Deck 6: Opioid Narcoticanalgesics and Antagonists

Question 1

A patient presents with itching and urticaria after codeine administration.This response most likely represents a

A)pharmacologic action of codeine.
B)hypersensitivity reaction to codeine.
C)placebo effect from receiving codeine.
D)reaction unrelated to codeine administration.

Answer 1

pharmacologic action of codeine.

Question 2

Which one of the following conditions can be managed or treated with opioids?

A)Diarrhea
B)Depression
C)Infections
D)Hypertension

Answer 2

Diarrhea

Question 3

Tolerance occurs to the following effects of the opioids except which one?

A)Miosis
B)Analgesia
C)Respiratory depression
D)Nausea
E)Histamine release

Answer 3

Miosis

Question 4

Which of the following conditions is an adverse reaction to the opioids?

A)Diarrhea
B)Miosis
C)CNS excitation
D)Hepatotoxicity

Question 5

Tylenol #3 contains _____ mg of codeine.

A)7.5
B)15
C)30
D)60

Question 6

Which of the following drugs can be used to treat heroin addiction?

A)Hydromorphone
B)Methadone
C)Naltrexone
D)Both A and C
E)Both B and C

Question 7

Which is the major symptom of opioid overdose?

A)Miosis
B)Mydriasis
C)Urticaria
D)Respiratory depression

Question 8

Beta-endorphin is a naturally occurring peptide with opioid-like action.It possesses analgesic action but has no addiction potential.

A)Both statements are true.
B)Both statements are false.
C)The first statement is true;the second statement is false.
D)The first statement is false;the second statement is true.

Question 9

Morphine has its most potent action on the _____ class of opioid receptors,and pentazocine has its most potent action on the _____ class of opioid receptors.

A)mu;kappa
B)mu;delta
C)sigma;delta
D)kappa;mu
E)delta;kappa

Question 10

Which opioid is commonly used as an antitussive?

A)Propoxyphene
B)Codeine
C)Diphenoxylate
D)Pentazocine

Question 11

What do aspirin,acetaminophen,ibuprofen,and codeine have in common?

A)They are all antiinflammatory.
B)They are all analgesic.
C)They all inhibit platelet aggregation.
D)They are all antipyretic.

Question 12

The following are conditions for which opioid analgesics should be used with extreme caution or not at all except which one?

A)Head injury
B)Nausea
C)Respiratory disease
D)Hypertension
E)Near-term pregnancy

Question 13

Which of the following opioids is used primarily in the treatment of opioid addiction?

A)Propoxyphene
B)Meperidine
C)Hydromorphone
D)Methadone

Question 14

Enkephalins,endorphins,and dynorphins probably function as _____,although their exact function has not been elucidated.

A)prostaglandins
B)neurotransmitters
C)sedative-hypnotics
D)enzymes

Question 15

_____ is usually the cause of death with an overdose of opioid analgesics.

A)Tachycardia
B)Respiratory depression
C)Electrolyte imbalance
D)Cellular necrosis

Question 16

Oral bioavailability of opioids is primarily limited by

A)incomplete absorption.
B)first-pass metabolism.
C)side effects of nausea and vomiting.
D)enterohepatic circulation.
E)rapid renal excretion.

Question 17

Which of the following opioids is a metabolite of oxycodone that is three times more potent than oral morphine?

A)Codeine
B)Hydrocodone
C)Hydromorphone
D)Oxymorphone

Question 18

Which of the following products is the most commonly used opioid in dentistry?

A)Hydrocodone (Vicodin)
B)Morphine
C)Codeine
D)Oxymorphone

Question 19

Which of the following statements is true concerning the pharmacokinetics of opioid analgesics?

A)Absorption may occur through mucous membranes of the nose but is not possible through intact skin.
B)The opioids are bound to plasma proteins to varying degrees and distributed throughout the body.
C)Given orally,opioids have vastly different durations of action for analgesia,ranging from 1 to almost 12 hours.
D)Metabolized opioids are excreted in urine;however,the unchanged drug is not.

Question 20

Which is an advantage of the nonsteroidal antiinflammatory drugs (NSAIDs)over the opioids for the management of dental pain in an opioid addict?

A)They are not addictive.
B)They are antitussive.
C)They are all useful if the patient is pregnant.
D)They cause less fluid retention (edema).

Question 21

Morphine is stronger than oxycodone.

Question 22

Children should not receive codeine after a tonsillectomy due to an increased risk for

A)central nervous system depression.
B)respiratory depression.
C)postural hypotension.
D)constipation.

Question 23

Codeine may cause nausea and vomiting by activating the chemoreceptor trigger zone in the

A)thalamus.
B)hypothalamus.
C)medulla.
D)frontal lobe.

Question 24

Which opioid agonist provides a strength of analgesic action between codeine and morphine?

A)Acetaminophen
B)Aspirin
C)Oxycodone (in Percodan,Percocet)
D)Dihydrocodone (in Synalgos-DC)

Question 25

Codeine activates the chemoreceptor trigger zone.

Question 26

Which of the following are classified as mixed opioid? (Select all that apply. )

A)Morphine
B)Pentazocine
C)Naloxone
D)Buprenorphine

Question 27

The following statements are false of tramadol except which one?

A)It binds to mu opioid receptors.
B)It inhibits reuptake of serotonin and norepinephrine.
C)It modifies ascending pain pathways.
D)It causes mydriasis.
E)Its analgesic efficacy is equivalent to that of codeine.

Question 28

How does adding naloxone to pentazocine reduce the addiction potential of orally administered pentazocine?

A)Naloxone is an opioid agonist that is effective orally but not parenterally.
B)Naloxone is an opioid agonist that is effective parenterally but not orally.
C)Naloxone is an opioid antagonist that is effective orally but not parenterally.
D)Naloxone is an opioid antagonist that is effective parenterally but not orally.
E)Naloxone is a nonsteroidal antiinflammatory.

Question 29

Which of the following agents is the only mixed opioid available for oral use?

A)Dezocine
B)Nalbuphine
C)Pentazocine
D)Butorphanol

Question 30

Combining an opioid with a nonopioid analgesic produces an additive analgesic effect with fewer adverse reactions.

Question 31

Which opioid analgesic is most likely to produce dysphoria?

A)Meperidine
B)Codeine
C)Pentazocine
D)Oxycodone
E)Hydrocodone

Question 32

Dentists prescribed about _____% of all opioids prescribed in the United States.

A)2
B)12
C)22
D)32
E)42

Question 33

Which of the following agents is a potent,short-acting,parenterally administered opioid that is commonly used during general anesthesia?

A)Dynorphin
B)Hydromorphone
C)Nalmefene
D)Fentanyl
E)Tramadol

Question 34

Tapentadol is an oral opioid receptor _____ and a _____ reuptake inhibitor.

A)agonist;norepinephrine
B)agonist;acetylcholine
C)antagonist;norepinephrine
D)antagonist;acetylcholine

Question 35

Which of the following choices is the drug of choice to treat a patient who has taken an overdose of an opioid?

A)2-pralidoxime
B)Naloxone
C)N-acetylcysteine
D)Activated charcoal
E)Methadone

Question 36

Which opioid analgesic is a Schedule II controlled substance?

A)Pentazocine (in Talwin HX)
B)Hydrocodone (in Vicodin,Lortab,Lorcet)
C)Codeine (in Tylenol #3,Empirin #3)
D)Dihydrocodeine (in Synalgos-DC)

Question 37

Each of the following contains naltrexone except one.Which is the exception?

A)Embeda
B)Targiniq ER
C)Xtampza
D)Troxyca

Question 38

What is the primary advantage of oxycodone ER over previous formulations?

A)It is formulated to help deter substance abuse.
B)It is not a controlled substance.
C)It is a liquid for administration to patients who have difficulty swallowing.
D)It is a Schedule III narcotic,so it is easier to prescribe.

Question 39

Which is true regarding naloxone access laws?

A)Federal law restricts the use of naloxone to emergency medical services (EMS)teams.
B)The law requires criminal prosecution for persons who need to use of naloxone.
C)A number of jurisdictions have passed laws making naloxone available to first responders,family members,and close friends of persons taking or abusing opioids.
D)Naloxone will potentiate effects of a narcotic and should be used strictly to prevent withdrawal.

Question 40

Which of the following types of pain medications is the best choice for management of most dental pain?

A)Antidepressants
B)Nonsteroidal antiinflammatory drugs (NSAIDs)
C)Aspirin
D)Acetaminophen

Question 41

A patient who feels nauseated after taking codeine is allergic to it.

Question 42

Opioids are the first choice for the treatment of chronic pain,such as temporomandibular joint and muscle disorders.