Notes in 10 Analgesic Agents

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Published	12/13/2023	Opioid receptors are coupled to {{c1::G proteins}}.
Published	12/13/2023	Activation of {{c3::post}}ganglionic opioid receptors causes membrane {{c1::hyper}}polarization by stimulating inwardly rectifying {{c2…
Published	12/13/2023	Activation of opioid receptors inhibits the enzyme {{c2::adenylyl cyclase}}, which causes a reduction in intracellular {{c1::CAMP}}
Published	12/13/2023	Activation of {{c1::pre}}ganglionic opioid receptors inhibit {{c2::voltage-gated calcium}} channels, leading to an inhibition of excitatory neurotrans…
Published	12/13/2023	{{c3::Alfentanil::opioid}} has a rapid onset and short duration because of its {{c1::high}} nonionized fraction, {{c1::small}} volume of distribution,…
Published	12/13/2023	{{c1::Context-sensitive half-time}} - half-life increases as the {{c2::total dose}} or {{c2::duration}} of infusion increases
Published	12/13/2023	What opioid is preferred for patients with liver disease?{{c1::Remifentanil}}
Published	12/13/2023	Morphine undergoes conjugation with {{c1::glucuronic acid}} to form {{c2::morphine 3-glucuronide}} and {{c2::morphine 6-glucuronide}}.
Published	12/13/2023	Hydromorphone undergoes conjugation with {{c1::glucuronic acid}} to form {{c2::hydromorphone 3-glucuronide}}.
Published	12/13/2023	Meperidine undergoes metabolism via {{c1::N-demethylation}} to {{c2::normeperidine}}
Published	12/13/2023	Normeperidine is the {{c1::active::active or inactive}} metabolite of {{c3::meperidine}} that is associated with {{c2::seizure activity}} at large dos…
Published	12/13/2023	What opioids are preferred in renal failure?{{c1::Fentanyl and derivatives}}
Published	12/13/2023	Codeine is metabolized by CYP-{{c1::2D6}} into {{c2::morphine}}.
Published	12/13/2023	Opioids metabolized by CYP-2D6 are {{c1::codeine}}, {{c2::hydrocodone}}, and {{c3::oxycodone}}.
Published	12/13/2023	The ester structure of {{c3::remifentanil::opioid}} means it is metabolized via {{c1::hydrolysis}} from {{c2::nonspecific esterases}} in RBCs and tiss…
Published	12/13/2023	Is remifentanil context-sensitive?{{c1::No}}
Published	12/13/2023	Remifentanil has a distribution half-time of {{c1::3-4}} minutes regardless of the dose/duration of infusion.
Published	12/13/2023	Do pseudocholinesterase deficiencies affect remifentanil?{{c1::No.}}
Published	12/13/2023	Which of morphine's metabolites is more potent and lasts longer than morphine?{{c1::Morphine 6-glucuronide}}
Published	12/13/2023	Which opioid increases the heart rate?{{c1::Meperidine}}
Published	12/13/2023	Bolusing meperidine, hydromorphone, or morphine can cause decreased SVR through {{c1::histamine release}}.
Published	12/13/2023	Opioids cause respiratory depression that manifests primarily as decreased {{c1::respiratory rate}}.
Published	12/13/2023	What is the effect of opioids on the CO2 response curve?{{c1::Shift downwards and right}}
Published	12/13/2023	What do opioids do to the apneic threshold?{{c1::Increases }}
Published	12/13/2023	Rapid administration of large doses of fentanyl can cause {{c1::chest wall rigidity}}, which is mediated by central {{c2::μ}} receptors.
Published	12/13/2023	Chest wall rigidity after large doses of fentanyl is relieved with {{c1::neuromuscular blocking agents}}.
Published	12/13/2023	Opioids {{c1::decrease}} cerebral blood flow.
Published	12/13/2023	A common side effect of all opioids is {{c1::nausea}} and {{c1::vomiting}} due to its effects on the {{c2::chemoreceptor trigger zone}}…
Published	12/13/2023	Opioids cause {{c1::constipation}} via reduction of {{c2::peristalsis}}, which increases resorption of water in the large intestine.
Published	12/13/2023	A side effect of opioids is {{c2::biliary colic}}, which results from contraction of the {{c1::sphincter of Oddi}}.
Published	12/13/2023	Opioid-induced biliary spasm is reversed with {{c1::naloxone}} or {{c2::glucagon}}.
Published	12/13/2023	{{c3::Meperidine}} or {{c3::ephedrine}} should not be administered in patients taking {{c1::MAO inhibitors}} because of the risk of {{c2::serotonin sy…
Published	12/13/2023	The effects of {{c2::alfentanil::opioid}} may be prolonged when used alongside {{c1::erythromycin::antibiotic}}.
Published	12/13/2023	{{c2::Cyclooxygenase (COX)}} catalyzes the conversion of {{c1::arachidonic acid}} to {{c3::prostaglandins}}.
Published	12/13/2023	COX-{{c1::1}} receptors are present {{c2::all over the body}}.
Published	12/13/2023	COX-{{c2::2}} inhibition {{c1::increases}} the risk of {{c3::thrombotic}} events.
Published	12/13/2023	{{c2::Acetaminophen}} is not used as an anti-inflammatory drug because it inhibits COX in {{c1::the brain}} only.
Published	12/13/2023	{{c2::Acetaminophen}} toxicity can cause {{c3::hepatic failure}} because of the buildup of {{c1::NAPQI}}.
Published	12/13/2023	The most common side effect of COX-1 inhibitors is {{c1::GI upset}}.
Published	12/13/2023	NSAIDs should be avoided in patients with {{c1::reduced creatinine clearance}}.
Published	12/13/2023	Gabapentin and pregabalin bind to the {{c2::α-2 δ}} subunit of {{c1::voltage-gated Ca2+ channels}}.
Published	12/13/2023	The most common side effects of anticonvulsants (e.g. gabapentin) are {{c1::dizziness}} and {{c2::sedation}}.
Published	12/13/2023	Opioids are {{c1::indirect::direct/indirect}} myocardial depressants.
Published	12/13/2023	Opioids exert their effects on the body by acting on the four major {{c2::opioid}} receptors types:{{c1::μ}}, {{c1::κ}}, {{c1::δ}}, and {{c1::σ }…
Published	12/13/2023	Which opioids are associated with histamine release?{{c1::Meperidine}}, {{c1::hydromorphone}}, and {{c1::morphine}}
Published	12/13/2023	Demerol has {{c1::¼}} times the potency of morphine.
Published	12/13/2023	Hydromorphone has {{c1::10}} times the potency of morphine.
Published	12/13/2023	Alfentanil has {{c1::25}} times the potency of morphine.
Published	12/13/2023	Fentanyl and remifentanil have {{c1::100}} times the potency of morphine.
Published	12/13/2023	Sufentanil has {{c1::1000}} times the potency of morphine.
Published	12/13/2023	{{c4::Intrathecal}} opioids are more likely to cause {{c1::pruritis::side effect}} that is mediated by {{c2::5-HT3}} and {{c3::μ opioid}} receptors in…
Published	12/13/2023	Pruritis from intrathecal opioids can be treated with {{c1::ondansetron/zofran}} or {{c2::naloxone}}.
Published	12/13/2023	Intrathecal opioids can cause {{c2::urinary retention}} by {{c1::bladder detrusor::muscle}} relaxation and {{c3::urinary sphincter}} contraction.&nbsp…
Published	12/13/2023	The precursor molecule of Leu-enkephalin and Met-enkephalin is {{c1::proenkephalin A}}.
Published	12/13/2023	The precursor molecule of β-endorphin is {{c1::pro-opiomelanocortin}}.
Published	12/13/2023	The precursor molecule of Dynorphin and α-Neoendorphin is {{c1::prodynorphin}}.
Published	12/13/2023	What endogenous opioid peptides work primarily on μ and δ opioid receptors (MOP and DOP)?{{c1::Enkephalinsβ-Endorphins}}
Published	12/13/2023	What endogenous opioid peptides work primarily on κ opioid receptors (KOP)?{{c1::Dynorphins}}
Published	12/13/2023	What chemical class does the synthetic opioid derivative meperidine belong to?{{c1::Anilinopiperidine}}
Published	12/13/2023	In general, opioids will {{c1::decrease}} the blood pressure.
Published	12/13/2023	The {{c1::area postrema}} (chemoreceptor trigger zone) is located adjacent to the nucleus tractus solitarius in the {{c2…
Published	12/13/2023	The {{c1::nucleus tractus solitarius}}, also known as the vomiting center (located in the {{c3::medulla}}) receives main inputs fr…
Published	12/13/2023	Opioid-induced biliary spasm appears as a {{c1::common bile duct stone}} on cholangiography.
Published	12/13/2023	Opioid-induced pruritis is seen on the {{c1::central (head, neck, torso)}} parts of the body.
Published	12/13/2023	What opioid agonist-antagonists are used to treat opioid-induced pruritis?{{c2::Nalbuphine}} and {{c1::butorphanol}}
Published	12/13/2023	What opioid receptor produces antishivering effects?{{c1::κ}}
Published	12/13/2023	Opioids produce {{c1::miosis}} by inhibiting GABA interneurons at the {{c2::Edinger-Westphal}} nucleus.
Published	12/13/2023	Opioid-induced hypoventilation can {{c1::increase}} the intracranial pressure (ICP).
Published	12/13/2023	Opioids inhibit {{c1::natural killer}} cell function, which may increase the incidence of {{c2::cancer}}.
Published	12/13/2023	{{c1::Hydro}}philic opioids produce a larger spread for neuraxial blockade.
Published	12/13/2023	The advantage of using opioids for neuraxial anesthesia (as opposed to local anesthetics) is that it does not produce {{c1::motor blockade}} or {{c2::…
Published	12/13/2023	Which route of opioid administration require higher doses - epidural or intrathecal ?{{c1::Epidural}}
Published	12/13/2023	Meperidine is structurally similar to {{c1::atropine}}.
Published	12/13/2023	At physiologic pH, alfentanil is highly (90%) {{c1::nonionized::ionized/nonionized}}.
Published	12/13/2023	Alfentanil is metabolized via CYP-{{c1::3A4}}.
Published	12/13/2023	Remifentanil cannot be given {{c1::intrathecally}} because the {{c2::glycine}} buffer may cause neurotoxicity.
Published	12/13/2023	What opioid receptors does meperidine act on?{{c1::μ and κ }}
Published	12/13/2023	The symptoms of {{c4::serotonin}} syndrome can be remembered with the "3 A's":   1. {{c1::neuromuscular hyperActivity (clonus, hyp…
Published	12/13/2023	Buprenorphine has a duration of {{c1::8}} hours.
Published	12/13/2023	Buprenorphine is a partial agonist with agonist activity at {{c1::μ}} opioid receptors.
Published	12/13/2023	Buprenorphine is a partial agonist with antagonist activity at {{c1::κ}} opioid receptors.
Published	12/13/2023	Which partial opioid agonist/agonist-antagonist cannot be reversed by naloxone?{{c1::Buprenorphine}}
Published	12/13/2023	Naloxone has the highest affinity for {{c1::μ}} opioid receptors.
Published	12/13/2023	Naloxone has an onset of {{c1::1}} minute(s) and a duration of {{c2::30}} to {{c2::60}} minutes.
Published	12/13/2023	Naloxone is associated with two rare side effects ( {{c1::pulmonary edema}} and {{c2::sudden death}} ) due to SNS stimulation.
Published	12/13/2023	Naltrexone has a duration of action of 24 hours due to its {{c1::6-β}} metabolite.
Published	12/13/2023	COX-{{c1::2}} receptors are produced in response to inflammation.
Published	12/13/2023	Celecoxib is a part of the {{c1::coxib}} family of NSAIDs.
Published	12/13/2023	In general, NSAIDs have a protein binding of approximately {{c1::90}}%.
Published	12/13/2023	NSAIDs may be avoided during orthopedic surgeries because it may reduce {{c1::bone healing}}.
Published	12/13/2023	Ketorolac should not be administered for greater than {{c1::5}} days.
Published	12/13/2023	Gabapentin and pregabalin are both structural analogs of {{c1::GABA}}.
Published	12/13/2023	Which α2 agonist can be administered via neuraxial and intra-articulate routes?{{c1::Clonidine}}
Published	12/13/2023	What receptors are antagonized by nalbuphine and butorphanol?{{c1::μ opioid receptors}}
Published	12/13/2023	What receptors are agonized by nalbuphine and butorphanol?{{c1::κ opioid receptors}}
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