Deck 7: The Pharmacology of Opiates and Analgesia

Question 1

The term morphine comes from the

A) Hebrew word for bliss.
B) Greek word for analgesia.
C) Greek word for Morpheus, the god of dreams.
D) term morph, which means to change or transform.

Answer 1

C

Question 2

In the mid-1800s, morphine quickly emerged as a

A) cough suppressant.
B) effective analgesic for surgical pain.
C) treatment for fevers and diarrhea.
D) All of the above are correct

Answer 2

D

Question 3

The Harrison Narcotics Act was passed as an attempt to regulate

A) the availability of morphine to convert into heroin.
B) the manufacture and distribution of heroin.
C) heroin's availability to prescription only.
D) which medical conditions morphine and heroin were to be used for.

Answer 3

B

Question 4

The illicit importation and distribution of heroin was largely curtailed by the

A) Harrison Narcotics Act.
B) Controlled Substances Act.
C) Drug Enforcement Administration.
D) None of the above is correct

Question 5

Alkaloids are

A) chemical compounds related to alkali metals.
B) nitrogen-containing compounds produced by a variety of plants.
C) compounds that all have the same molecular structure and effects on the brain.
D) compounds that are synthesized from plant materials.

Question 6

Heroin is

A) converted to morphine during its metabolism.
B) less lipid-soluble than morphine.
C) more potent than morphine if taken by mouth.
D) None of the above is correct

Question 7

Codeine is synthesized from

A) oxycodone
B) thebaine
C) morphine
D) etorphine

Question 8

Which of the following is the most potent derivative of opium?

A) Morphine
B) Heroin
C) Oxycodone
D) Etorphine

Question 9

The structural difference between morphine and heroin is that heroin has

A) no methyl groups.
B) no acetyl groups.
C) two acetyl groups.
D) two methyl groups.

Question 10

Nociceptors detect

A) intense pressure.
B) extreme temperature.
C) inflammation.
D) All of the above are correct

Question 11

"First" or early pain

A) is transmitted by unmyelinated C fibers.
B) provides information about the unpleasantness of the painful sensation.
C) travels along myelinated Aδ fibers.
D) is often accompanied by autonomic responses, such as nausea.

Question 12

The neurotransmitter released in the dorsal horn of the spinal cord by pain-signaling neurons is

A) acetylcholine
B) substance P
C) norepinephrine
D) glutamate

Question 13

The ascending pain pathway beginning in the dorsal horn of the spinal cord is called the

A) thalamic reticular system.
B) nociceptive pathway.
C) spinothalamic pathway.
D) somatosensory pathway.

Question 14

The ascending pain pathway terminates in the

A) thalamus.
B) frontal cortex.
C) limbic system.
D) somatosensory and anterior cingulate cortices.

Question 15

The descending pain pathway originates in the

A) periaqueductal gray area.
B) thalamus.
C) medulla.
D) raphe nucleus.

Question 16

The descending pain pathway terminates in the

A) raphe nucleus.
B) cingulated cortex.
C) medulla.
D) Both a and c are correct

Question 17

The most important descending pathways for modulation of spinal cord transmission of pain originate in the

A) thalamus.
B) pons.
C) limbic system.
D) anterior cingulate cortex.

Question 18

Opiate receptors are concentrated in the

A) dorsal horn of the spinal cord.
B) thalamus.
C) raphe nucleus.
D) Both a and c are correct

Question 19

The ________ receptor is presumed to be the most important of the opiate receptors for pain analgesia.

A) mu
B) kappa
C) delta
D) theta

Question 20

Overdose death by opiates is mediated by

A) cardiac complications.
B) neural toxicity.
C) respiratory depression.
D) All of the above are correct

Question 21

Dysphoria may be caused by antagonism of ________ receptors.

A) kappa
B) mu
C) delta
D) theta

Question 22

Opiate receptors

A) are metabotropic and control K⁺ efflux.
B) are inhibitory.
C) hyperpolarize postsynaptic membranes.
D) All of the above are correct

Question 23

Which of the following is an example of a pure agonist?

A) Pentazocine
B) Fentanyl
C) Naltrexone
D) Both b and c are correct

Question 24

Partial agonists

A) have more affinity for receptors than pure agonists.
B) have both agonistic and antagonistic effects on receptors.
C) have less affinity for receptors than pure agonists.
D) are more useful clinically than pure agonists because they are not addictive.

Question 25

Pure antagonists

A) include drugs such as naloxone and naltrexone.
B) can reverse the effects of a heroin overdose within minutes.
C) have a high affinity for receptors, but do not exert any physiological effect on the receptor.
D) All of the above are correct

Question 26

The reinforcing effects of opiates take place in the

A) mesolimbic system.
B) frontal cortex.
C) cingulated cortex.
D) amygdala.

Question 27

Increases in dopamine activity in the ________ mediate the reinforcing effects of opiates.

A) striatum
B) nucleus accumbens
C) ventral tegmentum area
D) cingulate cortex

Question 28

Stimuli associated with ________ can control dopamine activity in the mesolimbic system.

A) feeding
B) engaging in sexual behavior
C) social interaction
D) Both a and b are correct

Question 29

Tolerance to opiate drugs

A) is primarily due to increased rate of metabolism.
B) develops quickly.
C) is largely mediated by Pavlovian drug onset cues.
D) All of the above are correct

Question 30

The Center for Disease Control estimates that there are approximately ________ opiate-dependent people in the United States.

A) 10 million
B) 1 million
C) 500,000
D) 25,000

Question 31

The recidivism rate for first-time treatment for opiate abuse is about ________ percent.

A) 25
B) 50
C) 80
D) 90

Question 32

Most opiate treatment programs utilize

A) aversion therapy.
B) synthetic opioids.
C) methadone maintenance.
D) a comprehensive residential treatment facility.

Question 33

When ________ is administered intravenously to opiate-dependent patients, withdrawals are experienced almost immediately.

A) naloxone
B) methadone
C) antabuse
D) None of the above is correct

Question 34

Critics of methadone treatment for opiate abuse claim that it

A) is not effective in reducing opiate dependency.
B) merely substitutes one addiction for another.
C) is more costly than a comprehensive residential treatment facility.
D) Both a and b are correct