Pharm Opioids – Nagelhout Questions and Answers 2026/2027 | Complete Pharmacology Study Guide | A+ Grade

Pharm Opioids- Nagelhout questions and answers 2026\027 A+
Grade


What are the 3 naturally occurring phenanthrenes?
- correct answer 1) Morphine --> HISTAMINE

2) Codeine ---> HISTAMINE

3) Thebaine



What are the 5 semisynthetic phenanthrenes?
- correct answer 1) heroin

2) vicodin (Hydrocodone)

3) dialudid (hydromorphone)

4) oxycodone (oxycontin)

5) oxymorphone



What are the 7 synthetic phenanthrenes?
- correct answer 1) levorphanol

2) butorphanol

3) nalbuphine

4) pentazocine

5) naloxone

6) naltrexone

7) nalmefene



What are the two mixed opioids? (synthetic phenanthrenes)
- correct answer 1) nalbuphine - can antagonize respiratory depression and pruritus, but maintain
analgesia

2) butorphanol

,MU antagonists, Kappa partial agonists, and Delta agonists



What are the 6 piperidines? (all are referred to as phenylpiperidines even though this isn't technically
correct)
- correct answer 1) meperidine --> HISTAMINE

2) loperamide

3) Fentanyl

4) Sufentanil

5) Alfentanil

6) Remifentanil



What is the only diphenylheptane?
- correct answer methadone



Which are the 3 specific drugs that are MOST likely to stimulate histamine release?
- correct answer 1) codeine

2) morphine

3) meperidine

-general rule = phenanthrines and demerol



Are there cross allergies between classes?
- correct answer NO

-just AMONG classes



1) If someone is allergic to Vicodin can they have oxycodone?

2) If someone is allergic to morphine can they have dilaudid?

3) If someone is allergic to codeine can they have demerol?

4) If someone is allergic to fentanyl can they have morphine?
- correct answer 1) NO

2) NO

3) YES

, 4) YES



Why do opioids cause analgesia?
- correct answer -suppress release of pain chemicals

-PRESYNAPTIC AGONISTS THAT CAUSE INHIBITION OF RELEASE OF SUBSTANCE P and other
neurotransmitters



What class includes the drugs of choice for asthmatics?
- correct answer -phenylpiperidines EXCEPT demerol

-ex: FENTANYL is safe



Opioid with equal potency to fentanyl
- correct answer remifentanil



Opioid with weakest potency
- correct answer codeine



Opioid with strongest potency
- correct answer Sufentanil (MU agonist)



What are the 4 endogenous opioid peptides?
- correct answer 1) enkephalins

2) B-endorphins

3) Dynorphins

4) Endomorphins



What is the MAIN receptor that causes analgesia?
- correct answer -MU

-if all do the action write MU because it is the MAIN one



What endogenous receptor causes dysphoria AND sedation?
- correct answer -Kappa