Opioids Class Slides & Lecture Notes
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Questions and Answers

Which opiate is derived from thebaine?

  • Fentanyl
  • Hydromorphone
  • Oxymorphone
  • Oxycodone (correct)

    • What percentage of morphine can be found in opium?

  • 1.5%
  • 0.75 to 2.5%
  • < 1%
  • 10% (correct)

    • Which of the following synthetic opioids is specifically known for being much more potent than heroin?

  • Methadone
  • Fentanyl (correct)
  • Meperidine
  • Buprenorphine

    • Which compound is derived by adding acetyl groups to the morphine molecule?

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

    What characteristic of opium production does NOT happen after the flower petals drop?

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

    What is the primary reason street users prefer fentanyl over heroin?

    <p>Higher potency</p> Signup and view all the answers

    Which opiate derivative is approximately 10 times more potent than morphine?

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

    What was the primary focus of the Opium Act of 1908?

    <p>Targeting the importation and sale of opium with a focus on dealers.</p> Signup and view all the answers

    In what year was the Opium and Narcotic Drug Act enacted?

    <p>1911</p> Signup and view all the answers

    What sparked the introduction of the Opium and Narcotic Drug Act in 1911?

    <p>A market panic in Montreal due to cocaine use.</p> Signup and view all the answers

    What maximum penalty could be imposed for violating the provisions of the Opium Act, 1908?

    <p>A maximum prison term of three years and/or a fine up to $1,000.</p> Signup and view all the answers

    Who was the Minister responsible for introducing the Opium and Narcotic Drug Act, 1911?

    <p>Mackenzie King</p> Signup and view all the answers

    What immediate effect can naloxone have when administered to someone experiencing an opiate overdose?

    <p>It will reverse depressed breathing in a matter of minutes.</p> Signup and view all the answers

    Which of the following is a historical use of laudanum?

    <p>Curing colic in infants.</p> Signup and view all the answers

    What distinguishes naltrexone from naloxone?

    <p>Naltrexone has no agonist effects.</p> Signup and view all the answers

    What was the purpose of the medicinal drink laudanum introduced by Paracelsus?

    <p>To create a tranquilizing effect.</p> Signup and view all the answers

    Which ancient civilization was known to have documented the medical uses of opium as early as 1550 BC?

    <p>Egyptian civilization.</p> Signup and view all the answers

    What outcome was experienced by Thomas DeQuincy after using laudanum for toothache?

    <p>He became addicted to opium.</p> Signup and view all the answers

    Which of the following uses of opiates has been recognized for thousands of years?

    <p>Management of cough.</p> Signup and view all the answers

    Which statement accurately reflects a characteristic of naloxone?

    <p>It has an immediate onset of action.</p> Signup and view all the answers

    What was a common misconception about the properties of laudanum marketed in the 1800s?

    <p>It could cure any ailment.</p> Signup and view all the answers

    What is suggested as the central discovery in the text regarding happiness?

    <p>Happiness is an attainable state that can be purchased.</p> Signup and view all the answers

    In which century did Galen document the presence of opium cakes and candy for sale on the streets?

    <p>2nd Century AD</p> Signup and view all the answers

    What role did opium dens play in society as described in the content?

    <p>They functioned as social spaces for all classes to consume opium.</p> Signup and view all the answers

    Why were specialized pipes and lamps essential in opium dens?

    <p>To heat opium for vaporization and inhalation.</p> Signup and view all the answers

    How did the opium dens in the United States compare to those in China?

    <p>They often mirrored the luxurious designs of Chinese dens.</p> Signup and view all the answers

    What is implied to be the nature of the experience offered by opium, as viewed by the speaker?

    <p>It is a magical solution to all human suffering.</p> Signup and view all the answers

    What aspect of society did opium dens reflect according to the passage?

    <p>The social stratification and economic means of patrons.</p> Signup and view all the answers

    What was the primary function of opium paraphernalia in the dens?

    <p>To facilitate the recreational use of opium.</p> Signup and view all the answers

    What illustrates the preferences of patrons in opium dens as indicated in the content?

    <p>Preference reflected social and financial diversity.</p> Signup and view all the answers

    What societal perception existed regarding opium use prior to the mid-1800s?

    <p>It was widely accepted and not considered problematic.</p> Signup and view all the answers

    What implication did the 1875 San Francisco law have on opium dens?

    <p>It outlawed the operation of opium dens.</p> Signup and view all the answers

    Which of the following accurately describes governmental efforts regarding opium in the mid to late 1800s?

    <p>Pharmacists became the exclusive source of opiates due to regulatory changes.</p> Signup and view all the answers

    What common misconception did the newspaper quote reflect regarding opium dens?

    <p>Moral ruin was only a concern for women and young girls.</p> Signup and view all the answers

    What was a notable characteristic of opium dens in society?

    <p>Their opulence varied based on the patrons' financial means.</p> Signup and view all the answers

    What root cause influenced governmental efforts to regulate opium in the 1800s?

    <p>Prejudicial views towards the Chinese and their use of opium.</p> Signup and view all the answers

    Which statement best describes the perception of opiods in the period leading to the mid-1800s?

    <p>Opioids were considered safe for recreational use.</p> Signup and view all the answers

    What historical artifact suggests opium use predates the 2nd century?

    <p>A ceramic opium pipe discovered in Cyprus.</p> Signup and view all the answers

    What was a significant legal change concerning opiate sales in Britain during the 1860s?

    <p>Pharmacists became the only authorized sellers of opiates.</p> Signup and view all the answers

    What aspect made opium a socially accepted substance among various levels of society?

    <p>The lack of understanding regarding addiction risks.</p> Signup and view all the answers

    Which of the following opiate administration methods involves injecting the drug directly into a vein?

    <p>Intravenous injection</p> Signup and view all the answers

    What mechanism do opiates use to inhibit neurotransmitter release at presynaptic neurons?

    <p>Inhibiting calcium influx</p> Signup and view all the answers

    Which of the following drugs is NOT directly mentioned as an alkaloid or derivative prohibited for non-medical use?

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

    Which opiate is metabolized into morphine and often considered to have a rapid effect due to its short half-life?

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

    In which brain area do opiates primarily concentrate, particularly influencing the reward system?

    <p>Limbic system</p> Signup and view all the answers

    Which of the following opiates is derived from codeine and is less potent than morphine?

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

    What distinguishes heroin from morphine in terms of its chemical composition?

    <p>It has additional acetyl groups.</p> Signup and view all the answers

    Which synthetic compound is known for being 30 to 50 times more potent than heroin?

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

    Which of the following opiates has the lowest natural occurrence in opium?

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

    In relation to its euphoric effects, how does methadone compare to morphine?

    <p>Less potent in euphoric effects than morphine.</p> Signup and view all the answers

    What is the primary method of raw opium collection from the opium poppy?

    <p>Making incisions in the seedpod.</p> Signup and view all the answers

    Which opiate derivative is derived from thebaine and is often utilized for pain management?

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

    What effect does naloxone have when administered to an individual who has overdosed on opioids?

    <p>It reverses depressed breathing rapidly.</p> Signup and view all the answers

    Which of the following historical uses of opium was NOT documented?

    <p>Enhancement of cognitive abilities.</p> Signup and view all the answers

    What distinguishes naltrexone from naloxone in terms of its pharmacological effects?

    <p>Naltrexone has longer-lasting effects than naloxone.</p> Signup and view all the answers

    What was the primary composition of laudanum introduced by Paracelsus?

    <p>Opium, alcohol, and spices.</p> Signup and view all the answers

    In which century did Galen recommend opium for various diseases?

    <p>2nd century AD</p> Signup and view all the answers

    Which statement accurately describes the recommendation of laudanum in the 18th century?

    <p>It was prescribed for menstrual pain and melancholy.</p> Signup and view all the answers

    What was one of the consequences of using laudanum as a remedy for toothache?

    <p>It sometimes led to addiction to opium.</p> Signup and view all the answers

    What is a significant characteristic of naloxone's role as an opioid antagonist?

    <p>It is a competitive antagonist at multiple receptor types.</p> Signup and view all the answers

    What was a common feedback from individuals who experienced the effects of laudanum?

    <p>It offered a profound sense of euphoria.</p> Signup and view all the answers

    What was a significant change regarding opiate sales in Britain in the late 1800s?

    <p>Pharmacists became the only legal source for opiates.</p> Signup and view all the answers

    Which factor contributed to the social acceptance of opium use until the mid-1800s?

    <p>Perceived lack of addiction risks associated with usage.</p> Signup and view all the answers

    What did the 1875 San Francisco law regarding opium dens suggest about societal concerns?

    <p>There were worries about the moral deterioration linked to opium dens.</p> Signup and view all the answers

    Which misconception is highlighted by the historical perception of opium dens?

    <p>Moral ruin was exclusively caused by opium dens.</p> Signup and view all the answers

    What marked the shift in governmental attitudes toward opium in the mid to late 1800s?

    <p>Heightened concerns about addiction and anti-Chinese sentiment.</p> Signup and view all the answers

    What was common among opium dens regarding their patrons and environment?

    <p>They were frequented by all societal classes and varied in opulence.</p> Signup and view all the answers

    What led to the gradual regulation of opium in the United States?

    <p>The influence of anti-opium advocacy groups.</p> Signup and view all the answers

    Historical evidence suggests opium use dates back to which period?

    <p>The Bronze Age.</p> Signup and view all the answers

    How did opium consumption transition in perception by the late 1800s?

    <p>It was increasingly viewed as a public health concern.</p> Signup and view all the answers

    What aspect of opium dens reflected the dynamics of society at that time?

    <p>The nature and setup indicated varying economic backgrounds among patrons.</p> Signup and view all the answers

    What was a primary focus of the Opium Act, 1908, in Canada?

    <p>Targeting opium dealers over users</p> Signup and view all the answers

    What led to the introduction of the Opium and Narcotic Drug Act, 1911?

    <p>The panic in Montreal due to cocaine use</p> Signup and view all the answers

    What maximum prison term could be faced for violating the provisions of the Opium Act, 1908?

    <p>Three years</p> Signup and view all the answers

    Which of the following does NOT accurately describe the Opium Act, 1908?

    <p>It encouraged uncontrolled opium imports.</p> Signup and view all the answers

    How did Mackenzie King justify the introduction of the Opium and Narcotic Drug Act, 1911?

    <p>By citing the need for special police powers</p> Signup and view all the answers

    What was one of the significant components of the Opium Act, 1908?

    <p>It required permits for opium importation.</p> Signup and view all the answers

    What was a result of the enforcement challenges highlighted in the Opium and Narcotic Drug Act, 1911?

    <p>New laws to enhance police enforcement were introduced.</p> Signup and view all the answers

    What consequence did the Opium Act, 1908, establish for those found violating its provisions?

    <p>A maximum fine of $1,000</p> Signup and view all the answers

    What did the Opium and Narcotic Drug Act, 1911, respond to in Canadian society?

    <p>Increasing public health concerns over drug misuse</p> Signup and view all the answers

    What was the intention behind the Opium Act, 1908, with regards to opiate use?

    <p>To strictly control and regulate its distribution</p> Signup and view all the answers

    Which opioid has the most diverse routes of administration listed in the table?

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

    Which of the following opioids can be administered via both oral and parenteral routes?

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

    Which recreational method of administration is NOT commonly associated with codeine?

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

    Which opioid is exclusively administered parenterally and does not have an oral form listed?

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

    Which opioid is known to be administered both orally and rectally, providing flexibility in its use?

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

    Which of these opioids is administered through an intranasal route?

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

    Which opioid's recreational use involves snorting as a common method of administration?

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

    What is the primary form of administration for heroin listed in the table?

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

    Which opioid listed is primarily used in a medical context and not typically recreationally used?

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

    Which opiate is known for being derived from morphine and is more than 10 times its potency?

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

    What is a distinguishing factor of fentanyl compared to other opiates?

    <p>It is marketed as Sublimaze.</p> Signup and view all the answers

    What is unique about the method of administration for fentanyl?

    <p>It can be smoked or injected.</p> Signup and view all the answers

    Which of the following opiates is synthesized from thebaine?

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

    Which statement accurately reflects the potency comparison between methadone and morphine?

    <p>Methadone is as potent as morphine in terms of analgesic effect.</p> Signup and view all the answers

    What percentage of codeine can typically be found in raw opium?

    <p>0.75% to 2.5%</p> Signup and view all the answers

    Which of the following correctly describes the production process of opium?

    <p>Opium is produced for 10 days following the dropping of flower petals.</p> Signup and view all the answers

    What primary mechanism explains the analgesic effects of opiates at the spinal cord level?

    <p>Blocking incoming pain signals and releasing enkephalins</p> Signup and view all the answers

    What effect does opiate usage have on the gastrointestinal system?

    <p>Diminishes peristalsis and increases muscle tone</p> Signup and view all the answers

    Which of the following accurately describes the role of kappa receptors in opiate function?

    <p>Located in the nucleus accumbens and associated with euphoric effects</p> Signup and view all the answers

    What physiological effect can early administration of opiates have on the vomiting center in the brain?

    <p>Initial excitatory response that may cause nausea and vomiting</p> Signup and view all the answers

    How do opiates influence sex hormone levels and sexual function?

    <p>Decrease levels of sex hormones and impact sexual health</p> Signup and view all the answers

    Which societal aspect was reflected in the varied opulence of opium dens?

    <p>The financial means of the patrons</p> Signup and view all the answers

    What was a significant change regarding opium regulation in Britain during the 1860s?

    <p>Pharmacists became the only legal source of opiates</p> Signup and view all the answers

    What misconception did a San Francisco newspaper quote highlight about opium dens?

    <p>They morally ruined women and young girls</p> Signup and view all the answers

    What factor contributed to the social acceptance of opium prior to the mid-1800s?

    <p>Widespread addiction rates being underestimated</p> Signup and view all the answers

    What common sentiment existed regarding opium use prior to governmental regulation in the 1800s?

    <p>It was a respected medical solution</p> Signup and view all the answers

    What underlying prejudice influenced governmental regulation of opium in the late 1800s?

    <p>Anti-Chinese sentiment affecting policy decisions</p> Signup and view all the answers

    How did opium usage and sales change in America from the early to mid-1800s?

    <p>Regulated due to addiction concerns</p> Signup and view all the answers

    What historical evidence suggests that opium use predates the 2nd century?

    <p>A ceramic opium pipe discovered in Cyprus</p> Signup and view all the answers

    What is implied about the experience offered by opium in society during its peak use?

    <p>It provided escapism from societal pressures</p> Signup and view all the answers

    What was a significant outcome of the Opium Act of 1908 regarding opium usage?

    <p>It aimed primarily at restricting dealers rather than users.</p> Signup and view all the answers

    Which historical event prompted the introduction of further restrictions on drug use in 1911?

    <p>The growing panic over cocaine use in Montreal.</p> Signup and view all the answers

    In what way did the Opium Act of 1908 penalize violators?

    <p>Prison terms of up to three years and substantial fines were imposed.</p> Signup and view all the answers

    What was one of the main purposes of the Opium and Narcotic Drug Act, 1911?

    <p>To empower police with the ability to enforce drug laws.</p> Signup and view all the answers

    What does the Opium Act of 1908 specifically prohibit?

    <p>The importation and manufacture of opium without permissions.</p> Signup and view all the answers

    How did the introduction of the Opium Act affect the perception of opium use?

    <p>It shifted the perception of opium to one of criminality, primarily affecting dealers.</p> Signup and view all the answers

    What characteristic of the Opium Act of 1908 indicates its focus on dealers rather than users?

    <p>Focus on the importation and sale of opium.</p> Signup and view all the answers

    Which of the following best describes the legislative approach taken by the Opium and Narcotic Drug Act of 1911?

    <p>It sought to clarify and expand existing restrictions.</p> Signup and view all the answers

    What main factor highlighted by Mackenzie King influenced the enactment of the 1911 law?

    <p>Concerns over public health related to substance abuse.</p> Signup and view all the answers

    Which of the following routes of opiate administration is NOT considered parenteral?

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

    What pharmacological action do opiates primarily have on neuronal firing rates?

    <p>Decrease the rate of neuronal firing by inhibiting K influx.</p> Signup and view all the answers

    Which of these opiates has the longest half-life?

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

    Where in the brain do opiates primarily concentrate to influence the reward system?

    <p>Limbic system</p> Signup and view all the answers

    Which of the following opiate derivatives requires metabolism to exert a therapeutic effect?

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

    What is the primary receptor type on which opiates exert their agonist action?

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

    Which of the following substances is NOT among those explicitly prohibited for non-medical use?

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

    What physiological change occurs in infants born to mothers addicted to opiates?

    <p>Withdrawal symptoms</p> Signup and view all the answers

    Which alkaloid is specifically mentioned as being prohibited for non-medical use?

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

    What is the method by which opiates inhibit the release of neurotransmitters in presynaptic neurons?

    <p>Inhibiting calcium influx</p> Signup and view all the answers

    Study Notes

    Opiates: Definitional Issues

    • Opiates are naturally-occurring, synthetic, and derived compounds with analgesic properties.
    • Often referred to as "narcotic analgesics."
    • "Narcotic" describes opiates, but can be confusing as it groups them with dissimilar drugs.

    Naturally Occurring Opiates

    • Morphine, codeine, and thebaine are found in opium.
    • Opium is the sap from opium poppy seedpods.
    • Morphine accounts for approximately 10% of opium.
    • Codeine is .75% to 2.5% of opium.
    • Thebaine is less than 1% of opium.
    • Opium flowers can be white, pink, or red.
    • Production of opium typically takes about 10 days.

    Opiate Derivatives/Semi-Synthetics

    • Heroin is an opiate derivative.
    • Hydromorphone, oxymorphone, oxycodone, and hydrocodone are examples of other semi-synthetic opiates.
    • Heroin is derived by adding acetyl groups to morphine, resulting in a 3x increase in potency compared to morphine.
    • Hydromorphone is a more potent opiate than morphine.
    • Oxycodone and oxymorphone are 1.5 and 10 times more potent than morphine, respectively.
    • Hydrocodone is less potent than morphine.

    Synthetic Opiates

    • Meperidine and methadone are commonly prescribed pain killers.
    • Fentanyl is a highly potent synthetic opiate, used to treat chronic pain, like cancer.
    • Fentanyl comes in various forms, increasing its accessibility and potential for misuse.
    • Some reasons for preferential heroin use over the use of Fentanyl include its cheaper cost, greater availability and perceived greater effects or "rush."

    Opiate Antagonists

    • Naloxone (Narcan) and naltrexone are used to treat opioid overdoses.
    • Naloxone is a competitive antagonist at mu, kappa, and delta receptors.
    • Naloxone reverses depressed breathing quickly.
    • Naloxone induces withdrawal symptoms in individuals using opiates.
    • Naltrexone has a longer duration of effect compared to naloxone.

    Uses of Opiates

    • Opiates have been used medically for pain, diarrhea, and coughs for thousands of years.

    Uses and History

    • Documentation of opium use dates back hundreds of years.
    • Ancient Egyptian medical texts reference opium.
    • Galen (2nd century AD) recommended opium for various ailments.
    • In 1520, Paracelsus introduced laudanum.

    History of Opiate Use

    • Opium use was widely accepted up to the early-to-mid 1800s.
    • Mid- to late 1800s: Governmental efforts to regulate opium in the US and Britain.
    • Reasons for regulation were tied to concerns regarding the negative impacts of chronic opium abuse and anti-Chinese prejudice.
    • 1908 Opium Act (Canada): restrictions on opium importation, manufacture, and sale.
    • 1911 Opium and Narcotic Act (Canada): prohibited improper use of Opium and other drugs.

    Mechanism of Action (MOA)

    • Opiates are administered orally, parenterally (intramuscular, subcutaneous, intravenous), and transdermally.

    Distribution

    • Opiates reach high concentrations in lungs, liver, and spleen.
    • They readily cross the placental barrier.
    • Opiates concentrate in the limbic system, basal ganglia, nucleus acumbens, ventral tegmental area, periaqueductal gray area, and brain stem.

    Metabolism

    • Codeine and much of heroin become inactive after metabolism.
    • Metabolism is rapid for most opiates, excluding some synthetic opiates like methadone and LAAM.
    • Half-life varies by opiate: heroin (30 minutes), fentanyl (1-2 hours), methadone (10-25 hours), LAAM (36-48 hours)

    CNS Actions

    • Opiates act as agonists at mu, kappa, and delta receptors in the spinal cord.
    • This action leads to the inhibition of pain signals and the alteration of emotional responses.

    Effects on Eyes

    • Opiates cause pupil constriction, but the mechanism is unknown.

    Gastrointestinal Effects

    • Opiates decrease peristalsis and increase intestinal muscle tone.
    • These actions often result in constipation.

    Psychological Effects

    • Opiates can cause euphoria and dysphoria (unhappiness).
    • They decrease concentration and dull emotional pain.
    • Mechanisms for these effects include indirect activation of dopamine-producing neurons and action at mu, kappa, and sigma receptors.

    Tolerance

    • Opiate tolerance develops.
    • It develops more rapidly with daily use.
    • Tolerance develops to respiratory depression, analgesia, sedation, euphoria, and pupil constriction.
    • Constipation is not a tolerance factor.
    • Different tolerance mechanisms include changes in the number of enzymes involved in metabolism (pharmacokinetic) and changes in receptor densities (pharmacodynamic).
    • Cross-tolerance with other opiates and alcohol is possible.

    Physical Dependence

    • Characteristic withdrawal symptoms can develop within 2-10 days of cessation of opiate use.
    • Withdrawal symptoms include restlessness, agitation, yawning, fever, chills, deep sleep, muscle cramps, limb twitching, profuse sweating, and intense symptoms.

    Psychological Dependence

    • Opiate-induced psychological dependence is more difficult to treat than physical dependence.
    • Some success has been noted with methadone and other synthetic opiates, such as buprenorphine and LAAM, in treating psychological dependence.

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