Podcast
Questions and Answers
Which of the following is a phenanthrene alkaloid present in opium?
Which of the following is a phenanthrene alkaloid present in opium?
Which of the following opioids lacks analgesic activity?
Which of the following opioids lacks analgesic activity?
Which of the following opioids is a synthetic opioid?
Which of the following opioids is a synthetic opioid?
Which of the following is a classification of opioid receptors?
Which of the following is a classification of opioid receptors?
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Which alkaloid is the best known opiate?
Which alkaloid is the best known opiate?
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What is the source of 20 distinct alkaloids?
What is the source of 20 distinct alkaloids?
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What term is derived from the Greek word for stupor and traditionally used to refer to potent morphine-like analgesics with the potential to produce physical dependence?
What term is derived from the Greek word for stupor and traditionally used to refer to potent morphine-like analgesics with the potential to produce physical dependence?
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What classification of opioids includes substances that bind specifically to any of several subpopulations of opioid receptors and produce at least some agonist effects?
What classification of opioids includes substances that bind specifically to any of several subpopulations of opioid receptors and produce at least some agonist effects?
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Which receptors are primarily found in the periaqueductal gray, locus ceruleus, and the rostral ventral medulla?
Which receptors are primarily found in the periaqueductal gray, locus ceruleus, and the rostral ventral medulla?
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Where are opioid receptors found in the spinal cord?
Where are opioid receptors found in the spinal cord?
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What is the principal responsibility of μ-opioid receptors?
What is the principal responsibility of μ-opioid receptors?
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What is the role of δ receptors?
What is the role of δ receptors?
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Which brain regions are associated with the activation of the μ-opioid receptor system?
Which brain regions are associated with the activation of the μ-opioid receptor system?
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What is the effect of morphine on systemic blood pressure?
What is the effect of morphine on systemic blood pressure?
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How does morphine affect heart rate during exposure to volatile anesthetics?
How does morphine affect heart rate during exposure to volatile anesthetics?
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What is the effect of morphine on vulnerability to ventricular fibrillation?
What is the effect of morphine on vulnerability to ventricular fibrillation?
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Which of the following is a possible adverse effect of opioids on the respiratory system?
Which of the following is a possible adverse effect of opioids on the respiratory system?
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Which of the following factors can increase the ventilatory depressant effects of opioids?
Which of the following factors can increase the ventilatory depressant effects of opioids?
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Which type of opioids can suppress cough without producing analgesia or depression of ventilation?
Which type of opioids can suppress cough without producing analgesia or depression of ventilation?
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What is the likely explanation for opioid-induced increased skeletal muscle tone?
What is the likely explanation for opioid-induced increased skeletal muscle tone?
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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?
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What can opioids cause in the biliary tract?
What can opioids cause in the biliary tract?
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Which medication can relieve pain caused by biliary spasm but not myocardial ischemia?
Which medication can relieve pain caused by biliary spasm but not myocardial ischemia?
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What is the percentage increase in common bile duct pressure caused by equal analgesic doses of fentanyl?
What is the percentage increase in common bile duct pressure caused by equal analgesic doses of fentanyl?
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What may opioid-induced spasm of the sphincter of Oddi appear as radiologically during surgery?
What may opioid-induced spasm of the sphincter of Oddi appear as radiologically during surgery?
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What is the usual recommendation for morphine titration?
What is the usual recommendation for morphine titration?
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Which of the following is true about the administration of morphine and fentanyl anesthesia?
Which of the following is true about the administration of morphine and fentanyl anesthesia?
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What is the role of opioids in protecting the myocardium from ischemia?
What is the role of opioids in protecting the myocardium from ischemia?
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What effect do opioid agonists have on ventilation?
What effect do opioid agonists have on ventilation?
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What is the effect of pretreatment with H1- and H2-receptor antagonists on the release of histamine evoked by morphine?
What is the effect of pretreatment with H1- and H2-receptor antagonists on the release of histamine evoked by morphine?
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Which of the following opioids lacks analgesic activity?
Which of the following opioids lacks analgesic activity?
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What is the principal responsibility of μ-opioid receptors?
What is the principal responsibility of μ-opioid receptors?
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Which type of opioids can suppress cough without producing analgesia or depression of ventilation?
Which type of opioids can suppress cough without producing analgesia or depression of ventilation?
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What is the source of 20 distinct alkaloids?
What is the source of 20 distinct alkaloids?
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Which of the following areas of the brain is primarily associated with opioid receptors?
Which of the following areas of the brain is primarily associated with opioid receptors?
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Where are opioid receptors found in the spinal cord?
Where are opioid receptors found in the spinal cord?
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Which opioid receptor subtype is responsible for supraspinal and spinal analgesia?
Which opioid receptor subtype is responsible for supraspinal and spinal analgesia?
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What is the role of δ opioid receptors?
What is the role of δ opioid receptors?
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Which of the following is an opioid antagonist?
Which of the following is an opioid antagonist?
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What is the source of 20 distinct alkaloids?
What is the source of 20 distinct alkaloids?
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What is the term used to refer to potent morphine-like analgesics with the potential to produce physical dependence?
What is the term used to refer to potent morphine-like analgesics with the potential to produce physical dependence?
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What is the effect of opioids on touch, proprioception, and consciousness?
What is the effect of opioids on touch, proprioception, and consciousness?
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Which of the following is a potential adverse effect of opioids on the respiratory system?
Which of the following is a potential adverse effect of opioids on the respiratory system?
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Which of the following factors can increase the ventilatory depressant effects of opioids?
Which of the following factors can increase the ventilatory depressant effects of opioids?
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What is the effect of morphine on cerebral blood flow and intracranial pressure (ICP)?
What is the effect of morphine on cerebral blood flow and intracranial pressure (ICP)?
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What is the likely cause of opioid-induced increased skeletal muscle tone?
What is the likely cause of opioid-induced increased skeletal muscle tone?
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Which of the following is a possible adverse effect of opioids on the cardiovascular system?
Which of the following is a possible adverse effect of opioids on the cardiovascular system?
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What is the effect of morphine on systemic blood pressure?
What is the effect of morphine on systemic blood pressure?
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What is the likely explanation for opioid-induced increased skeletal muscle tone?
What is the likely explanation for opioid-induced increased skeletal muscle tone?
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Which brain regions are associated with the activation of the μ-opioid receptor system?
Which brain regions are associated with the activation of the μ-opioid receptor system?
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Which of the following is true about the cardiovascular effects of morphine and fentanyl anesthesia?
Which of the following is true about the cardiovascular effects of morphine and fentanyl anesthesia?
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Which of the following is true about the combination of an opioid and a benzodiazepine?
Which of the following is true about the combination of an opioid and a benzodiazepine?
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What is the effect of opioids on the myocardium?
What is the effect of opioids on the myocardium?
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What is the effect of opioid agonists on ventilation?
What is the effect of opioid agonists on ventilation?
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Which of the following opioids is reported to have the highest incidence of difficult ventilation after a moderate dose?
Which of the following opioids is reported to have the highest incidence of difficult ventilation after a moderate dose?
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What is the usual recommendation for morphine titration?
What is the usual recommendation for morphine titration?
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What is a common reason to discontinue morphine titration for postoperative analgesia?
What is a common reason to discontinue morphine titration for postoperative analgesia?
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What can opioids cause in the biliary tract?
What can opioids cause in the biliary tract?
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What may opioid-induced spasm of the sphincter of Oddi appear as radiologically during surgery?
What may opioid-induced spasm of the sphincter of Oddi appear as radiologically during surgery?
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Which medication can relieve pain caused by biliary spasm but not myocardial ischemia?
Which medication can relieve pain caused by biliary spasm but not myocardial ischemia?
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Which of the following opioids is NOT derived from opium?
Which of the following opioids is NOT derived from opium?
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What is the term used to refer to drugs that bind specifically to opioid receptors and produce morphine-like effects?
What is the term used to refer to drugs that bind specifically to opioid receptors and produce morphine-like effects?
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Which classification of opioids includes substances that can both activate and block opioid receptors?
Which classification of opioids includes substances that can both activate and block opioid receptors?
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What is the source of the 20 distinct alkaloids that are derived from opium?
What is the source of the 20 distinct alkaloids that are derived from opium?
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Which of the following areas of the brain primarily contains opioid receptors?
Which of the following areas of the brain primarily contains opioid receptors?
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Where are opioid receptors found in the peripheral nervous system?
Where are opioid receptors found in the peripheral nervous system?
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Which opioid receptor subtype is speculated to produce analgesia?
Which opioid receptor subtype is speculated to produce analgesia?
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What is the principal role of κ-opioid receptors?
What is the principal role of κ-opioid receptors?
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Which of the following opioids lacks analgesic activity?
Which of the following opioids lacks analgesic activity?
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Which of the following opioids has the highest analgesic potency compared to morphine?
Which of the following opioids has the highest analgesic potency compared to morphine?
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Which of the following opioids is a semisynthetic derivative of morphine?
Which of the following opioids is a semisynthetic derivative of morphine?
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Which of the following is a principal phenanthrene alkaloid present in opium?
Which of the following is a principal phenanthrene alkaloid present in opium?
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Which of the following is NOT a potential side effect of morphine?
Which of the following is NOT a potential side effect of morphine?
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Which brain region is NOT involved in the opioid-sensitive pain modulation system?
Which brain region is NOT involved in the opioid-sensitive pain modulation system?
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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?
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Which opioid agonist has the highest specificity for receptors and produces little or no side effects?
Which opioid agonist has the highest specificity for receptors and produces little or no side effects?
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Which of the following is NOT a pharmacologic effect of opioids?
Which of the following is NOT a pharmacologic effect of opioids?
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Which combination of drugs is most likely to result in cardiovascular depression?
Which combination of drugs is most likely to result in cardiovascular depression?
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Which of the following is NOT a mechanism by which opioids protect the myocardium from ischemia?
Which of the following is NOT a mechanism by which opioids protect the myocardium from ischemia?
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How do opioid agonists affect ventilation?
How do opioid agonists affect ventilation?
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What is the effect of opioids on cerebral blood flow and intracranial pressure (ICP)?
What is the effect of opioids on cerebral blood flow and intracranial pressure (ICP)?
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What is the likely cause of skeletal muscle rigidity induced by opioids?
What is the likely cause of skeletal muscle rigidity induced by opioids?
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What is the effect of opioids on the medullary cough centers?
What is the effect of opioids on the medullary cough centers?
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What is the effect of opioids on ventilation?
What is the effect of opioids on ventilation?
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Which of the following is a potential side effect of morphine titration for postoperative analgesia?
Which of the following is a potential side effect of morphine titration for postoperative analgesia?
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What is the effect of opioids on the biliary tract?
What is the effect of opioids on the biliary tract?
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Which medication can relieve pain caused by biliary spasm but not myocardial ischemia?
Which medication can relieve pain caused by biliary spasm but not myocardial ischemia?
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What is the effect of fentanyl on common bile duct pressure?
What is the effect of fentanyl on common bile duct pressure?
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What is the potential misinterpretation of opioid-induced spasm of the sphincter of Oddi during surgery?
What is the potential misinterpretation of opioid-induced spasm of the sphincter of Oddi during surgery?
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What is the effect of morphine on systemic blood pressure?
What is the effect of morphine on systemic blood pressure?
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Which of the following is a synthetic opioid?
Which of the following is a synthetic opioid?
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Which of the following opioids lacks analgesic activity?
Which of the following opioids lacks analgesic activity?
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Which opioid receptor subtype is responsible for analgesia and euphoria?
Which opioid receptor subtype is responsible for analgesia and euphoria?
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Which opioid antagonist is commonly used to reverse the effects of opioid overdose?
Which opioid antagonist is commonly used to reverse the effects of opioid overdose?
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Which of the following is NOT a classification of opioids?
Which of the following is NOT a classification of opioids?
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What is the effect of opioids on touch, proprioception, and consciousness?
What is the effect of opioids on touch, proprioception, and consciousness?
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Which of the following opioids is a natural derivative of opium?
Which of the following opioids is a natural derivative of opium?
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What is the likely cause of opioid-induced increased skeletal muscle tone?
What is the likely cause of opioid-induced increased skeletal muscle tone?
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Which brain region is primarily associated with opioid receptors?
Which brain region is primarily associated with opioid receptors?
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What is the effect of opioids on the cardiovascular system?
What is the effect of opioids on the cardiovascular system?
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Which medication can enhance the analgesic response to a placebo?
Which medication can enhance the analgesic response to a placebo?
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What is the most suitable starting point for studying the side effects of opioids?
What is the most suitable starting point for studying the side effects of opioids?
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Which of the following is a potential adverse effect of opioid agonists at the cellular level?
Which of the following is a potential adverse effect of opioid agonists at the cellular level?
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What is the main cause of death from an opioid overdose?
What is the main cause of death from an opioid overdose?
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Which of the following factors can increase the ventilatory depressant effects of opioids?
Which of the following factors can increase the ventilatory depressant effects of opioids?
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What is the effect of opioids on cough?
What is the effect of opioids on cough?
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Where are opioid receptors primarily found in the brain?
Where are opioid receptors primarily found in the brain?
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Where are opioid receptors found in the spinal cord?
Where are opioid receptors found in the spinal cord?
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Which opioid receptor subtype is responsible for supraspinal and spinal analgesia?
Which opioid receptor subtype is responsible for supraspinal and spinal analgesia?
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Which opioid receptor subtype may serve to modulate the activity of μ receptors?
Which opioid receptor subtype may serve to modulate the activity of μ receptors?
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Which of the following is a possible adverse effect of opioids on the cardiovascular system?
Which of the following is a possible adverse effect of opioids on the cardiovascular system?
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What is the role of opioids in protecting the myocardium from ischemia?
What is the role of opioids in protecting the myocardium from ischemia?
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What is the effect of opioids on touch, proprioception, and consciousness?
What is the effect of opioids on touch, proprioception, and consciousness?
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What is a common reason to discontinue morphine titration for postoperative analgesia?
What is a common reason to discontinue morphine titration for postoperative analgesia?
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Which of the following is a potential adverse effect of morphine titration for postoperative analgesia?
Which of the following is a potential adverse effect of morphine titration for postoperative analgesia?
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What is the effect of fentanyl on common bile duct pressure?
What is the effect of fentanyl on common bile duct pressure?
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Which of the following is NOT a potential cause of epigastric distress or biliary colic?
Which of the following is NOT a potential cause of epigastric distress or biliary colic?
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What is the primary reason to discontinue morphine titration for postoperative analgesia?
What is the primary reason to discontinue morphine titration for postoperative analgesia?
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Which opioid antagonist can relieve pain caused by biliary spasm but not myocardial ischemia?
Which opioid antagonist can relieve pain caused by biliary spasm but not myocardial ischemia?
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Which of the following opioids increases common bile duct pressure the least?
Which of the following opioids increases common bile duct pressure the least?
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True or false: Opioids are used for perioperative care and pain management.
True or false: Opioids are used for perioperative care and pain management.
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True or false: The term narcotic is derived from the Greek word for stupor.
True or false: The term narcotic is derived from the Greek word for stupor.
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True or false: Opioids produce analgesia without loss of touch, proprioception, or consciousness.
True or false: Opioids produce analgesia without loss of touch, proprioception, or consciousness.
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True or false: Opioid agonists, opioid agonist-antagonists, and opioid antagonists are three classifications of opioids.
True or false: Opioid agonists, opioid agonist-antagonists, and opioid antagonists are three classifications of opioids.
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Opioid receptors are primarily found in the periaqueductal gray, locus ceruleus, and the rostral ventral medulla.
Opioid receptors are primarily found in the periaqueductal gray, locus ceruleus, and the rostral ventral medulla.
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Direct application of opioid agonists to the spinal cord can produce intense analgesia.
Direct application of opioid agonists to the spinal cord can produce intense analgesia.
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Activation of κ receptors results in respiratory depression characteristic of μ-receptor activation.
Activation of κ receptors results in respiratory depression characteristic of μ-receptor activation.
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True or false: Morphine is classified as an opioid antagonist?
True or false: Morphine is classified as an opioid antagonist?
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δ receptors respond to the endogenous ligands known as enkephalins.
δ receptors respond to the endogenous ligands known as enkephalins.
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True or false: Papaverine is a phenanthrene alkaloid present in opium?
True or false: Papaverine is a phenanthrene alkaloid present in opium?
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True or false: Fentanyl is a synthetic opioid that is widely used as a primary anesthetic drug?
True or false: Fentanyl is a synthetic opioid that is widely used as a primary anesthetic drug?
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True or false: Opioid receptors belong to a superfamily of seven transmembrane-segment guanine protein-coupled receptors?
True or false: Opioid receptors belong to a superfamily of seven transmembrane-segment guanine protein-coupled receptors?
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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.
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True or false: The activation of the μ-opioid receptor system is associated with reductions in the sensory and affective ratings of pain.
True or false: The activation of the μ-opioid receptor system is associated with reductions in the sensory and affective ratings of pain.
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True or false: Positive treatment expectancy can enhance the analgesic benefit of remifentanil.
True or false: Positive treatment expectancy can enhance the analgesic benefit of remifentanil.
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True or false: All opioids have similar side effects that vary only in degree.
True or false: All opioids have similar side effects that vary only in degree.
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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?
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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.
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True or false: Morphine sensitizes the heart to catecholamines and predisposes to cardiac dysrhythmias.
True or false: Morphine sensitizes the heart to catecholamines and predisposes to cardiac dysrhythmias.
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True or false: The combination of an opioid agonist such as morphine or fentanyl with nitrous oxide results in cardiovascular depression.
True or false: The combination of an opioid agonist such as morphine or fentanyl with nitrous oxide results in cardiovascular depression.
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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?
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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?
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True or false: Advanced age and natural sleep can increase the ventilatory depressant effects of opioids?
True or false: Advanced age and natural sleep can increase the ventilatory depressant effects of opioids?
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True or false: Opioids depress cough by effects on the medullary cough centers that are distinct from the effects of opioids on ventilation?
True or false: Opioids depress cough by effects on the medullary cough centers that are distinct from the effects of opioids on ventilation?
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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%?
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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?
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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?
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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?
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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?
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True or false: Opioid-induced spasm of the sphincter of Oddi may appear radiologically as a sharp constriction at the distal end of the common bile duct and be misinterpreted as a common bile duct stone?
True or false: Opioid-induced spasm of the sphincter of Oddi may appear radiologically as a sharp constriction at the distal end of the common bile duct and be misinterpreted as a common bile duct stone?
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True or false: Opioids can cause analgesia without loss of touch, proprioception, or consciousness?
True or false: Opioids can cause analgesia without loss of touch, proprioception, or consciousness?
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True or false: The term narcotic is derived from the Greek word for stupor?
True or false: The term narcotic is derived from the Greek word for stupor?
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True or false: Opioids are referred to as opiates because they are derived from opium?
True or false: Opioids are referred to as opiates because they are derived from opium?
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True or false: Opioids can produce physical dependence?
True or false: Opioids can produce physical dependence?
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True or false: Opioid receptors are primarily found in the brain and spinal cord.
True or false: Opioid receptors are primarily found in the brain and spinal cord.
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True or false: Activation of μ-opioid receptors is speculated to produce analgesia.
True or false: Activation of μ-opioid receptors is speculated to produce analgesia.
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True or false: κ-receptor activation results in respiratory depression.
True or false: κ-receptor activation results in respiratory depression.
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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.
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True or false: The activation of the μ-opioid receptor system is associated with increases in the sensory and affective ratings of the pain experience.
True or false: The activation of the μ-opioid receptor system is associated with increases in the sensory and affective ratings of the pain experience.
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True or false: Positive treatment expectancy can enhance the analgesic benefit of remifentanil.
True or false: Positive treatment expectancy can enhance the analgesic benefit of remifentanil.
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True or false: Morphine-induced histamine release and subsequent decrease in systemic blood pressure can be minimized by optimizing intravascular fluid volume.
True or false: Morphine-induced histamine release and subsequent decrease in systemic blood pressure can be minimized by optimizing intravascular fluid volume.
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True or false: Fentanyl infusion can cause the release of histamine in all patients.
True or false: Fentanyl infusion can cause the release of histamine in all patients.
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True or false: Opioid receptors belong to a superfamily of seven transmembrane-segment guanine protein-coupled receptors.
True or false: Opioid receptors belong to a superfamily of seven transmembrane-segment guanine protein-coupled receptors.
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True or false: The principal phenanthrene alkaloids present in opium are morphine, codeine, and thebaine.
True or false: The principal phenanthrene alkaloids present in opium are morphine, codeine, and thebaine.
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True or false: The active components of opium can be divided into two distinct chemical classes: phenanthrenes and benzylisoquinolines.
True or false: The active components of opium can be divided into two distinct chemical classes: phenanthrenes and benzylisoquinolines.
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True or false: Synthetic opioids are manufactured by synthesis rather than chemical modification of morphine.
True or false: Synthetic opioids are manufactured by synthesis rather than chemical modification of morphine.
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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?
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True or false: The miotic effect of morphine can be antagonized by atropine?
True or false: The miotic effect of morphine can be antagonized by atropine?
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True or false: Opioids decrease cerebral blood flow and possibly intracranial pressure (ICP)?
True or false: Opioids decrease cerebral blood flow and possibly intracranial pressure (ICP)?
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True or false: Opioids alter the responses to neuromuscular-blocking drugs?
True or false: Opioids alter the responses to neuromuscular-blocking drugs?
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True or false: Pretreatment of patients with H1- and H2-receptor antagonists alters release of histamine evoked by morphine.
True or false: Pretreatment of patients with H1- and H2-receptor antagonists alters release of histamine evoked by morphine.
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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.
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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.
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True or false: Opioid-induced depression of ventilation is characterized by increased responsiveness of ventilation centers to carbon dioxide.
True or false: Opioid-induced depression of ventilation is characterized by increased responsiveness of ventilation centers to carbon dioxide.
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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%?
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True or false: Sedation occurs in up to 60% of patients during morphine titration for postoperative analgesia?
True or false: Sedation occurs in up to 60% of patients during morphine titration for postoperative analgesia?
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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?
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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?
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True or false: Opioid-induced spasm of the sphincter of Oddi may appear radiologically as a sharp constriction at the distal end of the common bile duct and be misinterpreted as a common bile duct stone?
True or false: Opioid-induced spasm of the sphincter of Oddi may appear radiologically as a sharp constriction at the distal end of the common bile duct and be misinterpreted as a common bile duct stone?
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True or false: Opioids can cause spasm of biliary smooth muscle, resulting in increases in biliary pressure that may be associated with epigastric distress or biliary colic?
True or false: Opioids can cause spasm of biliary smooth muscle, resulting in increases in biliary pressure that may be associated with epigastric distress or biliary colic?
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Study Notes
Opioids and Analgesics
- The principal phenanthrene alkaloid present in opium is morphine.
- Papaverine is a phenanthrene alkaloid present in opium.
- Nalorphine is a synthetic opioid.
- Opioid receptors are classified into three subpopulations: μ, δ, and κ.
Opioid Receptors
- μ-opioid receptors are primarily found in the periaqueductal gray, locus ceruleus, and the rostral ventral medulla.
- Opioid receptors are found in the spinal cord in the dorsal horn and substantia gelatinosa.
- μ-opioid receptors are responsible for analgesia and euphoria.
- δ opioid receptors are responsible for analgesia and modulate emotional responses.
- κ-opioid receptors are involved in spinal analgesia and modulate stress responses.
Effects of Opioids
- Opioids can cause respiratory depression, particularly in high doses.
- Opioids can increase the ventilatory depressant effects in the presence of other sedatives.
- Opioids can suppress cough without producing analgesia or depression of ventilation.
- Opioids can cause increased skeletal muscle tone, likely due to stimulation of the μ-opioid receptor.
- Morphine can increase systemic blood pressure, but this effect is dose-dependent.
- Morphine can affect heart rate, particularly during exposure to volatile anesthetics.
- Morphine can increase vulnerability to ventricular fibrillation.
Opioid-Induced Effects on Specific Systems
- Opioids can cause spasm of the sphincter of Oddi, leading to increased common bile duct pressure.
- Opioids can cause nausea and vomiting, particularly in the setting of biliary spasm.
- Opioids can affect the cardiovascular system, particularly in combination with other sedatives.
- Opioids can affect the respiratory system, particularly in high doses.
Opioid Antagonists and Agonists
- Naloxone is an opioid antagonist commonly used to reverse the effects of opioid overdose.
- Opioid agonists can produce analgesia, but also have side effects such as respiratory depression.
- Opioid agonists can affect ventilation, particularly in high doses.
Miscellaneous
- The term "narcotic" is derived from the Greek word for stupor and is traditionally used to refer to potent morphine-like analgesics with the potential to produce physical dependence.
- Opium is the source of 20 distinct alkaloids.
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