Morphine and Opioid Derivatives Quiz
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Questions and Answers

What is the effect of developing tolerance to morphine?

  • It increases the effectiveness of morphine.
  • It requires higher doses for the same effect. (correct)
  • It results in consistent sedation.
  • It eliminates the risk of respiratory depression.

    • Which receptor does morphine primarily agonize?

  • Kappa receptors
  • Mu receptors (correct)
  • Delta receptors
  • Beta receptors

    • What is opioid induced constipation primarily a result of?

  • Stimulation of peripheral opioid receptors. (correct)
  • Increased gut motility.
  • Direct effect on the intestinal lining.
  • Reduced water absorption in the intestines.

    • Which of the following is an undesirable effect of morphine?

    <p>Respiratory depression</p> Signup and view all the answers

    What condition is NOT a contraindication for morphine use?

    <p>Hepatitis</p> Signup and view all the answers

    Which of the following opioids is most potent compared to morphine?

    <p>Hydromorphone</p> Signup and view all the answers

    What is unique about naloxone?

    <p>It has a short half-life.</p> Signup and view all the answers

    What is the primary mechanism by which buprenorphine acts?

    <p>Partial mu agonist and kappa 1 antagonist</p> Signup and view all the answers

    What defines cross tolerance in the context of opioids?

    <p>Tolerance to one opioid leads to tolerance to all opioids.</p> Signup and view all the answers

    What is a common use of loperamide in patients with opioid-induced constipation?

    <p>It targets opioid receptors in the gut.</p> Signup and view all the answers

    What is the initial dosage range typically recommended for morphine?

    <p>2-10 mg</p> Signup and view all the answers

    Which of the following opioids is considered 2-4 times more potent than morphine?

    <p>Heroin</p> Signup and view all the answers

    What is a characteristic of hydromorphone in comparison to morphine?

    <p>It is more potent than morphine (8-10x).</p> Signup and view all the answers

    What type of receptor does buprenorphine primarily act as a partial agonist for?

    <p>Mu receptor</p> Signup and view all the answers

    Which condition is NOT listed as a contraindication for morphine use?

    <p>Gastroesophageal reflux disease</p> Signup and view all the answers

    What is one of the most common adverse effects of opioid usage?

    <p>Respiratory depression</p> Signup and view all the answers

    How does loperamide work in the context of opioid-induced constipation?

    <p>It targets receptors in the gut.</p> Signup and view all the answers

    Which opioid is known for having a short duration and can cause seizures?

    <p>Meperidine</p> Signup and view all the answers

    What is the primary reason tolerance to morphine develops?

    <p>Reduced receptor sensitivity</p> Signup and view all the answers

    What kind of pain is morphine less effective in treating?

    <p>Neuropathic pain</p> Signup and view all the answers

    Match the following opioids with their primary property or characteristic:

    <p>Hydromorphone = 8-10x more potent than morphine Fentanyl = 80-100x more potent than morphine Codeine = 1/10th more potent than morphine Methadone = Longer plasma half life</p> Signup and view all the answers

    Match the following opioid receptors with their corresponding effects or characteristics:

    <p>Mu receptors = Endomorphin production Kappa receptors = Dynorphin production Delta receptors = Enkephalins production Beta receptors = Adrenergic effect when bound</p> Signup and view all the answers

    Match the following opioids with their primary usage:

    <p>Loperamide = Treatment for diarrhea Buprenorphine = Used in narcotic/alcohol dependence treatment Naloxone = Opioid overdose reversal Meperidine = Short duration, causes seizures</p> Signup and view all the answers

    Match the following opioid effects with their descriptions:

    <p>Sedation = Good for chronic pain patients that cannot sleep Constipation = Most common adverse effect of opioids Respiratory depression = Potentially life-threatening side effect Tolerance = Decreased effectiveness with continued use</p> Signup and view all the answers

    Match the following conditions with their respective contraindications for morphine use:

    <p>Asthma = Respiratory compromise Liver disease = Impacts drug metabolism Low BP = Risk of exacerbating hypotension Epilepsy = Risk of seizure disorders</p> Signup and view all the answers

    Match the following concepts with their definitions:

    <p>Cross tolerance = Tolerance to one opioid affecting tolerances to others Associative tolerance = Tolerance developed in specific environments or situations Non-associative tolerance = Decreased receptor availability due to constant use Periphery receptors = Not typically present without inflammation</p> Signup and view all the answers

    Match the following opioids with their unique characteristics:

    <p>Heroin = Crosses blood-brain barrier faster than morphine Oxymorphone = Metabolized from oxycodone Hydrocodone = Similar to oxycodone with abuse deterrents Dilaudid = Another name for hydromorphone</p> Signup and view all the answers

    Match the type of opioid with how it interacts with mu receptors:

    <p>Buprenorphine = Partial mu agonist Nalbuphine = Mu antagonist Butorphanol = Mu receptor antagonist Methadone = Full mu agonist</p> Signup and view all the answers

    Match the following opioid classes with their properties:

    <p>Agonists = Increase activity at receptors Antagonists = Block activity at receptors Partial agonists = Activate receptors but with less effect Mixed agonist/antagonists = Target multiple receptor types with varying effects</p> Signup and view all the answers

    Match the following responses with their effects on mood:

    <p>Sedation = Can improve sleep for chronic pain patients Pain relief = Desirable effect in acute pain management Euphoria = May occur with opioid use Dysphoria = Negative mood effect in some individuals</p> Signup and view all the answers

    What effect does naloxone have when administered in the presence of opioid overdose?

    <p>Reduces opioid receptor activity</p> Signup and view all the answers

    What is a significant method by which methadone is utilized in clinical settings?

    <p>Treatment of narcotic dependence</p> Signup and view all the answers

    Which statement correctly describes the effect of buprenorphine compared to full mu agonists?

    <p>It has a ceiling effect on opioid activity</p> Signup and view all the answers

    Which characteristic defines hydrocodone in comparison to oxycodone?

    <p>Presence of abuse deterrents</p> Signup and view all the answers

    Which of the following opioids is specifically noted for its rapid onset and use as an anesthetic?

    <p>Fentanyl</p> Signup and view all the answers

    What is the primary reason respiratory depression occurs with morphine overdose?

    <p>Direct action on mu receptors in the medulla</p> Signup and view all the answers

    What describes the difference between cross tolerance and associative tolerance regarding opioids?

    <p>Cross tolerance applies to other mu receptor targeting opioids</p> Signup and view all the answers

    Which receptor is primarily involved when opioid-induced constipation occurs?

    <p>Mu receptors in the gut</p> Signup and view all the answers

    Which opioid is known for causing seizures as a significant side effect?

    <p>Meperidine</p> Signup and view all the answers

    What adverse effect is most commonly associated with the use of opioids?

    <p>Constipation</p> Signup and view all the answers

    Study Notes

    Morphine and Opioid Derivatives

    • Morphine is derived from poppy seeds.
    • Continued use of morphine leads to tolerance, decreasing its effectiveness.
    • Opioids bind to various receptors, including mu, kappa, and beta receptors, triggering adrenergic effects.
    • Mu receptors bind endomorphins, kappa receptors bind dynorphins, and delta receptors bind enkephalines.

    Morphine Properties

    • Morphine is a mu agonist with broad effectiveness across doses.
    • It can improve mood and induce sedation, beneficial for chronic pain patients.
    • Initial dosage typically ranges from 2-10 mg.
    • Desirable properties include its wide range of effectiveness and ability to improve mood and induce sedation.

    Undesirable Effects of Morphine

    • Sedation is a potential side effect.
    • Constipation, a common adverse effect, is often treated with loperamide.
    • Respiratory depression is a serious concern, stemming from stimulation of mu opioid receptors in the prebotizinger complex.
    • Tolerance develops over time, requiring increased dosage for similar effects.

    Opioid Use and Tolerance

    • Opioids are used to manage acute, moderate to severe pain, including surgical and post-surgical pain, and cancer pain, but are less effective for neuropathic pain.
    • Associative tolerance develops when opioids are consistently administered with specific cues (e.g., same time, environment).
    • Cross-tolerance means tolerance to one opioid often translates to tolerance for others targeting the same receptor.
    • Non-associative tolerance arises from receptor downregulation with prolonged use, leading to fewer active receptors.

    Contraindications for Morphine

    • Asthma, spinal curvature, liver/kidney disease, hypothyroidism, history of brain tumors, epilepsy, low blood pressure and drug/alcohol use disorders are contraindications.

    Opioid Analogs

    • Hydromorphone (Dilaudid) is 8-10 times more potent than morphine, available as a suppository.
    • Oxymorphone is similar to hydromorphone but with different dosing strategies.
    • Heroin is 2-4 times more potent than morphine and crosses the blood-brain barrier faster, converting to morphine within the body.
    • Codeine (methylmorphine) is one-tenth as potent as morphine and only partially metabolizes into morphine in some patients (lower conversion rates).
    • Oxycodone is 10 times more potent than codeine, metabolizing into oxymorphone (often in controlled-release formulations).
    • Hydrocodone is similar to oxycodone, and has abuse-deterrent properties.
    • Meperidine is slightly less potent than morphine but has a shorter duration of action and can induce seizures.
    • Fentanyl is 80-100 times more potent than morphine, used as an anesthetic, with rapid onset and short duration.
    • Methadone is similarly potent to morphine orally but is 4x stronger intravenously. Used for opioid/alcohol dependence. Has longer plasma half-life.
    • Buprenorphine is a partial mu agonist and kappa-3 agonist, sometimes used to treat opioid dependence.
    • Nalbuphine is a kappa agonist and mu receptor antagonist, used in ambulances for its lower abuse potential, less dysphoria, and slight efficacy advantage in women.
    • Butorphanol is a kappa agonist and mu receptor antagonist, primarily a nasal spray.
    • Naloxone is a short-acting opioid antagonist, not effective orally, administered injectable or via nasal spray.

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    Description

    Test your knowledge on morphine and its derivatives with this quiz. It covers the properties, effects, and mechanisms of opioids, focusing on their interaction with various receptors. Explore both the therapeutic benefits and undesirable effects of morphine use.

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