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

The source of the naturally occurring opioid analgesics is:

A)the foxglove plant.
B)the opium poppy.
C)St Johns wort.
D)leaves from the gingko tree.
E)none of the above;opioid analgesics cannot be derived from natural sources.

Answer 2

the opium poppy.

Question 3

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.

Answer 3

physical dependence.

Question 4

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 dose of the drug to achieve a therapeutic effect when the drug is used for prolonged periods.
D)all of the above
E)none of the above

Question 5

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

A)catecholamines (epinephrine,norepinephrine).
B)glucocorticoids (cortisol).
C)anabolic steroids (testosterone).
D)endogenous opioids (endorphins,enkephalins).
E)insulinlike growth factor.

Question 6

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 (hyperpolarization)in postsynaptic neurons.
C)decrease production of endogenous chemicals known as catecholamines.
D)all of the above
E)A and B

Question 7

Drugs such as butorphanol (Stadol),nalbuphine (Nubain),and pentazocine (Talwin)may stimulate certain opioid receptors while blocking or only partially activating others.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 of the above

Question 8

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

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

Question 9

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)

Question 10

Opioid analgesics are also known 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 11

By blocking all opioid receptors,opioid antagonists such as nalmefene (Revex)and naloxone (Narcan)are used therapeutically to:

A)treat severe,acute postoperative pain.
B)treat severe,chronic pain.
C)treat opioid overdose.
D)treat diarrhea.
E)none of the above;opioid antagonists have no therapeutic value.

Question 12

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 opioidlike effects,but is not an opioid.
D)does not cross the blood-brain barrier.
E)none of the above

Question 13

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 14

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)none of the above;there is no evidence that opioids can produce analgesic effects outside to the central nervous system.