Anesthesia Pharmacology Chapter 27: Gastrointestinal Pharmacology Practice Questions

Naldemedine (Symproic):
1. Naltrexone derivative
2. Limited access to the central nervous system in part due to polar side chains
3. Both
4. Neither
Naldemedine:
1. Orally administered
2. Metabolized by the cytochrome P450 liver microsomal metabolizing system, specifically by CYP3A .
3. Both
4. Neither
Naldemedine:
1. Management of opioid-induced constipation in adults being treated for noncancer chronic pain.
2. Adverse reactions are mainly due to CNS effects.
3. Contraindicated in individuals who may have or have confirmed G.I. tract obstruction.
4. A & B
5. B & C
6. A & C
7. A, B & C
Naldemedine administration may induce opioid withdrawal.
1. True
2. False
Naldemedine is a substrate for P-glycoprotein 1 (PGP i.e. permeability glycoprotein) a.k.a. multidrug resistance protein 1 and as a result this transporter limits accumulation of naldemedine in the brain.
1. True
2. False
Naloxegol (Movantik):
1. Consists of naloxone conjugated to a polyethylene glycol (PEG) polymer.
2. Substrate for the PGP multidrug resistance transporter which limits naloxegol access to the CNS.
3. Both
4. Neither
Naloxegol would be categorized as a peripherally-restricted morphine receptor blocker.
1. True
2. False
Naloxegol administration and metabolism:
1. By IV administration
2. Metabolized mainly by the liver drug metabolizing system (cytochrome P450 isoform type CYP3A)
3. Both
4. Neither
Naloxegol may be administered for management of opioid-induced constipation and all patients, following discontinuation of other laxatives.
1. True
2. False
Major adverse reaction(s) associated with naloxegol administration:
1. Diarrhea
2. Nausea and vomiting
3. Both
4. Neither

Anesthesia Pharmacology: Gastrointestinal Pharmacology Practice Questions