NURS 3550 Test 2 Review questions with correct
answers
Effects of Morphine at Mu Receptors Correct Answer-analgesia
sedation
euphoria*
physical dependence*
respiratory depression*
miosis (pinpoint)*
vasodilation*
decreased GI activity
Effects of Morphine at Kappa Receptors Correct Answer-Analgesia
Sedation
Hallucinations*
Dysphoria*
Nightmares*
Decreased GI activity
What type of drug is pentazocine? Correct Answer-A mixed opioid
agonist-antagonist that mostly activates kappa receptors and blocks mu
receptors
What type of drug is morphine? Correct Answer-Opioid agonist
,Why use pentazocine over a pure opioid agonist? Correct Answer-Better
choice in someone who has an issue with euphoria, respiratory
depression, or dependence
May not be a good choice in someone with problems with dysphoria or
high BP
What enzyme(s) metabolize morphine? Correct Answer-CYP 2D6 and
CYP 3A4
Therapeutic Indication of Morphine Correct Answer-1. Treatment of
moderate to severe pain by decreasing transmission pain (Substance P)
2. Diarrhea (by decreasing GI motility - Loperamide)
3. Cough suppression (codeine)
Contraindications of Morphine Correct Answer-1.
Hypersensitivity/Allergy
2. Premature Neonates
3. Heart Failure from lung disease
4. Arrhythmia
5. Biliary Tract Surgery
Cautions of Morphine Correct Answer-1. Compromised respiratory
function
2. Head injury
3. Pregnancy
,4. Labour and Delivery
5. Infants/Elderly
6. IBD
7. Hepatic dysfunction
8. Hypotension/hypovolemia
9. BPH
10. Hx of drug dependence
How much of dose of morphine actually reach the site of action and
why? Correct Answer-- only a fraction
- not very lipid soluble, does not cross BBB very easily
What are some effects of prolonged use of morphine? Correct Answer--
Compromised immune system
- Neurotoxicity
- Decreased cortisol
- Increased prolactin
- Decreased LH, FSH, testosterone and estrogen
What is the classic triad of overdose/toxicity? Correct Answer--
Respiratory depression
- Miosis
- Coma
, What are some symptoms of opioid withdrawal? Correct Answer--
yawning
- sweating
- sneezing
- muscle and bone pain
- muscle spasm and kicking
Adverse Effects of Opioids Correct Answer-- Respiratory depression
- Hypoventilation
- Apnea
- Constipation
- N/V
- Spasm of common bile duct
- Orthostatic hypotension (mu)
- Morphine itch (histamine release)
- Bradycardia
- Sedation
- Cough suppression (increased risk of resp infection)
- Euphoria (mu) and dysphoria (kappa)
- Increased ICP
- Urinary urgency/hesitation
- Hallucinations (kappa)
- Miosis (mu)
answers
Effects of Morphine at Mu Receptors Correct Answer-analgesia
sedation
euphoria*
physical dependence*
respiratory depression*
miosis (pinpoint)*
vasodilation*
decreased GI activity
Effects of Morphine at Kappa Receptors Correct Answer-Analgesia
Sedation
Hallucinations*
Dysphoria*
Nightmares*
Decreased GI activity
What type of drug is pentazocine? Correct Answer-A mixed opioid
agonist-antagonist that mostly activates kappa receptors and blocks mu
receptors
What type of drug is morphine? Correct Answer-Opioid agonist
,Why use pentazocine over a pure opioid agonist? Correct Answer-Better
choice in someone who has an issue with euphoria, respiratory
depression, or dependence
May not be a good choice in someone with problems with dysphoria or
high BP
What enzyme(s) metabolize morphine? Correct Answer-CYP 2D6 and
CYP 3A4
Therapeutic Indication of Morphine Correct Answer-1. Treatment of
moderate to severe pain by decreasing transmission pain (Substance P)
2. Diarrhea (by decreasing GI motility - Loperamide)
3. Cough suppression (codeine)
Contraindications of Morphine Correct Answer-1.
Hypersensitivity/Allergy
2. Premature Neonates
3. Heart Failure from lung disease
4. Arrhythmia
5. Biliary Tract Surgery
Cautions of Morphine Correct Answer-1. Compromised respiratory
function
2. Head injury
3. Pregnancy
,4. Labour and Delivery
5. Infants/Elderly
6. IBD
7. Hepatic dysfunction
8. Hypotension/hypovolemia
9. BPH
10. Hx of drug dependence
How much of dose of morphine actually reach the site of action and
why? Correct Answer-- only a fraction
- not very lipid soluble, does not cross BBB very easily
What are some effects of prolonged use of morphine? Correct Answer--
Compromised immune system
- Neurotoxicity
- Decreased cortisol
- Increased prolactin
- Decreased LH, FSH, testosterone and estrogen
What is the classic triad of overdose/toxicity? Correct Answer--
Respiratory depression
- Miosis
- Coma
, What are some symptoms of opioid withdrawal? Correct Answer--
yawning
- sweating
- sneezing
- muscle and bone pain
- muscle spasm and kicking
Adverse Effects of Opioids Correct Answer-- Respiratory depression
- Hypoventilation
- Apnea
- Constipation
- N/V
- Spasm of common bile duct
- Orthostatic hypotension (mu)
- Morphine itch (histamine release)
- Bradycardia
- Sedation
- Cough suppression (increased risk of resp infection)
- Euphoria (mu) and dysphoria (kappa)
- Increased ICP
- Urinary urgency/hesitation
- Hallucinations (kappa)
- Miosis (mu)
