Opioids: Question Set #2

Anesthesia Pharmacology Chapter 13: Opioid Pharmacology Advanced Topics Practice Questions

More appropriate term because it implies the production of analgesia:
1. narcotic
2. opioid analgesic
Principal alkaloid in opium (derived from opium poppy)
1. morphine
2. fentanyl (Sublimaze)
3. codeine
4. naloxone (Narcan)
5. meperidine (Demerol)
Descriptive of the drug that may have an agonist effect at one opioid receptor site and an antagonist effect at another opioid receptor site.
1. full agonist
2. pure antagonist
3. mixed agonist-antagonist
4. endorphin
5. dynorphins
Endogenous opioid precursor that contains the met-enkephalin sequence, beta-endorphins, and several nonopioid peptides including ACTH, beta-lipotropin, and melanocyte-stimulating hormone.
1. preproenkephalin (proenkephalin A)
2. prepro-opiomelanocortin (POMC)
3. preprodynorphin (proenkephalin B)
Main tissue reservoir for opioids:
1. fat
2. skeletal muscle
3. spleen
4. liver
5. lungs
Crosses the blood-brain barrier most easily:
1. morphine
2. codeine
3. both
4. neither
Very short-acting; substrate for tissue esterases
1. morphine
2. levorphanol (Levo-dromoran)
3. remifentanil (Ultiva)
4. fentanyl (Sublimaze)
5. none of the above
Crosses the neonatal blood-brain barrier:
1. morphine
2. meperidine (Demerol)
3. fentanyl (Sublimaze)
4. oxycodone (Roxicodone)
5. all of the above
Polar glucuronide metabolite of this opioid may have higher analgesic potency then the parent compound:
1. remifentanil (Ultiva)
2. morphine
3. both
4. neither
Analgesia, euphoria, respiratory depression associated with morphine are probably mediated mainly through this opioid receptor type:
1. Kappa
2. Delta
3. Mu
Opioid direct action on neurons:
1. may close a voltage-gated calcium channel on presynaptic nerve terminals, resulting in reduced transmitter release
2. depolarization of postsynaptic neurons by opening a sodium channel
3. blockade of sodium channels, in a manner similar to the neurotoxin, tetrodotoxin
4. A & C
5. B & C
Anatomical sites of opioid action: pain-modulating descending pathways --
1. rostral ventral medulla
2. locus ceruleus
3. periaqueductal gray
4. A & C
5. A, B & C
Most reliable indicator of opioid-mediated respiratory depression:
1. reduced patient responsiveness
2. alveolar PCO2 increased
3. depressed patient response to a carbon dioxide challenge
4. increased levels of alkaline phosphatase
5. increased levels of creatinine
Opioid + Route of Administration most likely associated with truncal rigidity:
1. oral pentazocine (Talwain)
2. oral propoxyphene (Darvon)
3. intravenous, rapidly infused, alfentanil
4. intravenous naloxone (Narcan)
5. intravenous naltrexone (ReVia)
Opioid effect least likely to exhibit tolerance following prolonged opioid administration:
1. analgesia
2. bradycardia
3. respiratory depression
4. miosis
5. euphoria