Pharm > Opiods > Flashcards

Opiods Flashcards

(59 cards)

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1
Q

What is the primary effect of opioids in the body?

A

Effects primarily at the central nervous system

Opioids are used for therapy, pain relief, and can also serve as research mechanisms.

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2
Q

What must opioids do to exert their effects?

A

They must cross the blood-brain barrier

This is essential for opioids to reach the central nervous system.

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3
Q

What do opioids mimic in the body?

A

They mimic endogenous ligands

Endogenous ligands are naturally occurring substances in the body that opioids imitate.

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4
Q

What is the role of pain in the body?

A

Pain signals that something is wrong and prompts action

Pain is an important sensation that indicates the need for corrective measures.

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5
Q

What are endorphins released in response to?

A
  • Pain
  • Anticipation of pain
  • Excitement
  • Exercise
  • Orgasm
  • Love

Endorphins contribute to feelings of well-being and pain suppression.

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6
Q

What are the two main systems of central nervous system signaling?

A
  • Hierarchical systems
  • Non-specific neurotransmitter systems - diffuse system

These systems describe how signals are transmitted and processed in the CNS.

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7
Q

What neurotransmitters are primarily involved in hierarchical systems?

A
  • Glutamate
  • Glycine
  • gaba
    -opiod peptides

These neurotransmitters play key roles in excitatory and inhibitory signaling.

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8
Q

What neurotransmitters are associated with non-specific neurotransmitter systems?

A
  • Norepinephrine
  • Dopamine
  • Serotonin
    -ach

These neurotransmitters are released by specific nuclei and can affect multiple brain areas simultaneously.

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9
Q

What is the function of nociceptors?

A

They are pain receptors that signal noxious stimuli

Nociceptors are free nerve endings that detect harmful stimuli.

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10
Q

What are the two types of nerve fibers involved in pain signaling?

A
  • A-delta fibers: transmit sharp pain
  • C fibers: transmit slow, burning pain

These fibers differ in speed and type of pain they convey.

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11
Q

What is the gate control theory of pain?

A

It suggests that non-painful stimuli can inhibit pain signals

Rubbing an injured area activates A fibers, which can close the gate to pain signals.

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12
Q

What are the three prominent pathways for pain signaling?

A
  • Spinothalamic pathway- fast via thalamus to post central gyrus
  • Spinoreticular pathway- slow via reticular formation
  • Spinamesincephalic pathway - 3rd order via periaqueductal gray (PAG)

Each pathway has a role in processing and interpreting pain.

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13
Q

What is the role of the somatosensory cortex?

A

It interprets pain sensations

The somatosensory cortex is where pain is consciously perceived and processed.

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14
Q

What are mechanical receptors responsible for?

A

They detect non-painful stimuli like vibration and pressure

Mechanical receptors differ from nociceptors, which are specifically for pain.

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15
Q

What is the arachidonic acid cascade associated with?

A

It contributes to the production of prostaglandins and other mediators of pain

This cascade is activated during tissue damage and inflammation.

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16
Q

What is the significance of substance P in pain signaling?

A

It is a neuropeptide involved in the transmission of pain signals

Substance P plays a role in the excitatory action potential in pain pathways.

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17
Q

What happens during tissue damage in relation to pain?

A

Mediators like prostaglandins and bradykinins are released

These mediators activate pain receptors and contribute to the pain response.

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18
Q

What is the function of free nerve endings?

A

They detect noxious chemicals and pain stimuli

Free nerve endings are scattered throughout the body and are crucial for pain perception.

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19
Q

What is the function of the periaqueductal gray (PAG) in pain modulation?

A

Stimulates the release of endorphins to suppress pain signals

The PAG is rich in endorphin receptors and helps to reduce the intensity of pain signals.

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20
Q

True or false: The periacoductal gray completely eliminates pain signals.

A

FALSE

While the PAG reduces pain signal intensity, it does not eliminate pain entirely.

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21
Q

What are the three types of opioids mentioned?

A
  • Agonists
  • Partial agonists
  • Antagonists

These classifications indicate how opioids interact with receptors in the body.

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22
Q

Name two examples of full agonists in opioids.

A
  • Morphine
  • Fentanyl

Full agonists bind to opioid receptors and produce strong analgesic effects.

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23
Q

What is the primary receptor targeted by most opioids?

A

Mu opioid receptor

The mu receptor is primarily responsible for analgesia and other effects of opioids.

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24
Q

Fill in the blank: Endogenous opioids include ________, ________, and ________.

Study These Flashcards
A
  • Endorphins
  • Enkephalins
  • Dynorphins

These are naturally occurring peptides that modulate pain and stress responses.

25
What is the effect of opioids on **neurotransmitter release**?
Reduces neurotransmitter release ## Footnote Opioids inhibit the release of various neurotransmitters, contributing to their analgesic effects.
26
What is a common **side effect** of opioid use related to the gastrointestinal system?
Constipation ## Footnote Patients do not develop tolerance to constipation caused by opioids, making it a significant concern for long-term use.
27
What is the **mechanism of action** of opioids at the synapse?
Block calcium channels and enhance potassium channels ## Footnote This action leads to hyperpolarization of neurons, reducing pain signal transmission.
28
What is the **first-pass metabolism** effect on opioids like morphine?
Decreases effectiveness when taken orally ## Footnote Morphine is less effective orally due to significant first-pass metabolism.
29
What is the role of **naloxone** in opioid treatment?
Antagonist that reverses opioid effects ## Footnote Naloxone is used to treat opioid overdoses by blocking opioid receptors.
30
What are the **effects** of opioids on the **respiratory system**?
Respiratory depression ## Footnote Opioids can significantly depress respiratory function, which is a major risk in overdose situations.
31
What is the **clinical use** of opioids in patients with acute pulmonary edema?
Relieves anxiety and reduces sympathetic nervous system response ## Footnote Opioids help manage pain and anxiety, improving patient comfort in acute situations.
32
What is the **effect** of opioids on pupil size?
Causes miosis (pupil constriction) ## Footnote Opioids block the pain response that typically causes pupil dilation.
33
What is the **relationship** between opioids and the **dopamine mesolimbic system**?
Opioids activate the system, leading to euphoria and potential addiction ## Footnote This activation is a key factor in the addictive properties of opioids.
34
What is the **primary therapeutic use** of opioids?
Management of severe pain ## Footnote Opioids are primarily prescribed for severe, constant pain, especially in chronic conditions.
35
What is the effect of **epinephrine** and **norepinephrine** on preload and afterload?
* increases preload * increases afterload ## Footnote This effect is beneficial for multiple different conditions.
36
List some **uses** of Demerol.
* Post-op shivering * Anesthesia pre-op for anxiety * Anesthesia post-op for pain * Perioperative anesthetic agent ## Footnote Demerol is widely used for its various therapeutic effects.
37
What are some **side effects** associated with opioids?
* Dysphoric reactions * Respiratory depression * Nausea * Vomiting * Increased intracranial pressure * Postural hypotension * Constipation * Urinary retention * Itch ## Footnote These side effects are related to the therapeutic effects of opioids.
38
True or false: **Tolerance** to opioids means that a patient will need more of the drug over time to achieve the same effect.
TRUE ## Footnote Tolerance is related to receptor desensitization and internalization.
39
What are the two types of **dependence** associated with opioids?
* Physical dependence * Mental dependence ## Footnote Physical dependence leads to withdrawal symptoms if the drug is discontinued abruptly.
40
Fill in the blank: **Naloxone** and **naltrexone** do not develop a tolerance, so they can be given ________.
no matter how many times ## Footnote They can almost immediately reverse the signs and symptoms of opioid overdose.
41
What are the **three different classes** of opioids?
* Phenanthrenes * Phenylheptamines * Phenylpiperidines ## Footnote These classes are based on the basic structure of the opioids.
42
Name a **strong agonist** in the phenanthrene class.
* Morphine ## Footnote Morphine is a breakdown product of heroin and is a full agonist.
43
What is the primary use of **methadone**?
* Chronic pain relief * Opioid addiction treatment ## Footnote Methadone is associated with rehabilitation for opioid abuse.
44
True or false: **Fentanyl** is considered to be 100 times more powerful than morphine.
TRUE ## Footnote Fentanyl has many analogues and is a strong agonist.
45
What is a significant side effect of **Demerol**?
* Induces seizures in predisposed patients ## Footnote Demerol is primarily used for postoperative shivering.
46
What is the effect of **opioid-induced hyperalgesia**?
* Increased susceptibility to pain signaling ## Footnote This occurs in patients on long-term opioid therapy - desensitization Or split mu receptor - MOR -1k - increases camp rather than decrease camp
47
List some **withdrawal symptoms** associated with opioids.
* Running nose * Watering eyes * Yawning * Eye erection * Hyperventilation * Hyperthermia * Nausea * Vomiting * Diarrhea * Hostility * Anxiety ## Footnote These symptoms result from physical and mechanical dependence.
48
What is the role of **naloxagol**?
* Blocks opioid-induced constipation in the gut ## Footnote Naloxagol specifically targets the gut without systemic effects.
49
What is the classification of **tramadol**?
* Moderate agonist of phenylpiperdines class ## Footnote Tramadol is considered safer than many opioids and also acts as a selective serotonin and norepinephrine reuptake inhibitor.
50
What is **buprenorphine** classified as?
* Partial agonist ## Footnote Buprenorphine is often used in the treatment of opioid abuse.
51
What drug is nature of the **racemic mixture**?
Tramadol ## Footnote A racemic mixture contains equal amounts of two enantiomers.
52
What is **buprenorphine** also known as?
Buprenex ## Footnote It is a partial agonist often used in the treatment of opioid abuse.
53
What is the use of **mutorphinol** or **Stadol**?
Useful for post-op shivering ## Footnote It is also a partial agonist, making it less strong than other opioids.
54
What is **dextromethorphan** primarily used for?
Coughing ## Footnote It is a common ingredient in cough suppressants.
55
What is the main argument for the use of **mepiridine**?
Safer than other opioids ## Footnote It specifically targets the G protein pathway, minimizing adverse effects.
56
What does the **G protein pathway** lead to in opioid action?
* Suppression of cyclic AMP * Blocking of calcium channels * Opening of potassium channels * Analgesia response ## Footnote This pathway is desired for effective pain relief.
57
What are the **adverse effects** associated with the **beta-restin pathway**?
* Activation of junk and ERC pathways * Suppression of analgesia response * Internalization of the receptor ## Footnote These effects can lead to tolerance and reduced pain relief.
58
What is the duration of action for **naloxone**?
One to three minutes ## Footnote It is used to dramatically reverse opioid effects but has a shorter half-life than most opioids.
59
True or false: **Naloxone** can harm a patient who is unconscious regardless of opioid use.
FALSE ## Footnote Naloxone blocks agonists without causing harm, but it may not help if opioids are not involved.
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