Nagelhout Pharm 1 Exam 3 |66 Q’s and
A’s |100% Verified
What is the least potent opiate? - -Codeine.
Relative potency of 0.04 relative to morphine.
- T or F. High dose opioids like sufentanil provide all of the requirement of
general anesthesia? - -False.
Supplemental drugs may be need to achieve amnesia/unconsciousness,
relaxation and sympathetic control.
- What is the most potent opioid? - -Sufentanil
500-1000 as potent as morphine sulfate
- Rank these drugs from least potent to most potent-
Meperidine, Fentanil, Codeine, Alfentanil, Sufentanil, Morphine, Remifentanil?
- -1. Codeine 0.04
2. Meperidine 0.1
3. Morphine 1
4. Alfentanil 10
5. Fentanil 100
6. Remifentanil 100
7.Sufentanil 1,000
- T or F. It's ok to give fentanyl to someone with morphine allergy. - -True.
Fentanyl is a piperidine derivative. Morphine is phenantrene alkaloid. Cross
allergy occurs to drugs in the same classes
- T or F. Morphine's metabolite has no significant analgesic activity? - -False.
They have significant analgesic activity. Accumulation may occur with
repetitive dosing in renal patient.
- Which class of opioids are best to give to asthmatics? - -phenylpiperadines
(i.e fentanil)
(no histamine release)
- Which opioid has a metabolite that is CNS toxic? - -Meperidine.
metabolite (normeperidine) causes seizure. caution in patient with renal
disease or the elderly or when used repeatedly.
- Which opioid is metabolized by non esterase dependent enzymes? - -
Remifentanil
This happens via hydrolysis of ester bonds in the blood plasma
, - What is the elimination half life of remifentanil? - -5-10 minutes
- T or F. Remifentanil has anti shivering property? - -False.
Only Meperidine has anti shivering property.
- Which stimuli requires the highest dose narcotics to achieve no response:
skin incision, skin closure, intubation? - -Intubation
- T or F. Opiates have anti-emetic properties. - -True.
They inhibit vomiting center especially with repeated doses.
- What receptors are responsible for the ventilatory depressing and
analgesic effects of opiods? - -Mu
- T or F. Naloxone is an antagonist at ALL opioid receptors? - -True.
- A patient who's taking Monoamine oxidase inhibitor and has been given
meperidine may suffer from? - -SEIZURES
Serotoninergic crisis: clonus, agitation, hyperreflexia and hyperthermia
- What is the precursor molecule for beta-endorphin? - -Pro-
ipiomelanocortin or POMC.
- What is the precursor molecule for Enkephalins? - -Proenkaphalin A
- What is the precursor molecule for Dynorphins? - -Prodynorphin
- On what body systems to narcotics act? - -1. CNS
2. GI system
- What is the ultimate goal of multimodal therapy in the relief of pain? - -
Lower the dose of any single agent to improve anti-nociception and
Decrease side effects (especially of opioids: sedation, respiratory depression,
constipation, pruritus, and PONV.)
- Stadol (Butorphanol), a partial agonist is also considered an opioid
antagonist, why? - -When given after a full agonist such as morphine, can
replace morphine (compete with morphine for the opioid receptor) and
produce a lower level of analgesia
- How does Buprenex, a partial opioid agonist, relieve pruritis from
morphine? - -It acts as an antagonist of morphine, competes with morphine
at the receptor.
- Which opioid class should be avoided in asthmatics? - -Phenantrene
alkaloids - they produce histamine
A’s |100% Verified
What is the least potent opiate? - -Codeine.
Relative potency of 0.04 relative to morphine.
- T or F. High dose opioids like sufentanil provide all of the requirement of
general anesthesia? - -False.
Supplemental drugs may be need to achieve amnesia/unconsciousness,
relaxation and sympathetic control.
- What is the most potent opioid? - -Sufentanil
500-1000 as potent as morphine sulfate
- Rank these drugs from least potent to most potent-
Meperidine, Fentanil, Codeine, Alfentanil, Sufentanil, Morphine, Remifentanil?
- -1. Codeine 0.04
2. Meperidine 0.1
3. Morphine 1
4. Alfentanil 10
5. Fentanil 100
6. Remifentanil 100
7.Sufentanil 1,000
- T or F. It's ok to give fentanyl to someone with morphine allergy. - -True.
Fentanyl is a piperidine derivative. Morphine is phenantrene alkaloid. Cross
allergy occurs to drugs in the same classes
- T or F. Morphine's metabolite has no significant analgesic activity? - -False.
They have significant analgesic activity. Accumulation may occur with
repetitive dosing in renal patient.
- Which class of opioids are best to give to asthmatics? - -phenylpiperadines
(i.e fentanil)
(no histamine release)
- Which opioid has a metabolite that is CNS toxic? - -Meperidine.
metabolite (normeperidine) causes seizure. caution in patient with renal
disease or the elderly or when used repeatedly.
- Which opioid is metabolized by non esterase dependent enzymes? - -
Remifentanil
This happens via hydrolysis of ester bonds in the blood plasma
, - What is the elimination half life of remifentanil? - -5-10 minutes
- T or F. Remifentanil has anti shivering property? - -False.
Only Meperidine has anti shivering property.
- Which stimuli requires the highest dose narcotics to achieve no response:
skin incision, skin closure, intubation? - -Intubation
- T or F. Opiates have anti-emetic properties. - -True.
They inhibit vomiting center especially with repeated doses.
- What receptors are responsible for the ventilatory depressing and
analgesic effects of opiods? - -Mu
- T or F. Naloxone is an antagonist at ALL opioid receptors? - -True.
- A patient who's taking Monoamine oxidase inhibitor and has been given
meperidine may suffer from? - -SEIZURES
Serotoninergic crisis: clonus, agitation, hyperreflexia and hyperthermia
- What is the precursor molecule for beta-endorphin? - -Pro-
ipiomelanocortin or POMC.
- What is the precursor molecule for Enkephalins? - -Proenkaphalin A
- What is the precursor molecule for Dynorphins? - -Prodynorphin
- On what body systems to narcotics act? - -1. CNS
2. GI system
- What is the ultimate goal of multimodal therapy in the relief of pain? - -
Lower the dose of any single agent to improve anti-nociception and
Decrease side effects (especially of opioids: sedation, respiratory depression,
constipation, pruritus, and PONV.)
- Stadol (Butorphanol), a partial agonist is also considered an opioid
antagonist, why? - -When given after a full agonist such as morphine, can
replace morphine (compete with morphine for the opioid receptor) and
produce a lower level of analgesia
- How does Buprenex, a partial opioid agonist, relieve pruritis from
morphine? - -It acts as an antagonist of morphine, competes with morphine
at the receptor.
- Which opioid class should be avoided in asthmatics? - -Phenantrene
alkaloids - they produce histamine
