Pharm Opioids- Nagelhout Exam |144
Questions with Verified Answers
What are the 3 naturally occurring phenanthrenes? - -1) Morphine -->
HISTAMINE
2) Codeine ---> HISTAMINE
3) Thebaine
- What are the 5 semisynthetic phenanthrenes? - -1) heroin
2) vicodin (Hydrocodone)
3) dialudid (hydromorphone)
4) oxycodone (oxycontin)
5) oxymorphone
- What are the 7 synthetic phenanthrenes? - -1) levorphanol
2) butorphanol
3) nalbuphine
4) pentazocine
5) naloxone
6) naltrexone
7) nalmefene
- What are the two mixed opioids? (synthetic phenanthrenes) - -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) - -1) meperidine --> HISTAMINE
2) loperamide
3) Fentanyl
4) Sufentanil
5) Alfentanil
6) Remifentanil
- What is the only diphenylheptane? - -methadone
- Which are the 3 specific drugs that are MOST likely to stimulate histamine
release? - -1) codeine
2) morphine
3) meperidine
-general rule = phenanthrines and demerol
, - Are there cross allergies between classes? - -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? - -1) NO
2) NO
3) YES
4) YES
- Why do opioids cause analgesia? - --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? - --
phenylpiperidines EXCEPT demerol
-ex: FENTANYL is safe
- Opioid with equal potency to fentanyl - -remifentanil
- Opioid with weakest potency - -codeine
- Opioid with strongest potency - -Sufentanil (MU agonist)
- What are the 4 endogenous opioid peptides? - -1) enkephalins
2) B-endorphins
3) Dynorphins
4) Endomorphins
- What is the MAIN receptor that causes analgesia? - --MU
-if all do the action write MU because it is the MAIN one
- What endogenous receptor causes dysphoria AND sedation? - --Kappa
-also think SHIVERING for kappa
- What 4 factors put pts more at risk for effects of demerol toxic metabolite?
- -1) elderly
2) renal disease 3) liver disease 4) chronic use
- Where is remifentanil metabolized? - --hydrolyzed in the plasma by non-
specific esterases (rapid metabolism due to addition of ester group)
- Which opioid has a toxic metabolite? - --demerol --> metabolized to
normeperidine
-can be CNS toxic
Questions with Verified Answers
What are the 3 naturally occurring phenanthrenes? - -1) Morphine -->
HISTAMINE
2) Codeine ---> HISTAMINE
3) Thebaine
- What are the 5 semisynthetic phenanthrenes? - -1) heroin
2) vicodin (Hydrocodone)
3) dialudid (hydromorphone)
4) oxycodone (oxycontin)
5) oxymorphone
- What are the 7 synthetic phenanthrenes? - -1) levorphanol
2) butorphanol
3) nalbuphine
4) pentazocine
5) naloxone
6) naltrexone
7) nalmefene
- What are the two mixed opioids? (synthetic phenanthrenes) - -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) - -1) meperidine --> HISTAMINE
2) loperamide
3) Fentanyl
4) Sufentanil
5) Alfentanil
6) Remifentanil
- What is the only diphenylheptane? - -methadone
- Which are the 3 specific drugs that are MOST likely to stimulate histamine
release? - -1) codeine
2) morphine
3) meperidine
-general rule = phenanthrines and demerol
, - Are there cross allergies between classes? - -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? - -1) NO
2) NO
3) YES
4) YES
- Why do opioids cause analgesia? - --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? - --
phenylpiperidines EXCEPT demerol
-ex: FENTANYL is safe
- Opioid with equal potency to fentanyl - -remifentanil
- Opioid with weakest potency - -codeine
- Opioid with strongest potency - -Sufentanil (MU agonist)
- What are the 4 endogenous opioid peptides? - -1) enkephalins
2) B-endorphins
3) Dynorphins
4) Endomorphins
- What is the MAIN receptor that causes analgesia? - --MU
-if all do the action write MU because it is the MAIN one
- What endogenous receptor causes dysphoria AND sedation? - --Kappa
-also think SHIVERING for kappa
- What 4 factors put pts more at risk for effects of demerol toxic metabolite?
- -1) elderly
2) renal disease 3) liver disease 4) chronic use
- Where is remifentanil metabolized? - --hydrolyzed in the plasma by non-
specific esterases (rapid metabolism due to addition of ester group)
- Which opioid has a toxic metabolite? - --demerol --> metabolized to
normeperidine
-can be CNS toxic
