Deck 14: Opioid Analgesics

Question 1

Morphine and many other powerful opioids exert their primary analgesic effects by binding to the

A) alpha adrenergic receptor
B) beta adrenergic receptor
C) beta opioid receptor
D) alpha opioid receptor
E) mu opioid receptor

Answer 1

mu opioid receptor

Question 2

Opioid drugs exert their analgesics effects by binding to the same receptors as

A) the catecholamines (epinephrine, norepinephrine)
B) glucocorticoids (cortisol)
C) anabolic steroids (testosterone)
D) endogenous opioids (endorphins, enkephalins)
E) insulin-like growth factor

Answer 2

endogenous opioids (endorphins, enkephalins)

Question 3

Which of the following side effects is NOT associated with opioid drugs?

A) sedation
B) increased respiration
C) constipation
D) orthostatic hypotension
E) mood changes (euphoria)

Answer 3

increased respiration

Question 4

Certain patients may fail to respond to opioids or may report increased pain (hyperalgesia)when given opioid drugs.This opioid-induced hyperalgesia is likely due _____ in nociceptive pathways in susceptible patients.

A) increased activity of glutamate
B) decreased activity of substance P
C) increased activity of GABA
D) decreased activity of acetylcholine
E) opioids never cause increased pain when administered in clinical situations

Question 5

Drugs such as butorphanol,nalbuphine,and pentazocine may stimulate certain opioid receptors while blocking or only partially activating other receptors.These drugs

A) may produce adequate analgesia with less risk of side effects such as respiratory depression
B) may have fewer addictive qualities than strong opioids such as morphine
C) may produce more psychotropic effects (hallucinations, vivid dreams) than other opioids
D) are known as mixed agonist-antagonists
E) all the above are true

Question 6

In addition to their use as analgesics,opioid drugs can also be administered

A) as a preoperative medication
B) as a general anesthetic
C) as a cough suppressant
D) to treat severe diarrhea
E) all the above are true

Question 7

When used to treat pain,opioids can be administered by all of the following routes EXCEPT

A) inhalation
B) intravenously
C) intrathecally
D) transdermally
E) orally

Question 8

Preliminary studies on animals suggest that opioids can exert analgesic effects when administered directly into peripheral tissues (e.g.,injected into an inflamed joint)because

A) opioids decrease the production of inflammatory substances in peripheral tissues
B) opioids increase vasodilation in peripheral tissues
C) opioids cause vasoconstriction in peripheral tissues
D) opioids may bind to receptors located on the distal (peripheral) ends of primary afferent (sensory) neurons.
E) there is no evidence that opioids can produce analgesic effects outside to the CNS

Question 9

Methadone is often used to treat opioid addiction because methadone

A) is a strong opioid antagonist
B) has much more severe withdrawal symptoms than other opioids
C) has opioid-like effects even though methadone is not an opioid
D) methadone does not cross the blood-brain barrier
E) none of the above are true

Question 10

Certain patients can develop "tolerance" to opioid analgesics,which is indicated by

A) the onset of withdrawal symptoms if the drug is suddenly discontinued
B) the fact that the patient may still crave the drug several years after he/she has ceased taking it
C) the need to progressively increase the dosage of the drug to achieve a therapeutic effect when the drug is used for prolonged periods
D) all the above are true
E) none of the above are true

Question 11

Opioid analgesics are also known commonly as _______ because they tend to have sedative or sleep-inducing side effects and high doses can produce a state of unresponsiveness and stupor.

A) narcotics
B) narcoleptics
C) neuroleptics
D) naturopathics
E) nonsteroidal anti-inflammatory drugs

Question 12

The source of the naturally occurring opioid (narcotic)analgesics is

A) the foxglove plant
B) the opium poppy
C) St Johns wort
D) leaves from the gingko tree
E) opioid analgesics cannot be derived from natural sources

Question 13

The onset of withdrawal symptoms (body aches,shivering,sweating,and so forth)after sudden discontinuation of opioid analgesics is an example of

A) drug tolerance
B) physical dependence
C) psychological dependence
D) anaphylaxis
E) drug intolerance

Question 14

Opioid drugs exert their effects on afferent pain pathways by binding to neuronal receptors that in turn

A) decrease transmitter release from presynaptic terminals
B) decrease excitability (hyperpolarize) postsynaptic neurons
C) decrease production of endogenous chemicals known as catecholamines
D) all the above are true
E) A and B only are true

Question 15

By blocking all opioid receptors,opioid antagonists such as nalmefene and naloxone are used primarily to

A) treat severe, acute postoperative pain
B) treat severe chronic pain
C) treat opioid overdose
D) treat diarrhea
E) opioid antagonists have no therapeutic value