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</p> Signup and view all the answers

    Why do opioids cause pinpoint pupils?8j

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

    What is the effect of opioids on the cardiovascular system?

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

    What is a contraindication for the use of opioids?

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

    What is the effect of morphine on the ureter?

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

    Which of the following opioids does not release histamine?

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

    What is the effect of morphine on labor?

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

    Why is morphine not usually given orally?

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

    What is the primary route of excretion of morphine conjugates?

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

    Which of the following opioids is the least lipophilic?

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

    What is the primary effect of adjuvants?

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

    What is the primary use of opioids?

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

    What type of receptors do opioids bind to?

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

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

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

    What is a symptom of withdrawal from morphine?

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

    What is the receptor binding profile of meperidine?

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

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