreceptor trigger zone (CTZ)
None
Where is the CTZ located
Area postrema
What is the mechanism of opioid-induced respiratory depression
Reduced sensitivity of respiratory center to carbon dioxide levels
None
What is the most common cause of death in opioid overdose
Respiratory depression
None
What are the two most lipophilic opioids
Heroin; Fentanyl (these two medications rapidly cross the BBB to produce euphoric effects
None
Which opioid is the least lipophilic
Morphine
None
Is morphine metabolized via phase I or phase II reactions
Phase II (glucuronidation)
Does morphine-3-glucuronide have analgesic activity
No
Does morphine-6-glucuronide have analgesic activity
Yes
Which two opioid-induced effects do patients not develop tolerance to
Constipation; Miosis
What are the signs and symptoms of opioid withdrawal
Lacrimation
Rhinorrhea
Diaphoresis
Yawning
Goose bumps
Anxiety
Muscle spasms
Diarrhea
Increased pain sensation
None
Which medication is used to counteract the respiratory depression seen in opioid overdose
IV naloxone (may need to give multiple doses as naloxone has a shorter half-life than morphine)
None
What is the mechanism of action of naloxone
Mu-receptor antagonist
What is the half-life of naloxone
1-1.5 hours
What is the half-life of morphine
2-4 hours
Which opioid antagonist is given orally to decrease cravings in alcoholism
Naltrexone
None
What is the half-life of naltrexone
4 hours
Which opioid analgesic is used to prevent withdrawal symptoms in patients discontinuing heroin use
Methadone
None
Which central-acting α2 agonist is used to prevent withdrawal symptoms in patients discontinuing heroin use
Clonidine
Give examples of strong opioid agonists
Morphine
Heroin

Hydromorphone
Methadone
Meperidine
Fentanyl
Hydrocodone
None
Give examples of weak opioid agonists
Codeine
Propoxyphene
None
Give examples of partial opioid agonists
Buprenorphine
Pentazocine
None
What is the mechanism of action of pentazocine
Kappa-receptor agonist
Mu-receptor antagonist
None
Propoxyphene is a derivative of which opioid analgesic
Methadone
None
Name two synthetic opioid analgesics
Methadone
Meperidine
None
Fentanyl is chemically related to which synthetic opioid analgesic
Meperidine
None
Does morphine have a high or low oral bioavailability
Low
Which two opioids should not be given in combination with MAOIs
Meperidine and Dextromethorphane (these combinations may produce serotonin syndrome)
What drug do you get by acetylating morphine
Heroin
None
Is codeine itself an active opioid analgesic
No (must be metabolized via cytochrome P-450 2D6 to active morphine)
None
Which medication is commonly given in combination with codeine for the treatment of pain
Acetaminophen
Which medication is commonly given in combination with propoxyphene for the treatment of pain
Acetaminophen