Opioids PP

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Which of the following is a semisynthetic opioid?

Codeine

What is the major pharmacodynamic difference between synthetic opioids and semisynthetic opioids?

Site of drug effect

Which alkaloid is present in most opioid agonists?

Thebaine

Which of the following is NOT a side effect of remifentanil administration?

<p>Histamine release</p> Signup and view all the answers

What is the potential disadvantage of remifentanil possessing a short recovery period?

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

Which administration of remifentanil is NOT recommended?

<p>Spinal administration</p> Signup and view all the answers

Which part of the brain primarily contains opioid receptors?

<p>Periaqueductal gray</p> Signup and view all the answers

Which opioid receptor is primarily responsible for analgesia?

<p>𝜇1</p> Signup and view all the answers

Which opioid receptor is primarily responsible for hypoventilation and physical dependence?

<p>𝜇2</p> Signup and view all the answers

What is the main effect of opioids on the cardiovascular system?

<p>Increased activity over vagal nerves</p> Signup and view all the answers

Which opioid agonist is 75-125 times more potent than morphine?

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

Which opioid agonist is primarily eliminated through hepatic metabolism?

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

Which opioid agonist has a longer elimination half-time than morphine?

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

Which opioid agonist is commonly administered as a transmucosal preparation?

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

Which opioid agonist has the greatest affinity for opioid receptors?

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

Which opioid agonist is associated with a risk of opioid overdose when in contact with an upper body warming blanket?

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

Which opioid agonist is known to cause bradycardia more prominently than morphine?

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

Which opioid agonist has the fastest onset of action?

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

Which opioid side effect is caused by direct stimulation of the chemoreceptor trigger zone in the floor of the fourth ventricle?

<p>Nausea &amp; Vomiting</p> Signup and view all the answers

Which opioid side effect is characterized by the dilation of cutaneous vessels with flushing of the face, neck, and upper chest?

<p>Cutaneous Changes</p> Signup and view all the answers

Which opioid side effect is associated with an increase in the tone and peristaltic activity of the ureter?

<p>Genitourinary System</p> Signup and view all the answers

Which opioid side effect can occur in neonates when opioids are readily transported across the placenta?

<p>Placental Transfer</p> Signup and view all the answers

Which opioid agonist has a rapid onset and offset of intense analgesia, reflecting its very prompt effect-site equilibration?

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

Which opioid agonist has a blood-brain equilibration time similar to that of alfentanil and is 15-20 times as potent as alfentanil?

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

Which opioid agonist is unique in undergoing metabolism by nonspecific plasma and tissue esterases to inactive metabolites?

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

Which opioid agonist has a context-sensitive half-time that is independent of the duration of infusion and is estimated to be about 4 minutes?

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

Which part of the brain primarily contains opioid receptors?

<p>Periaqueductal gray</p> Signup and view all the answers

Which opioid receptor is primarily responsible for analgesia?

<p>Mu1</p> Signup and view all the answers

Which opioid side effect is characterized by the dilation of cutaneous vessels with flushing of the face, neck, and upper chest?

<p>Histamine release</p> Signup and view all the answers

Which opioid agonist is commonly associated with constipation as a side effect?

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

Which opioid agonist has a longer elimination half-time than morphine?

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

Which opioid agonist is primarily eliminated through hepatic metabolism?

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

Which opioid agonist is associated with a risk of opioid overdose when in contact with an upper body warming blanket?

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

Which opioid agonist has the fastest onset of action?

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

Which opioid agonist has the longest elimination half-time?

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

Which opioid agonist is primarily eliminated through hepatic metabolism?

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

Which opioid agonist is 75-125 times more potent than morphine?

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

Which opioid agonist has a faster onset and shorter duration of action than morphine?

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

Which opioid agonist has a rapid onset and offset of intense analgesia, reflecting its very prompt effect-site equilibration?

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

Which opioid agonist is primarily eliminated through hepatic metabolism?

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

Which opioid agonist has a context-sensitive half-time that is independent of the duration of infusion and is estimated to be about 4 minutes?

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

Which opioid agonist is associated with a risk of opioid overdose when in contact with an upper body warming blanket?

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

Which alkaloid is naturally occurring in the opium poppy?

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

What is the chemical modification in heroin compared to morphine?

<p>Substitution of acetyl group on carbon 3 and 6</p> Signup and view all the answers

Which class of opioids is manufactured by synthesis rather than chemical modification of morphine?

<p>Synthetic opioids</p> Signup and view all the answers

Which opioid agonist is commonly used to supplement general anesthesia or as a primary anesthetic in high doses?

<p>Synthetic opioids</p> Signup and view all the answers

Which opioid side effect is characterized by the dilation of cutaneous vessels with flushing of the face, neck, and upper chest?

<p>Cutaneous changes</p> Signup and view all the answers

Which opioid agonist is primarily eliminated through hepatic metabolism?

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

What is the major pharmacodynamic difference between synthetic opioids and semisynthetic opioids?

<p>Semisynthetic opioids have a greater analgesic potency</p> Signup and view all the answers

Which opioid agonist is 75-125 times more potent than morphine?

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

Which administration of remifentanil is NOT recommended?

<p>Epidural administration</p> Signup and view all the answers

What is the potential disadvantage of remifentanil possessing a short recovery period?

<p>Increased risk of postoperative nausea and vomiting</p> Signup and view all the answers

Which opioid side effect is characterized by the dilation of cutaneous vessels with flushing of the face, neck, and upper chest?

<p>Cutaneous vasodilation (flushing)</p> Signup and view all the answers

What is the major pharmacodynamic difference between synthetic opioids and semisynthetic opioids?

<p>Semisynthetic opioids are derived from natural opioids</p> Signup and view all the answers

Which opioid receptor is primarily responsible for hypoventilation and physical dependence?

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

Which opioid agonist has a rapid onset and offset of intense analgesia, reflecting its very prompt effect-site equilibration?

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

Opioids are unique in producing analgesia without loss of touch, proprioception, or consciousness.

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

Semisynthetic opioids are manufactured by synthesis rather than chemical modification of morphine.

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

Synthetic opioids are widely used to supplement general anesthesia or as primary anesthetics in very high doses.

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

True or false: MAOI's impair the formation of glucuronide conjugates, which can contribute to exaggerated morphine effects.

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

True or false: Plasma morphine concentrations are greater in the elderly.

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

True or false: Meperidine shares structural features present in local anesthetics.

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

True or false: Fentanyl is 75-125 times more potent than morphine.

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

Opioid receptors primarily found in the brain include the periaqueductal gray, locus ceruleus, and the rostral ventral medulla.

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

Opioid receptors primarily found in the spinal cord include interneurons and primary afferent neurons in the dorsal horn.

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

Opioid agonists-antagonists often act on Kappa receptors.

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

Opioid receptors in sensory neurons and immune cells can be found outside the central nervous system.

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

True or false: Fentanyl and sufentanil have similar elimination half-times.

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

True or false: Fentanyl can cause seizures due to its effect on inhibitory neurons.

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

True or false: Fentanyl can cause bradycardia, leading to occasional decreases in blood pressure and cardiac output.

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

True or false: Fentanyl does not evoke the release of histamine, unlike morphine.

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

True or false: Cirrhosis of the liver prolongs the elimination half-time of alfentanil?

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

True or false: Renal failure alters the clearance or elimination half-time of alfentanil?

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

True or false: The low pKa of alfentanil results in rapid effect-site equilibration?

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

True or false: The Vd of alfentanil is larger than that of fentanyl?

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

True or false: The spinal or epidural administration of remifentanil is recommended for its safety and efficacy?

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

True or false: Remifentanil administration can lead to nausea, vomiting, and mild decreases in blood pressure and heart rate?

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

True or false: High-dose remifentanil increases cerebral blood flow and cerebral metabolic oxygen requirements?

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

True or false: Opioid agonists can cause an increase in GI secretions and delayed passage of intestinal content towards the colon.

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

True or false: Opioid agonists can cause an increase in the tone and peristaltic activity of the ureter.

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

True or false: Opioid agonists can cause cutaneous vessels to dilate with flushing of the face, neck, and upper chest.

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

True or false: Opioid agonists can readily cross the placenta and cause depression in the neonate.

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

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