Pain Management: Opioids and Adjuvants
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Questions and Answers

What is the most common cause of death in acute opioid overdose?

  • Hypertension
  • Cardiovascular failure
  • Cerebral edema
  • Respiratory depression (correct)

What is the effect of increased Pco2 on cerebrovascular vessels?

  • Vasoconstriction
  • No effect
  • Vessel rupture
  • Vasodilation (correct)

Why are opioids usually contraindicated in severe brain injury?

  • They can cause nausea and vomiting
  • They can cause respiratory depression
  • They can increase intracranial pressure (correct)
  • They can cause cardiovascular failure

What is the mechanism of antitussive properties of morphine and codeine?

<p>Suppression of the cough reflex by unknown mechanisms (B)</p> Signup and view all the answers

Why do opioids cause pinpoint pupils?8j

<p>Stimulation of the Edinger-Westphal nucleus (C)</p> Signup and view all the answers

What is the effect of opioids on the cardiovascular system?

<p>No effect on the cardiovascular system (D)</p> Signup and view all the answers

What is the main effect of morphine on the gut?

<p>It decreases motility and increases tone of smooth muscle (D)</p> Signup and view all the answers

What is a contraindication for the use of opioids?

<p>Biliary colic due to gallstones (C)</p> Signup and view all the answers

What is the effect of morphine on the ureter?

<p>It decreases ureteric spasm (C)</p> Signup and view all the answers

Which of the following opioids does not release histamine?

<p>Fentanyl (C)</p> Signup and view all the answers

What is the effect of morphine on the anal sphincter?

<p>It increases the tone of the anal sphincter (C)</p> Signup and view all the answers

What is the effect of morphine on labor?

<p>It prolongs labor (A)</p> Signup and view all the answers

What is the primary purpose of methadone in the management of opioid dependence?

<p>To treat opioid withdrawal states (B)</p> Signup and view all the answers

Why is morphine not usually given orally?

<p>Due to its slow absorption from the GIT (B)</p> Signup and view all the answers

What is the primary route of excretion of morphine conjugates?

<p>Urine (C)</p> Signup and view all the answers

What is the effect of morphine on infants born to addicted mothers?

<p>They exhibit withdrawal symptoms if opioids are not administered (B)</p> Signup and view all the answers

Why do elderly patients require lower doses of morphine?

<p>Due to their decreased metabolism, decreased lean body mass, and renal function (D)</p> Signup and view all the answers

Which of the following opioids is the least lipophilic?

<p>Morphine (C)</p> Signup and view all the answers

What type of pain do nonopioids, such as NSAIDs and Paracetamol, are useful in treating?

<p>Nociceptive pain (A)</p> Signup and view all the answers

What is the primary effect of adjuvants?

<p>Antiepileptic effect (D)</p> Signup and view all the answers

What is the term for any substance that produces morphine-like effects that are blocked by antagonists?

<p>Opioid (C)</p> Signup and view all the answers

What is the primary use of opioids?

<p>To relieve severe pain (B)</p> Signup and view all the answers

What is the term for compounds such as morphine and codeine that are found in the opium poppy?

<p>Opiate (C)</p> Signup and view all the answers

What type of receptors do opioids bind to?

<p>Gi-protein-coupled receptors (B)</p> Signup and view all the answers

What is a contraindication for the use of morphine in neonates?

<p>Low conjugating capacity (B)</p> Signup and view all the answers

What is a serious adverse effect of morphine in patients with head injuries?

<p>Elevation of intracranial pressure (A)</p> Signup and view all the answers

What is a characteristic of tolerance to morphine?

<p>It does not develop to the miosis and constipation (A)</p> Signup and view all the answers

What is a characteristic of cross-tolerance between opioids?

<p>It occurs between drugs acting on the same receptor (A)</p> Signup and view all the answers

What is a symptom of withdrawal from morphine?

<p>Yawning (A)</p> Signup and view all the answers

What is the receptor binding profile of meperidine?

<p>Binding particularly to mu receptors (C)</p> Signup and view all the answers

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