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Questions and Answers
What term is derived from the Greek word for stupor and traditionally refers to potent morphine-like analgesics with the potential to produce physical dependence?
What term is derived from the Greek word for stupor and traditionally refers to potent morphine-like analgesics with the potential to produce physical dependence?
- Opiate
- Alkaloid
- Opioid
- Narcotic (correct)
Which alkaloid is the best known opiate?
Which alkaloid is the best known opiate?
- Opium
- Papaverine
- Morphine (correct)
- Codeine
What is the source of 20 distinct alkaloids?
What is the source of 20 distinct alkaloids?
- Opium (correct)
- Morphine
- Poppy juice
- Codeine
Which classification of opioids includes opioid agonists, opioid agonist-antagonists, and opioid antagonists?
Which classification of opioids includes opioid agonists, opioid agonist-antagonists, and opioid antagonists?
Which of the following is a possible adverse effect of opioids?
Which of the following is a possible adverse effect of opioids?
What is the main cause of death from an opioid overdose?
What is the main cause of death from an opioid overdose?
Which factor increases the ventilatory depressant effects of opioids?
Which factor increases the ventilatory depressant effects of opioids?
Which opioid property allows for cough suppression without analgesia or depression of ventilation?
Which opioid property allows for cough suppression without analgesia or depression of ventilation?
Which of the following is a synthetic opioid?
Which of the following is a synthetic opioid?
Which class of opioid receptors is responsible for analgesia?
Which class of opioid receptors is responsible for analgesia?
Which of the following opioids is a partial agonist?
Which of the following opioids is a partial agonist?
Which opioid antagonist is commonly used to reverse opioid overdose?
Which opioid antagonist is commonly used to reverse opioid overdose?
Which brain region is associated with the activation of the μ-opioid receptor system and reductions in the sensory and affective ratings of pain experience?
Which brain region is associated with the activation of the μ-opioid receptor system and reductions in the sensory and affective ratings of pain experience?
Which receptors are antagonized by H1- and H2-receptor antagonists to prevent changes in systemic blood pressure and systemic vascular resistance?
Which receptors are antagonized by H1- and H2-receptor antagonists to prevent changes in systemic blood pressure and systemic vascular resistance?
What is the effect of morphine on the plasma concentration of histamine?
What is the effect of morphine on the plasma concentration of histamine?
What effect does morphine have on the sympathetic nervous system tone to peripheral veins?
What effect does morphine have on the sympathetic nervous system tone to peripheral veins?
What is the mechanism behind morphine-induced bradycardia?
What is the mechanism behind morphine-induced bradycardia?
What are the cardiovascular effects of morphine during anesthesia?
What are the cardiovascular effects of morphine during anesthesia?
How can the magnitude of morphine-induced histamine release and subsequent decrease in systemic blood pressure be minimized?
How can the magnitude of morphine-induced histamine release and subsequent decrease in systemic blood pressure be minimized?
What is the effect of combining an opioid agonist with nitrous oxide on cardiovascular parameters?
What is the effect of combining an opioid agonist with nitrous oxide on cardiovascular parameters?
Which areas of the brain are primarily responsible for the presence of opioid receptors?
Which areas of the brain are primarily responsible for the presence of opioid receptors?
Where are opioid receptors found in the spinal cord?
Where are opioid receptors found in the spinal cord?
Which opioid receptor is responsible for supraspinal and spinal analgesia?
Which opioid receptor is responsible for supraspinal and spinal analgesia?
What is the role of δ opioid receptors?
What is the role of δ opioid receptors?
According to the text, what is the reported incidence of difficult ventilation after a moderate dose of sufentanil?
According to the text, what is the reported incidence of difficult ventilation after a moderate dose of sufentanil?
What is the usual recommendation for morphine titration?
What is the usual recommendation for morphine titration?
What is a common reason to discontinue morphine titration for postoperative analgesia?
What is a common reason to discontinue morphine titration for postoperative analgesia?
What can opioids cause in the biliary tract?
What can opioids cause in the biliary tract?
Which opioid increases common bile duct pressure the most?
Which opioid increases common bile duct pressure the most?
What may opioid-induced spasm of the sphincter of Oddi appear as radiologically?
What may opioid-induced spasm of the sphincter of Oddi appear as radiologically?
Which term is used to refer to exogenous substances that bind specifically to opioid receptors and produce morphine-like effects?
Which term is used to refer to exogenous substances that bind specifically to opioid receptors and produce morphine-like effects?
Which of the following is a classification of opioids?
Which of the following is a classification of opioids?
Which alkaloid was isolated in 1803 and is the best known opiate?
Which alkaloid was isolated in 1803 and is the best known opiate?
What is the source of 20 distinct alkaloids?
What is the source of 20 distinct alkaloids?
Which of the following opioids lacks analgesic activity?
Which of the following opioids lacks analgesic activity?
Which of the following opioids is a semisynthetic derivative of morphine?
Which of the following opioids is a semisynthetic derivative of morphine?
Which of the following opioids is a synthetic derivative of morphine?
Which of the following opioids is a synthetic derivative of morphine?
Which of the following opioids is widely used as a primary anesthetic drug in very high doses?
Which of the following opioids is widely used as a primary anesthetic drug in very high doses?
Which brain region is primarily responsible for the release of endogenous opioids and the modulation of pain experience?
Which brain region is primarily responsible for the release of endogenous opioids and the modulation of pain experience?
What is the effect of morphine on the sinoatrial node?
What is the effect of morphine on the sinoatrial node?
What is the effect of morphine on systemic blood pressure?
What is the effect of morphine on systemic blood pressure?
What is the effect of positive treatment expectancy on the analgesic benefit of remifentanil?
What is the effect of positive treatment expectancy on the analgesic benefit of remifentanil?
Which of the following areas of the brain is NOT primarily responsible for the presence of opioid receptors?
Which of the following areas of the brain is NOT primarily responsible for the presence of opioid receptors?
Which of the following is a potential use of intraarticular morphine?
Which of the following is a potential use of intraarticular morphine?
Which opioid receptor is responsible for inhibition of neurotransmitter release via N-type calcium channels?
Which opioid receptor is responsible for inhibition of neurotransmitter release via N-type calcium channels?
Which opioid receptor subtype is speculated to produce analgesia, while another subtype is responsible for hypoventilation, bradycardia, and physical dependence?
Which opioid receptor subtype is speculated to produce analgesia, while another subtype is responsible for hypoventilation, bradycardia, and physical dependence?
Which of the following is a potential adverse effect of opioids?
Which of the following is a potential adverse effect of opioids?
Which opioid effect is responsible for the decreased frequency of breathing often seen with opioids?
Which opioid effect is responsible for the decreased frequency of breathing often seen with opioids?
Which opioid property allows for cough suppression without producing analgesia or depression of ventilation?
Which opioid property allows for cough suppression without producing analgesia or depression of ventilation?
What is the likely explanation for opioid-induced increased skeletal muscle tone?
What is the likely explanation for opioid-induced increased skeletal muscle tone?
Which of the following is a characteristic of opioid-induced depression of ventilation?
Which of the following is a characteristic of opioid-induced depression of ventilation?
Which of the following opioids is commonly administered with inhaled or IV anesthetics to ensure amnesia?
Which of the following opioids is commonly administered with inhaled or IV anesthetics to ensure amnesia?
Which receptors contribute to the cardiovascular responses observed during anesthesia with morphine?
Which receptors contribute to the cardiovascular responses observed during anesthesia with morphine?
Which opioid agonist is associated with significant decreases in mean arterial pressure and systemic vascular resistance when administered after injection of diazepam?
Which opioid agonist is associated with significant decreases in mean arterial pressure and systemic vascular resistance when administered after injection of diazepam?
Which of the following is a common reason to discontinue morphine titration for postoperative analgesia?
Which of the following is a common reason to discontinue morphine titration for postoperative analgesia?
What can opioids cause in the biliary tract?
What can opioids cause in the biliary tract?
Which opioid increases common bile duct pressure the most?
Which opioid increases common bile duct pressure the most?
What effect does morphine have on the sympathetic nervous system tone to peripheral veins?
What effect does morphine have on the sympathetic nervous system tone to peripheral veins?
What may opioid-induced spasm of the sphincter of Oddi appear as radiologically?
What may opioid-induced spasm of the sphincter of Oddi appear as radiologically?
Which factor increases the ventilatory depressant effects of opioids?
Which factor increases the ventilatory depressant effects of opioids?
Opiates and opioids are derived from the same source.
Opiates and opioids are derived from the same source.
Morphine can only be derived from opium.
Morphine can only be derived from opium.
Narcotic is a term used to refer to any substance that produces physical dependence.
Narcotic is a term used to refer to any substance that produces physical dependence.
Opioids can produce analgesia without loss of touch, proprioception, or consciousness.
Opioids can produce analgesia without loss of touch, proprioception, or consciousness.
True or false: Morphine is classified as an opioid antagonist?
True or false: Morphine is classified as an opioid antagonist?
True or false: Codeine is a synthetic opioid?
True or false: Codeine is a synthetic opioid?
True or false: Naloxone is an opioid agonist?
True or false: Naloxone is an opioid agonist?
True or false: Fentanyl is a phenylpiperidine derivative?
True or false: Fentanyl is a phenylpiperidine derivative?
True or false: Opioid receptors are primarily found in the brain.
True or false: Opioid receptors are primarily found in the brain.
True or false: Activation of κ receptors results in inhibition of neurotransmitter release via N-type calcium channels.
True or false: Activation of κ receptors results in inhibition of neurotransmitter release via N-type calcium channels.
True or false: δ receptors respond to the endogenous ligands known as enkephalins.
True or false: δ receptors respond to the endogenous ligands known as enkephalins.
True or false: σ receptors are considered to be true opioid receptors.
True or false: σ receptors are considered to be true opioid receptors.
True or false: The analgesic response to a placebo involves the release of endorphins.
True or false: The analgesic response to a placebo involves the release of endorphins.
True or false: Positive treatment expectancy enhances the analgesic benefit of remifentanil.
True or false: Positive treatment expectancy enhances the analgesic benefit of remifentanil.
True or false: Morphine can cause direct myocardial depression.
True or false: Morphine can cause direct myocardial depression.
True or false: Morphine-induced histamine release always leads to a decrease in systemic blood pressure.
True or false: Morphine-induced histamine release always leads to a decrease in systemic blood pressure.
True or false: Pretreatment with H1- and H2-receptor antagonists alters the release of histamine evoked by morphine.
True or false: Pretreatment with H1- and H2-receptor antagonists alters the release of histamine evoked by morphine.
True or false: Morphine-induced decreases in systemic blood pressure and systemic vascular resistance are accompanied by increases in the plasma concentration of histamine.
True or false: Morphine-induced decreases in systemic blood pressure and systemic vascular resistance are accompanied by increases in the plasma concentration of histamine.
True or false: Opioids sensitize the heart to catecholamines and predispose to cardiac dysrhythmias.
True or false: Opioids sensitize the heart to catecholamines and predispose to cardiac dysrhythmias.
True or false: The combination of an opioid agonist and nitrous oxide results in cardiovascular depression.
True or false: The combination of an opioid agonist and nitrous oxide results in cardiovascular depression.
True or false: Opioid-induced ventilatory depression can be mitigated by using biased ligands at opioid receptors.
True or false: Opioid-induced ventilatory depression can be mitigated by using biased ligands at opioid receptors.
True or false: Depression of ventilation produced by opioids manifests as a decreased frequency of breathing accompanied by a compensatory increase in tidal volume.
True or false: Depression of ventilation produced by opioids manifests as a decreased frequency of breathing accompanied by a compensatory increase in tidal volume.
True or false: Opioids can depress cough by affecting the medullary cough centers.
True or false: Opioids can depress cough by affecting the medullary cough centers.
True or false: In the absence of hypoventilation, opioids can decrease cerebral blood flow and possibly intracranial pressure.
True or false: In the absence of hypoventilation, opioids can decrease cerebral blood flow and possibly intracranial pressure.
True or false: The reported incidence of difficult ventilation after a moderate dose of sufentanil ranges from 84% to 100%?
True or false: The reported incidence of difficult ventilation after a moderate dose of sufentanil ranges from 84% to 100%?
True or false: Sedation occurs in up to 60% of patients during morphine titration?
True or false: Sedation occurs in up to 60% of patients during morphine titration?
True or false: Opioids can cause spasm of biliary smooth muscle, resulting in increases in biliary pressure?
True or false: Opioids can cause spasm of biliary smooth muscle, resulting in increases in biliary pressure?
True or false: Naloxone will relieve pain caused by biliary spasm but not myocardial ischemia?
True or false: Naloxone will relieve pain caused by biliary spasm but not myocardial ischemia?
True or false: Nitroglycerin will relieve pain due to either biliary spasm or myocardial ischemia?
True or false: Nitroglycerin will relieve pain due to either biliary spasm or myocardial ischemia?
True or false: Equal analgesic doses of fentanyl, morphine, meperidine, and pentazocine increase common bile duct pressure 99%, 53%, 61%, and 15% above predrug levels, respectively?
True or false: Equal analgesic doses of fentanyl, morphine, meperidine, and pentazocine increase common bile duct pressure 99%, 53%, 61%, and 15% above predrug levels, respectively?
Which of the following is NOT a naturally occurring opium alkaloid?
Which of the following is NOT a naturally occurring opium alkaloid?
Which opioid receptor is responsible for supraspinal analgesia and most of the classic clinical actions of opioid agonists?
Which opioid receptor is responsible for supraspinal analgesia and most of the classic clinical actions of opioid agonists?
Which opioid receptor is responsible for spinal analgesia and sedation?
Which opioid receptor is responsible for spinal analgesia and sedation?
How many main types of opioid receptors are there in the central nervous system?
How many main types of opioid receptors are there in the central nervous system?
Which opioid receptor subtype is responsible for analgesia in the central nervous system?
Which opioid receptor subtype is responsible for analgesia in the central nervous system?
Which opioid receptor subtype is associated with sedation and dysphoria?
Which opioid receptor subtype is associated with sedation and dysphoria?
Which opioid receptor subtype is responsible for miosis?
Which opioid receptor subtype is responsible for miosis?
Which opioid receptor subtype is associated with inhibition of peristalsis and nausea?
Which opioid receptor subtype is associated with inhibition of peristalsis and nausea?
Which term is derived from the Greek word for 'sap' and refers to potent morphine-like analgesics with the potential to produce physical dependence?
Which term is derived from the Greek word for 'sap' and refers to potent morphine-like analgesics with the potential to produce physical dependence?
Which classification system divides opioids into four categories: agonists, partial agonists, agonists-antagonists, and antagonists?
Which classification system divides opioids into four categories: agonists, partial agonists, agonists-antagonists, and antagonists?
What is the effect of opioids on pain pathways in the central nervous system?
What is the effect of opioids on pain pathways in the central nervous system?
What is the relationship between the stereochemical structure and potency of opioids?
What is the relationship between the stereochemical structure and potency of opioids?
Which of the following factors can affect the pharmacokinetics and pharmacodynamics of opioids?
Which of the following factors can affect the pharmacokinetics and pharmacodynamics of opioids?
True or false: Advancing age requires higher opioid doses for the treatment of postsurgical pain.
True or false: Advancing age requires higher opioid doses for the treatment of postsurgical pain.
Which of the following statements about morphine dosage requirements is true?
Which of the following statements about morphine dosage requirements is true?
Which of the following is a common clinical effect of opioid agonists?
Which of the following is a common clinical effect of opioid agonists?
Which substance was isolated from opium in 1803 and named after the Greek god of dreams?
Which substance was isolated from opium in 1803 and named after the Greek god of dreams?
What was the goal of synthetic manufacture of analgesics?
What was the goal of synthetic manufacture of analgesics?
What term is used to refer to a group of drugs that possess opium-like properties?
What term is used to refer to a group of drugs that possess opium-like properties?
When were the syringe and needle introduced into clinical practice, allowing for accurate intravenous administration of opioids?
When were the syringe and needle introduced into clinical practice, allowing for accurate intravenous administration of opioids?
Which enzyme is responsible for metabolizing remifentanil?
Which enzyme is responsible for metabolizing remifentanil?
Which opioid has a low volume of distribution and a short half-life of approximately 10 minutes?
Which opioid has a low volume of distribution and a short half-life of approximately 10 minutes?
Which opioid metabolite is neurotoxic and may accumulate in the elderly or in patients with decreased renal or hepatic function?
Which opioid metabolite is neurotoxic and may accumulate in the elderly or in patients with decreased renal or hepatic function?
Which opioid is avoided in the elderly or patients with renal or hepatic dysfunction and where chronic use may be needed?
Which opioid is avoided in the elderly or patients with renal or hepatic dysfunction and where chronic use may be needed?
True or false: Physical and psychological dependence occur with repeat administration of opiates.
True or false: Physical and psychological dependence occur with repeat administration of opiates.
What is the effect of opiates on respiratory rate?
What is the effect of opiates on respiratory rate?
What is the mechanism of tolerance to opiates?
What is the mechanism of tolerance to opiates?
What is the effect of opiates on the CO2 response curve for respiration?
What is the effect of opiates on the CO2 response curve for respiration?
True or false: Opioids sensitize the heart to catecholamines and predispose to cardiac dysrhythmias.
True or false: Opioids sensitize the heart to catecholamines and predispose to cardiac dysrhythmias.
Which receptors in the brainstem do opiates affect to produce respiratory depression?
Which receptors in the brainstem do opiates affect to produce respiratory depression?
Study Notes
Opioid Agonists and Antagonists: Key Facts and Classifications
- Opioids are derived from the opium poppy and have been used for medicinal and religious purposes for centuries.
- Opiates are drugs derived from opium, such as morphine and codeine.
- The term "narcotic" refers to potent morphine-like analgesics with the potential for physical dependence.
- Opioids can be classified into three categories: agonists, agonist-antagonists, and antagonists.
- The active components of opium can be divided into two chemical classes: phenanthrenes (morphine, codeine) and benzylisoquinolines (papaverine, noscapine).
- Semisynthetic opioids are derived from modifications of the morphine molecule, resulting in compounds like codeine and heroin.
- Synthetic opioids are manufactured through synthesis and include compounds like fentanyl and methadone.
- Opioid receptors are classified as μ, δ, and κ receptors.
- Opioid receptors are found in the brain, spinal cord, sensory neurons, and immune cells.
- μ-Opioid receptors are responsible for supraspinal and spinal analgesia, while κ receptors inhibit neurotransmitter release and may produce dysphoria and diuresis.
- Opioid agonist-antagonists primarily act on κ receptors.
- Endogenous opioid agonists and receptors play a role in the body's pain-modulating mechanisms.
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Quiz: Understanding the Cellular Basis of Opioid-Induced Ventilatory Depression Test your knowledge about the cellular mechanisms behind opioid-induced ventilatory depression. Learn about the role of β-arrestin and the potential use of biased ligands at opioid receptors to mitigate this adverse effect. Explore the rapid and prolonged effects of opioid agonists on ventilation and their impact on carbon dioxide responses.
