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Questions and Answers
Which condition may be paradoxically induced by prolonged exposure to opioids?
Which condition may be paradoxically induced by prolonged exposure to opioids?
What effect is primarily associated with μ receptor activation in opioids?
What effect is primarily associated with μ receptor activation in opioids?
What unwanted effect can occur with the use of codeine, even at subanalgesic doses?
What unwanted effect can occur with the use of codeine, even at subanalgesic doses?
What typically happens to nausea and vomiting following morphine administration over time?
What typically happens to nausea and vomiting following morphine administration over time?
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What is a common gastrointestinal effect of opioids?
What is a common gastrointestinal effect of opioids?
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What specific feature is indicative of opioid poisoning?
What specific feature is indicative of opioid poisoning?
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Which of the following is NOT a consequence of opioid use?
Which of the following is NOT a consequence of opioid use?
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What rapid intervention can reverse respiratory depression caused by opioids?
What rapid intervention can reverse respiratory depression caused by opioids?
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What is primarily responsible for the development of tolerance to opioids?
What is primarily responsible for the development of tolerance to opioids?
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Which opioid is least likely to cause significant physical dependence when used?
Which opioid is least likely to cause significant physical dependence when used?
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The symptoms of withdrawal syndrome from opioids may include all of the following EXCEPT:
The symptoms of withdrawal syndrome from opioids may include all of the following EXCEPT:
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Which of the following methods can reduce withdrawal syndrome in opioid-dependent individuals?
Which of the following methods can reduce withdrawal syndrome in opioid-dependent individuals?
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Which type of opioid is known as a mixed agonist/antagonist?
Which type of opioid is known as a mixed agonist/antagonist?
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Which drug is primarily used to manage severe pain in conditions like myocardial infarction?
Which drug is primarily used to manage severe pain in conditions like myocardial infarction?
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What is the primary route for administering methadone for chronic pain management?
What is the primary route for administering methadone for chronic pain management?
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What are µ-receptor antagonists used for in opioid treatment?
What are µ-receptor antagonists used for in opioid treatment?
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What is the main action of major analgesics on the body?
What is the main action of major analgesics on the body?
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Which of the following best describes visceral pain?
Which of the following best describes visceral pain?
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Which neurotransmitter is NOT known to inhibit pain transmission in the nociceptive pathway?
Which neurotransmitter is NOT known to inhibit pain transmission in the nociceptive pathway?
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What function do anti-inflammatory drugs serve in the context of pain management?
What function do anti-inflammatory drugs serve in the context of pain management?
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What is the role of endogenous opioids in pain modulation?
What is the role of endogenous opioids in pain modulation?
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Which of the following substances is classified as a minor analgesic?
Which of the following substances is classified as a minor analgesic?
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The latex from the capsule of which plant is a source of opioid alkaloids?
The latex from the capsule of which plant is a source of opioid alkaloids?
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What defines neuropathic pain?
What defines neuropathic pain?
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What is a significant reason for using fentanyl over morphine in anesthesia?
What is a significant reason for using fentanyl over morphine in anesthesia?
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Which opioid is specifically indicated for analgesia during labor?
Which opioid is specifically indicated for analgesia during labor?
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What is a notable pharmacological action of methadone?
What is a notable pharmacological action of methadone?
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Which statement about morphine is true?
Which statement about morphine is true?
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What is the primary reason naloxone is administered?
What is the primary reason naloxone is administered?
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Why is codeine rarely addictive compared to other opioids?
Why is codeine rarely addictive compared to other opioids?
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What adverse effect is related to meperidine's antimuscarinic profile?
What adverse effect is related to meperidine's antimuscarinic profile?
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Which of the following opioids is less potent than morphine?
Which of the following opioids is less potent than morphine?
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Which statement correctly describes the mechanism of action of tramadol?
Which statement correctly describes the mechanism of action of tramadol?
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What is a primary indication for buprenorphine as an opioid analgesic?
What is a primary indication for buprenorphine as an opioid analgesic?
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Which property makes naloxone a suitable choice for treating opioid overdose?
Which property makes naloxone a suitable choice for treating opioid overdose?
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What potential effect can buprenorphine have on a person who is physically dependent on a full opioid agonist?
What potential effect can buprenorphine have on a person who is physically dependent on a full opioid agonist?
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What differentiates naltrexone from naloxone in terms of duration of action?
What differentiates naltrexone from naloxone in terms of duration of action?
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Which of the following conditions is tramadol NOT typically indicated for?
Which of the following conditions is tramadol NOT typically indicated for?
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What is a significant safety feature of tramadol compared to most opioids?
What is a significant safety feature of tramadol compared to most opioids?
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Which of the following accurately describes why opioids might be contraindicated in certain patients?
Which of the following accurately describes why opioids might be contraindicated in certain patients?
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Which statement accurately describes the use of naltrexone in patients with opioid addiction?
Which statement accurately describes the use of naltrexone in patients with opioid addiction?
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What is typically indicated for chronic primary pain conditions?
What is typically indicated for chronic primary pain conditions?
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How do opioids combined with paracetamol or aspirin primarily interact?
How do opioids combined with paracetamol or aspirin primarily interact?
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What is a common feature of neuropathic pain?
What is a common feature of neuropathic pain?
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Which of the following medications is primarily used to manage trigeminal neuralgia?
Which of the following medications is primarily used to manage trigeminal neuralgia?
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What characterizes fibromyalgia in terms of symptoms?
What characterizes fibromyalgia in terms of symptoms?
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Which of the following is not a characteristic of chronic secondary pain?
Which of the following is not a characteristic of chronic secondary pain?
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What is considered a benefit of using various antidepressants in pain management?
What is considered a benefit of using various antidepressants in pain management?
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Flashcards
Analgesia
Analgesia
The elimination of pain sensation by blocking pain pathways or mediators, or by disconnecting pain centers.
Analgesic drug
Analgesic drug
A drug designed to relieve pain.
Inflammation
Inflammation
The process of the body protecting itself against infection by inflammation.
Anti-inflammatory drug
Anti-inflammatory drug
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Major Analgesics (Opioids/Morphine-like)
Major Analgesics (Opioids/Morphine-like)
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Minor Analgesics (Paracetamol & NSAIDs)
Minor Analgesics (Paracetamol & NSAIDs)
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Local anesthetics
Local anesthetics
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Somatic Pain
Somatic Pain
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Visceral Pain
Visceral Pain
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Neuropathic Pain
Neuropathic Pain
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Glutamate
Glutamate
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Substance P
Substance P
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CGRP
CGRP
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Serotonin
Serotonin
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Papaver somniferum
Papaver somniferum
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Tolerance (Opioids)
Tolerance (Opioids)
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Physical Dependence (Opioids)
Physical Dependence (Opioids)
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Opioid Withdrawal Syndrome
Opioid Withdrawal Syndrome
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Opioid Rotation
Opioid Rotation
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Opioid Agonists
Opioid Agonists
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Opioid Antagonists
Opioid Antagonists
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Morphine
Morphine
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Fentanyl
Fentanyl
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Opioid-induced hyperalgesia
Opioid-induced hyperalgesia
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Respiratory depression from opioids
Respiratory depression from opioids
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Opioid-induced cough suppression
Opioid-induced cough suppression
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Nausea and vomiting from opioids
Nausea and vomiting from opioids
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Gastrointestinal effects of opioids
Gastrointestinal effects of opioids
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Pupil constriction (miosis) from opioids
Pupil constriction (miosis) from opioids
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Histamine release from opioids
Histamine release from opioids
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Immune system effects of opioids
Immune system effects of opioids
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Alfentanil
Alfentanil
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Meperidine
Meperidine
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Methadone
Methadone
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Codeine
Codeine
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Naloxone
Naloxone
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Opioid Side Effects
Opioid Side Effects
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Tramadol: Mechanism of Action
Tramadol: Mechanism of Action
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Tramadol: Indications
Tramadol: Indications
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Buprenorphine: Mechanism of Action
Buprenorphine: Mechanism of Action
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Buprenorphine: Indications
Buprenorphine: Indications
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Naloxone: Mechanism of Action
Naloxone: Mechanism of Action
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Naloxone: Indications
Naloxone: Indications
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Naltrexone: Mechanism of Action
Naltrexone: Mechanism of Action
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Naltrexone: Indications
Naltrexone: Indications
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Opioid Addiction Maintenance Therapy
Opioid Addiction Maintenance Therapy
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Opioid Synergy
Opioid Synergy
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Chronic Secondary Pain
Chronic Secondary Pain
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Chronic Primary Pain
Chronic Primary Pain
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Fibromyalgia
Fibromyalgia
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Allodynia
Allodynia
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Cancer Pain
Cancer Pain
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Study Notes
Analgesic Drugs
- Analgesia is the elimination of pain sensation by blocking pain pathways or disconnecting pain centers.
- Analgesic drugs are designed to relieve pain.
- Inflammation is the body's response to protect against infection and injury.
- Anti-inflammatory drugs inhibit the inflammatory process by targeting factors involved in inflammation and pain.
Types of Analgesics
- Major Analgesics (opioids/morphine-like): act centrally and are used for post-operative, oncological, myocardial infarction, acute or chronic pain.
- Minor Analgesics (paracetamol and NSAIDs): act peripherally by blocking inflammation mediators.
- Local Anesthetics (e.g., lidocaine): provide local action on peripheral nerves.
Types of Pain
- Somatic pain: well-localized pain in skin, subcutaneous tissue, or musculoskeletal tissue.
- Visceral pain: poorly localized pain originating in thoracic or abdominal structures, often referred to somatic areas.
- Neuropathic pain: pain caused by nerve damage (e.g., nerve compression, inflammation, diabetes).
Modulatory Mechanisms in Nociceptive Pathway
- Nociceptors are activated by stimuli (chemical, mechanical, thermal).
- Ascending pain pathways transmit pain signals from nociceptors to the brain.
- Descending inhibitory pathways from the brain reduce pain signals.
- Key neurotransmitters involved include glutamate, substance P, and CGRP.
- Analgesics can either activate or inhibit these pathways.
Analgesic Drugs - Opioids
- Opioid: any substance that produces morphine-like effects.
- Opiate: compounds found in opium poppy (e.g., morphine, codeine).
- Narcotic Analgesic: older term for opioids, referring to their sleep-inducing properties.
- Opioids act by inhibiting neurotransmitter release and causing hyperpolarization.
Opioid Receptors
- Opioid receptors are linked to Gi/Go proteins.
- µ-receptors are primarily responsible for analgesia and can cause euphoria, sedation, respiratory depression, and constipation.
- δ-receptors contribute to analgesia at the spinal level and may cause sedation, dysphoria, and hallucinations.
- κ-receptors contribute to analgesia at the spinal level as well, and may cause sedation, dysphoria, and hallucinations.
- NOP receptors have an anti-opioid effect and are involved in reducing learning and causing immobility
Opioid Effects
- Analgesia: pain relief.
- Dysphoria/Euphoria: mood changes, can range from unpleasant to pleasurable depending on circumstances
- Inhibition of cough reflex,
- Miosis (pupillary constriction)
- Physical dependence
- Respiratory Depression
- Tolerance:Decreased effectiveness with chronic use.
Opioids - Specific Drugs
- Morphine: used for acute severe pain. Available as IV, oral, transdermal patches, and intrathecally. Has slow-release preparations to increase duration of action
- Fentanyl: potent opioid agonist; more rapid onset & shorter duration of action, minimal cardio effects. Used in anesthesia and chronic pain.
- Meperidine : Used for analgesia during labor and short-term acute pain treatment . It does not reduce uterine contraction strength.
- Methadone: heroin substitution treatment. Acts on opioid receptors, reducing withdrawal symptoms without euphoria
- Codeine: antitussive, reliable oral absorption but weaker than morphine.
- Oxycodone/Hydrocodone: moderate to severe pain, slow-release oral preparations.
- Tramadol: weak u-opioid agonist; better safety profile, minimal tolerance/dependence.
- Buprenorphine: mixed opioid agonist/antagonist; safer in cases of overdose, opioid dependence treatment.
- Naloxone Pure Opioid antagonist, used to reverse respiratory depression.
- Naltrexone: longer-acting than naloxone, useful for prolonged opioid addiction treatment.
Chronic pain
- Secondary chronic pain originates from known causes like nerve damage, infection etc.
- Primary chronic pain has no known cause.
Other Pain Relieving Drugs
- Cannabinoids: useful for multiple sclerosis neuropathic pain (Nabilone, Dronabinol)
- Botulinum toxin: relieves back pain and spasticity.
- Nefopam: amine uptake inhibitor, treats persistent pain unresponsive to non-opioid drugs.
- Dopamine receptor agonists: (ropinirole, pramipexole, Rotigotine): useful for restless leg syndrome.
Use of Opioids and Pain Killers in Combination
Opioids combined with paracetamol or aspirin can produce synergy (stronger effect) rather than simple additivity.
Mechanism of Action of Opioids
- Opioids primarily work by activating Gi/Go protein-coupled receptors.
- Activation of these receptors leads to the opening of K+ channels and preventing voltage-gated Ca2+ channels.
- This decreased neuronal excitability and reduced transmitter release result in an inhibitory effect at a cellular level.
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Description
This quiz covers the essential concepts of analgesic drugs, including the different types such as major, minor, and local anesthetics. Learn about how these drugs function to relieve various types of pain and the body's inflammatory response. Ideal for students and professionals in the medical and pharmaceutical fields.