Deck 10: Opioid Analgesics

Question 1

The classical drug laudanum is a combination of opium and:

A)cocaine.
B)aspirin.
C)cholinergic blockers.
D)ethanol.

Answer 1

D

Question 2

Endorphins exert most of their analgesic effects:

A)on the ascending spinothalamic tract.
B)on the ascending spinoreticular tract.
C)on descending inhibitory neurons in the spinal cord.
D)by reducing peripheral inflammation.

Answer 2

C

Question 3

Cell bodies of pain neurons from the periphery are located in the ________ neurons; terminals of pain neurons from the periphery are located in the ________.

A)dorsal horn; brain stem
B)dorsal root ganglia; brain stem
C)dorsal horn; dorsal root ganglia
D)dorsal root ganglia; dorsal horn

Answer 3

D

Question 4

The mixed agonist-antagonist Talwin has its greatest effect at the ________ receptor.

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

Question 5

Opioid receptors are best described as:

A)directly gated.
B)G-protein-coupled.
C)voltage gated.
D)mechanically gated.

Question 6

In morphine-dependent subjects,administration of a mixed agonist-antagonist:

A)produces effects similar to morphine.
B)produces no effects.
C)induces withdrawal.
D)produces effects similar to,but weaker than,morphine.

Question 7

Within the spinal cord,opiates inhibit pain primarily through:

A)axo-somatic excitation.
B)axo-axonic excitation.
C)axo-somatic inhibition.
D)axo-axonic inhibition.

Question 8

Activation of kappa receptors causes:

A)euphoria.
B)severe respiratory depression.
C)pupil dilation.
D)dysphoria.

Question 9

The effect of pure opiate antagonists,such as naltrexone,on opiate-dependent subjects is:

A)decreased pain threshold.
B)dysphoria.
C)nonexistent.
D)decreased pain threshold and dysphoria.

Question 10

Analgesic drugs can modulate pain by all the following processes,EXCEPT:

A)reducing inflammation.
B)blocking NMDA receptors in the spinal cord.
C)activating descending fibers from the brain to the dorsal horn of the spinal cord.
D)inhibiting endorphin-secreting neurons in the dorsal horn of the spinal cord.

Question 11

The miosis produced by opiates is the result of action at the ________ receptor.

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

Question 12

Compared with a pure agonist,a partial agonist in drug-naive subjects:

A)has no effect.
B)has effects opposite to the agonist.
C)has lower efficacy.
D)has higher efficacy.

Question 13

Within the spinal cord,opiates inhibit pain primarily through:

A)postsynaptic excitation
B)postsynaptic inhibition.
C)presynaptic excitation.
D)presynaptic inhibition.

Question 14

Compared with a pure agonist,a mixed agonist-antagonist in drug-naive subjects has:

A)no effect.
B)effects opposite to the agonist.
C)lower efficacy.
D)has higher efficacy.

Question 15

Nociceptors are activated by:

A)noise.
B)pain centers in the brain .
C)pain-inhibiting pathways.
D)mechanical,thermal,or chemical injury.

Question 16

Neural pathways mediating analgesia from the brain to dorsal horn of the spinal cord are classic examples of:

A)ascending transmission.
B)presynaptic facilitation.
C)reflects arcs.
D)descending inhibition.

Question 17

The major euphoric and analgesic effects of opiates are the result of action at the ________ receptor.

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

Question 18

Mu receptors for opiates are found in high density in all of the following regions,EXCEPT:

A)the dorsal horn of the spinal cord.
B)the cerebral cortex.
C)the thalamus.
D)the spinal trigeminal nucleus.

Question 19

Enkephalin is comprised of:

A)beta-endorphin.
B)dynorphins.
C)both beta-endorphin and dynorphins.
D)neither beta-endorphins nor dynorphins.

Question 20

In drug-naive and opiate-dependent subjects,respectively,a mixed agonist-antagonist opiate has effects most resembling:

A)an opiate; an opiate antagonist.
B)an opiate antagonist; an opiate.
C)an opiate; an opiate.
D)an opiate antagonist; an opiate antagonist.

Question 21

The first-pass metabolism of morphine produces:

A)inactive metabolites only.
B)an active metabolite.
C)codeine.
D)both an active metabolite and codeine.

Question 22

Two signs characteristic of narcotic analgesic indigestion are:

A)analgesia and diarrhea.
B)diarrhea and pupil constriction.
C)diarrhea and pupil dilatation.
D)analgesia and pupil constriction.

Question 23

The main difference between OxyContin and Percodan is that OxyContin:

A)has greater efficacy.
B)has greater potency.
C)affects different opiate receptor subtypes.
D)is time-released.

Question 24

Opiate antagonists that reduce constipation without precipitating withdrawal act in:

A)both the CNS and the PNS.
B)neither the CNS nor the PNS.
C)the CNS but not the PNS.
D)the PNS but not the CNS.

Question 25

The most common cause of death by Fentanyl overdose is:

A)cardiac arrhythmia.
B)seizure.
C)hypotension.
D)respiratory arrest.

Question 26

The first-pass metabolite of morphine is active but less potent than morphine.

Question 27

A new class of opioid drugs aimed at curbing abuse combine opiate agonists with:

A)methadone.
B)5-HT reuptake inhibitors.
C)constipation-inducing agents.
D)opiate antagonists.

Question 28

Beta-endorphin is a type of enkephalin.

Question 29

Of the following,the major difference between morphine and heroin is in:

A)efficacy.
B)ceiling effect.
C)rate of elimination.
D)rate of absorption.

Question 30

Clonidine (Catapress)is a potent alpha-2-agonist that suppresses activity of locus coeruleus neurons.Based on your knowledge of the physiology of withdrawal,you would expect clonidine to:

A)have no effect on opiate withdrawal.
B)increase the severity of opiate withdrawal.
C)decrease the severity of opiate withdrawal.
D)have different effects depending on dopamine levels.

Question 31

Of the following,the most potent opiate is:

A)codeine.
B)morphine.
C)heroin.
D)Dilaudid.

Question 32

Which of the following statement is TRUE?

A)Morphine profoundly affects respiration and numerous sensory modalities.
B)Morphine profoundly affects respiration but no sensory modalities other than pain.
C)Morphine affects neither respiration nor any sensory modalities.
D)Morphine does not affect respiration but affects numerous sensory modalities.

Question 33

Opiate withdrawal symptoms are accompanied by ________ dopamine release in the nucleus accumbens and ________ norepinephrine release by the locus coeruleus.

A)increased; increased
B)increased; decreased
C)decreased; increased
D)decreased; decreased

Question 34

The first-pass metabolism of heroin produces:

A)an inactive metabolite.
B)an active metabolite.
C)morphine.
D)an inactive metabolite and an active metabolite.

Question 35

Talwin and Stadol are best described as:

A)opiate agonists.
B)mixed agonist-antagonists.
C)partial agonists.
D)opiate antagonists.

Question 36

Selective serotonin reuptake inhibitors:

A)have no interaction with codeine.
B)can potentiate the effectiveness of codeine.
C)can block the receptor for codeine.
D)can inhibit the metabolism of codeine,thereby blocking pain relief.

Question 37

Much of the analgesic action of the opiates occurs in the spinal cord.

Question 38

The effect of pure opiate antagonists,such as naltrexone,on drug-naive subjects is:

A)decreased pain threshold.
B)dysphoria.
C)analgesia.
D)nonexistent.

Question 39

Tramadol (Ultram)is a unique narcotic in that:

A)it is both an opiate analgesic and a serotonin and norepinephrine reuptake blocker.
B)it is both an opiate analgesic and an anxiolytic.
C)it is both an opiate analgesic and an anti-manic drug.
D)it has no action at the mu receptor.

Question 40

The first-pass metabolism of codeine produces:

A)an active metabolite.
B)cocaine.
C)morphine.
D)heroin.

Question 41

All the commercially available opiate antagonists readily cross the blood-brain barrier.

Question 42

Methadone and suboxare are equally efficacious for treating heroin dependency.

Question 43

Much of the action of morphine is mediated by its metabolite.

Question 44

Fentanyl is one of the most potent opiates known.

Question 45

Opiates affect the same dopamine reward pathways as cocaine.

Question 46

Opiates dilate pupils.

Question 47

Codeine is converted into morphine by the liver.

Question 48

Morphine analgesia occurs without affecting other sensory modalities.

Question 49

Owing to an FDA recommendation to ban Darvon,the drug is no longer commercially available.

Question 50

Heroin is converted into morphine by the liver.

Question 51

Tramadol can increase the toxicity of 5-HT-based antidepressants.

Question 52

Heroin is absorbed into the CNS more quickly than morphine.

Question 53

Opiate antagonists have "opiate-like" effects in drug-naive subjects.

Question 54

The relatively weak effect of Darvon is a result of its action as a partial opiate agonist.

Question 55

Opiate antagonists have "anti-opiate" effects in drug-naive subjects.