Pharmacy - Opioid Analgesics And Antagonists

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Pharmacy - Opioid Analgesics And Antagonists

An analgesic is a medicine that relieves pain and an antagonistic drug is one that blocks a biological response by blocking a receptor. Morphine is used as an analgesic and antagonist in most hospitals for patients with pain prior to general surgery. Take up the quiz to test your understanding on Opioid analgesics and antagonists.


Questions and Answers
  • 1. 
    Directions 1- 6 For each numbered item select the one lettered option which is most closely associated with it (each lettered option can be selected once, more than once, or not at all). This drugs is partial agonist at mu receptors and antagonist at kappa receptors
    • A. 

      Buprenorphine

    • B. 

      Codeine

    • C. 

      Fentanyl

    • D. 

      Heroin

    • E. 

      Loperamide

    • F. 

      Methadone

    • G. 

      Morphine

    • H. 

      Naloxone

    • I. 

      Pentazocine

    • J. 

      Propoxyphene

    • K. 

      Tramadol

  • 2. 
    Directions 1- 6 For each numbered item select the one lettered option which is most closely associated with it (each lettered option can be selected once, more than once, or not at all). This drug is the full opioid agonist with the highest oral bioavailability
    • A. 

      Buprenorphine

    • B. 

      Codeine

    • C. 

      Fentanyl

    • D. 

      Heroin

    • E. 

      Loperamide

    • F. 

      Methadone

    • G. 

      Morphine

    • H. 

      Naloxone

    • I. 

      Pentazocine

    • J. 

      Propoxyphene

    • K. 

      Tramadol

  • 3. 
    Directions 1- 6 For each numbered item select the one lettered option which is most closely associated with it (each lettered option can be selected once, more than once, or not at all). This drug has very week opioid activity and is used in the treatment of diarrhea
    • A. 

      Buprenorphine

    • B. 

      Codeine

    • C. 

      Fentanyl

    • D. 

      Heroin

    • E. 

      Loperamide

    • F. 

      Methadone

    • G. 

      Morphine

    • H. 

      Naloxone

    • I. 

      Pentazocine

    • J. 

      Propoxyphene

    • K. 

      Tramadol

  • 4. 
    Directions 1- 6 For each numbered item select the one lettered option which is most closely associated with it (each lettered option can be selected once, more than once, or not at all). This drug is partial agonist at mu receptors and full agonist at kappa receptors
    • A. 

      Buprenorphine

    • B. 

      Codeine

    • C. 

      Fentanyl

    • D. 

      Heroin

    • E. 

      Loperamide

    • F. 

      Methadone

    • G. 

      Morphine

    • H. 

      Naloxone

    • I. 

      Pentazocine

    • J. 

      Propoxyphene

    • K. 

      Tramadol

  • 5. 
    Directions 1- 6 For each numbered item select the one lettered option which is most closely associated with it (each lettered option can be selected once, more than once, or not at all). This drug has a high affinity but no intrinsic activity at opioid receptors
    • A. 

      Buprenorphine

    • B. 

      Codeine

    • C. 

      Fentanyl

    • D. 

      Heroin

    • E. 

      Loperamide

    • F. 

      Methadone

    • G. 

      Morphine

    • H. 

      Naloxone

    • I. 

      Pentazocine

    • J. 

      Propoxyphene

    • K. 

      Tramadol

  • 6. 
    Directions 1- 6 For each numbered item select the one lettered option which is most closely associated with it (each lettered option can be selected once, more than once, or not at all). A metabolite of this drug has neuroexcitatory properties and another is still active as analgesic
    • A. 

      Buprenorphine

    • B. 

      Codeine

    • C. 

      Fentanyl

    • D. 

      Heroin

    • E. 

      Loperamide

    • F. 

      Methadone

    • G. 

      Morphine

    • H. 

      Naloxone

    • I. 

      Pentazocine

    • J. 

      Propoxyphene

    • K. 

      Tramadol

  • 7. 
    A 22-year old woman was in labor for 12 hours and was experiencing strong and very painful contractions. An epidural dose of morphine was ordered for analgesia. Which of the following neuronal areas was most likely the main site of the analgesic action of morphine in this setting?
    • A. 

      Locus Ceruleus

    • B. 

      Substantia gelatinosa

    • C. 

      Periaqueductal gray

    • D. 

      Nucleus accumbens

    • E. 

      Substantia nigra

    • F. 

      Rostral ventrolateral medulla

  • 8. 
    A 58-year-old woman with metastasized breast cancer received IM injection of morphine for pain but she vomited after each dose. Which of the following brain areas is most likely the main site of this action of morphine?
    • A. 

      Locus Ceruleus

    • B. 

      Area postrema

    • C. 

      Median hypothalamic eminence

    • D. 

      Nucleus accumbens

    • E. 

      Putamen

    • F. 

      Rostral ventrolateral medulla

  • 9. 
    A 61-year-old woman complained of severe pain few hours after an operation to remove a renal cancer. An IM injection of morphine was made. Which of the following actions most likely contributed to the analgesic effect of morphine?
    • A. 

      Activation of brain stem neurons that modulate the pain transmission

    • B. 

      Stimulation of substance P release from nerve terminals in the spinal cord

    • C. 

      Induction of dissociative feeling and dysphoria

    • D. 

      Inhibition of adrenergic pathways from locus ceruleus

    • E. 

      Inhibition of serotonergic pathways from raphe nuclei

  • 10. 
    A 55-year-old man complained of severe pain after surgery to remove a colon cancer. The physician ordered a drug that is a partial mu opioid agonist, more potent than morphine and whose effects are not readily antagonized by naloxone. Which of the following drugs was most likely administered?
    • A. 

      Methadone

    • B. 

      Meperidine

    • C. 

      Codeine

    • D. 

      Buprenorphine

    • E. 

      Fentanyl

    • F. 

      Loperamide

  • 11. 
    A 34-year-old woman was admitted to the emergency room because of multiple fractures due to a car accident. The patient complained of severe pain and an IM injection of morphine was made. Which of the following molecular actions most likely mediated the analgesic effect of the drug in this patient?
    • A. 

      Opening of Ca++ channels on presynaptic nerve terminals

    • B. 

      Closing of chloride channels on postsynaptic neurons

    • C. 

      Stimulation of substance P release from nociceptive nerve terminals

    • D. 

      Opening of K+ channels on postsynaptic neurons

    • E. 

      Closing of Na+channels on presynaptic nerve terminals

    • F. 

      Stimulation of glutamate release from nociceptive nerve terminals

  • 12. 
    A 52-year-old man admitted to the emergency room with a myocardial infarction still complained of severe pain after an IV injection of nitroglycerin. An IM administration of morphine was made. Which of the following molecular actions most likely mediated the analgesic effect of the drug?
    • A. 

      Stimulation of release of endogenous opioid peptides

    • B. 

      Activation of mu-receptors

    • C. 

      Blockade of kappa-receptors

    • D. 

      Stimulation of substance P release from nerve terminals

    • E. 

      Activation of glutamate receptors

    • F. 

      Blockade of beta receptors

  • 13. 
    A 68-year-old patient suffering from metastasized neck cancer, had a characteristic pin point pupil because of the continuous SC infusion of morphine from an implanted pump. The activation of which of the following brain areas most likely mediated this drug effect?
    • A. 

      Locus ceruleus

    • B. 

      Nucleus ambiguus

    • C. 

      Edinger-Westphal nucleus

    • D. 

      Area postrema

    • E. 

      Nucleus accumbens

    • F. 

      Hippocampus

  • 14. 
    A 55-year-old woman suffering from terminal cancer started a spinal morphine infusion from an implanted subcutaneous pump. Which of the following was the most likely consequence of the activation of postsynaptic opioid mu receptors on the pain transmission neurons in the spinal cord?
    • A. 

      An increased firing of those neurons

    • B. 

      The production of an EPSP

    • C. 

      A decrease in membrane k+ conductance

    • D. 

      An increase in membrane Na+ conductance

    • E. 

      The production of an IPSP

  • 15. 
    A 51-year-old woman visited her physician office because of a strong abdominal pain of one hour duration. Physical examination showed a red-headed, pale-skinned woman in obvious distress, with severe pain and tenderness on right flank. A presumptive diagnosis of renal colic was made and the patient was given an IM injection of an opioid drug which is a partial agonist at mu receptors and a full agonist at kappa receptors. Which of the following drug was most likely administered?
    • A. 

      Pentazocine

    • B. 

      Buprenorphine

    • C. 

      Codeine

    • D. 

      Methadone

    • E. 

      Fentanyl

  • 16. 
    A 56-year-old woman suffering from osteoarthritis complained to her physician that the joint pain in her legs and shoulders was increased and the tablets of acetaminophen she was using didn’t function any more. She was fearful every morning of the incoming pain and asked for an effective analgesic drug. The physician decided to order an analgesic that can also lowers the anxiety, fear and suffering evoked by pain. Which of the following drugs was most likely prescribed?
    • A. 

      Indomethacin

    • B. 

      Ketorolac

    • C. 

      Sertraline

    • D. 

      Diazepam

    • E. 

      Venlafaxine

    • F. 

      Methadone

  • 17. 
    A 64-year-old man suffering from advanced heart failure was admitted to the emergency room because of extreme dyspnea of one hour duration. After physical examination a diagnosis of impending pulmonary edema was made and an appropriate therapy was ordered which included the IM injection of morphine. Which of the following cardiovascular actions most likely contributed to the therapeutic effect of the drug in the patient’s disorder?
    • A. 

      Increased systolic pressure

    • B. 

      Constriction of renal vascular bed

    • C. 

      Increased heart rate

    • D. 

      Peripheral venous dilation

    • E. 

      Increased left ventricular end-diastolic pressure

  • 18. 
    A 67-year-old woman complained to her physician of obstinate constipation. The woman, who had been suffering bone pain from metastatic breast cancer, started a therapy with morphine two weeks previously. Which of the following actions most likely mediated the adverse effect the patient was suffering from?
    • A. 

      Decreased anal sphincter tone

    • B. 

      Increased colonic tone

    • C. 

      Increased intestinal peristalsis

    • D. 

      Increased reflex response to rectal distension

    • E. 

      Increased softening of feces

  • 19. 
    A 39-year-old woman admitted to the hospital with stage IV ovarian cancer metastatic to the pelvis, complained of a gripping and burning abdominal pain. A treatment with sustained release morphine was started. Which of the following effects upon the patient’s respiratory system could be expected after few days of therapy?
    • A. 

      Stimulation of the cough reflex

    • B. 

      Bronchodilation

    • C. 

      Increased vital capacity

    • D. 

      Decreased tidal volume

    • E. 

      Increased rate of breathing

  • 20. 
    A 52-year-old man was in his physician office for a control visit. The man, suffering from metastasized stomach cancer, had started a therapy with morphine three weeks ago. Which of the following morphine effects was most likely unchanged in that patient after three weeks of therapy?
    • A. 

      Respiratory depression

    • B. 

      Miosis

    • C. 

      Analgesia

    • D. 

      Sedation

    • E. 

      Euphoria

    • F. 

      Nausea and vomiting