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