Nagelhout Pharm 1 Exam 3
Which opioid is metabolized by non esterase dependent enzymes? - CORRECT
ANSWER-Remifentanil
This happens via hydrolysis of ester bonds in the blood plasma
What is the elimination half life of remifentanil? - CORRECT ANSWER-5-10 minutes
T or F. Remifentanil has anti shivering property? - CORRECT ANSWER-False.
Only Meperidine has anti shivering property.
Which stimuli requires the highest dose narcotics to achieve no response: skin incision,
skin closure, intubation? - CORRECT ANSWER-Intubation
T or F. Opiates have anti-emetic properties. - CORRECT ANSWER-True.
They inhibit vomiting center especially with repeated doses.
What receptors are responsible for the ventilatory depressing and analgesic effects of
opiods? - CORRECT ANSWER-Mu
T or F. Naloxone is an antagonist at ALL opioid receptors? - CORRECT ANSWER-
True.
A patient who's taking Monoamine oxidase inhibitor and has been given meperidine
may suffer from? - CORRECT ANSWER-SEIZURES
Serotoninergic crisis: clonus, agitation, hyperreflexia and hyperthermia
What is the most potent opioid? - CORRECT ANSWER-Sufentanil
500-1000 as potent as morphine sulfate
Rank these drugs from least potent to most potent-
Meperidine, Fentanil, Codeine, Alfentanil, Sufentanil, Morphine, Remifentanil? -
CORRECT ANSWER-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. - CORRECT
ANSWER-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? - CORRECT
ANSWER-False.
They have significant analgesic activity. Accumulation may occur with repetitive dosing
in renal patient.
What is the least potent opiate? - CORRECT ANSWER-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? - CORRECT ANSWER-False.
Supplemental drugs may be need to achieve amnesia/unconsciousness, relaxation and
sympathetic control.
Which class of opioids are best to give to asthmatics? - CORRECT ANSWER-
phenylpiperadines (i.e fentanil)
(no histamine release)
Which opioid has a metabolite that is CNS toxic? - CORRECT ANSWER-Meperidine.
metabolite (normeperidine) causes seizure. caution in patient with renal disease or the
elderly or when used repeatedly.
What is the precursor molecule for beta-endorphin? - CORRECT ANSWER-Pro-
ipiomelanocortin or POMC.
What is the precursor molecule for Enkephalins? - CORRECT ANSWER-Proenkaphalin
A
What is the precursor molecule for Dynorphins? - CORRECT ANSWER-Prodynorphin
On what body systems to narcotics act? - CORRECT ANSWER-1. CNS
2. GI system
What is the ultimate goal of multimodal therapy in the relief of pain? - CORRECT
ANSWER-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? -
CORRECT ANSWER-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
Which opioid is metabolized by non esterase dependent enzymes? - CORRECT
ANSWER-Remifentanil
This happens via hydrolysis of ester bonds in the blood plasma
What is the elimination half life of remifentanil? - CORRECT ANSWER-5-10 minutes
T or F. Remifentanil has anti shivering property? - CORRECT ANSWER-False.
Only Meperidine has anti shivering property.
Which stimuli requires the highest dose narcotics to achieve no response: skin incision,
skin closure, intubation? - CORRECT ANSWER-Intubation
T or F. Opiates have anti-emetic properties. - CORRECT ANSWER-True.
They inhibit vomiting center especially with repeated doses.
What receptors are responsible for the ventilatory depressing and analgesic effects of
opiods? - CORRECT ANSWER-Mu
T or F. Naloxone is an antagonist at ALL opioid receptors? - CORRECT ANSWER-
True.
A patient who's taking Monoamine oxidase inhibitor and has been given meperidine
may suffer from? - CORRECT ANSWER-SEIZURES
Serotoninergic crisis: clonus, agitation, hyperreflexia and hyperthermia
What is the most potent opioid? - CORRECT ANSWER-Sufentanil
500-1000 as potent as morphine sulfate
Rank these drugs from least potent to most potent-
Meperidine, Fentanil, Codeine, Alfentanil, Sufentanil, Morphine, Remifentanil? -
CORRECT ANSWER-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. - CORRECT
ANSWER-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? - CORRECT
ANSWER-False.
They have significant analgesic activity. Accumulation may occur with repetitive dosing
in renal patient.
What is the least potent opiate? - CORRECT ANSWER-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? - CORRECT ANSWER-False.
Supplemental drugs may be need to achieve amnesia/unconsciousness, relaxation and
sympathetic control.
Which class of opioids are best to give to asthmatics? - CORRECT ANSWER-
phenylpiperadines (i.e fentanil)
(no histamine release)
Which opioid has a metabolite that is CNS toxic? - CORRECT ANSWER-Meperidine.
metabolite (normeperidine) causes seizure. caution in patient with renal disease or the
elderly or when used repeatedly.
What is the precursor molecule for beta-endorphin? - CORRECT ANSWER-Pro-
ipiomelanocortin or POMC.
What is the precursor molecule for Enkephalins? - CORRECT ANSWER-Proenkaphalin
A
What is the precursor molecule for Dynorphins? - CORRECT ANSWER-Prodynorphin
On what body systems to narcotics act? - CORRECT ANSWER-1. CNS
2. GI system
What is the ultimate goal of multimodal therapy in the relief of pain? - CORRECT
ANSWER-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? -
CORRECT ANSWER-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
