Pharmacology Chapter 19

Identify an accurate statement about nociceptors.

A. Nociceptors are the most active in the absence of a pain stimulus.

B. Nociceptors are blocked by peripheral neurotransmitters like prostaglandins, histamine, and serotonin.

C. Nociceptors are located in every part of the body except for the bones.

D. Nociceptors respond to tissue injury and painful stimuli.

D. Nociceptors respond to tissue injury and painful stimuli.

Pain is consciously experienced as sharp if the originating pain signal is transmitted through the _____ of the ascending pathway.

A. A-delta fibers B. A-alpha fibers

C. C fibers D. B fibers

A. A-delta fibers

Pain resulting from abnormal signals or nerves damaged by entrapment, amputation, or diabetes is known as _____.

A. hyperalgesia B. dysphoria

C. referred pain D. neuropathic pain

D. neuropathic pain

A peripheral neurotransmitter responsible for transmitting information about tissue injuries at peripheral receptors to the central nervous system (CNS) is:

A. gamma-aminobutyric acid. B. dopamine.

C. Substance P. D. serotonin.

C. Substance P

The inadequate control of pain can lead to:

A. insomnia.

B. mania.

C. a decrease in heart rate.

D. a decrease in blood pressure.

A. insomnia.

Which of the following opioids is used as an active agent in antidiarrheal medications?

A. Fentanyl B. Alfentanil

C. Codeine D. Loperamide

D. Loperamide

A reason for administering an opioid analgesic instead of a nonsteroidal anti-inflammatory drug (NSAID) for dental pain would be to:

A. reduce the risk of drug tolerance.

B. reduce the risk of drug dependency.

C. reduce the risk of bleeding.

D. reduce the risk of toxicity.

C. reduce the risk of bleeding.

Identify an accurate statement about opioid analgesics.

A. The majority of the opioid analgesics are used to induce preoperative sedation.

B. Opioid analgesics can only relieve mild to moderate pain.

C. It is held that opioid analgesics can relieve virtually any type of pain.

D. The use of opioids for postoperative pain can increase the risk of bleeding.

C. It is held that opioid analgesics can relieve virtually any type of pain.

The opioids used to suppress coughing include all of the following except:

A. loperamide.

B. codeine.

C. hydrocodone.

D. dextromethorphan.

A. loperamide.

Alex has developed a severe cough. He visits Dr. Harrison's clinic for a checkup. After a thorough examination, Dr. Harrison instructs him to take a certain opioid drug for its good antitussive activity. Which of the following drugs has Dr. Harrison most likely prescribed?

A. Loperamide

B. Codeine

C. Alfentanil

D. Heroin

B. Codeine

Two naturally occurring opiates derived from the poppy plant are:

A. morphine and heroin.

B. morphine and codeine.

C. codeine and heroin.

D. codeine and marijuana.

B. morphine and codeine.

Nonopioid analgesics include all of the following except:

A. meperidine.

B. nonsteroidal anti-inflammatory drugs (NSAIDs).

C. acetaminophen.

D. COX-2 inhibitors.

A. meperidine.

Which of the following drugs is not made from the natural opiates but is a synthetic chemical that behaves like the opiates?

A. Hydrocodone B. Hydromorphone

C. Oxycodone D. Fentanyl

D. Fentanyl

_____ is the prototype or standard opioid analgesic.

A. Codeine B. Morphine

C. Hydrocodone D. Loperamide

B. Morphine

Which of the following changes takes place when opioids bind to their mu receptors?

A. Calcium ion channels on presynaptic neurons close.

B. The release of glutamate increases.

C. Postsynaptic mu receptor binding closes potassium ion channels.

D. Calcium ions flow into the cells.

A. Calcium ion channels on presynaptic neurons close.

Which of the following classes of opioid receptors in the central nervous system (CNS) is responsible for respiratory depression?

A. Kappa receptors B. Mu1 receptors

C. Mu2 receptors D. Delta receptors

C. Mu2 receptors

Which of the following is true of Mu1 receptors?

A. Mu1 receptors are located inside the spinal cord.

B. Mu1 receptors are responsible for respiratory depression, analgesia, euphoria, and physical dependence.

C. Mu1 receptors primarily interact with enkephalin.

D. Mu1 receptors interpret pain.

D. Mu1 receptors interpret pain.

Enkephalins are endogenous peptides that are produced throughout the central nervous system (CNS) and peripheral nerve endings and have a preference for _____.

A. kappa receptors B. delta receptors

C. mu1 receptors D. mu2 receptors

B. delta receptors

Identify an accurate statement about opioid analgesics.

A. Opioid analgesics impair the function of peripheral nerves.

B. Opioid analgesics selectively act within the central nervous system (CNS) to reduce the reaction to pain.

C. Opioid analgesics trigger the release of neurotransmitters such as Substance P.

D. Opioid analgesics that are of significant therapeutic importance are known to interact with delta

B. Opioid analgesics selectively act within the central nervous system (CNS) to reduce the reaction to pain.

Pablo is prescribed an opioid analgesic for severe postoperative pain. He takes the drug for a few days but stops when he starts vomiting and feeling nauseous. He informs his doctor of these side effects and asks her for a way to suppress them. Pablo also tells her that these symptoms increase while standing or moving. Doing which of the following can potentially help reduce these symptoms?

A. Taking a lower dosage of the drug

B. Discontinuing the drug and bearing with the pain till it subsides

C. Taking a higher dosage of the drug

D. Taking a blood test

C. Taking a higher dosage of the drug

Aaron is prescribed an opioid analgesic after a surgery. What effect is this drug most likely to have on his body?

A. It will decrease his smooth muscle tone.

B. It will make him lose consciousness.

C. It will decrease his mental alertness.

D. It will make him urinate more frequently.

C. It will decrease his mental alertness.

Patients with _____ should be careful when using opioid analgesics because of the effect histamine may have on the bronchioles of the lungs.

A. congestive heart failure B. asthma

C. hypertension D. diabetes

B. asthma

At therapeutic doses, opioid analgesics:

A. do not decrease mental alertness.

B. produce pinpoint pupils.

C. cause hyperactivity.

D. do not cause a loss of consciousness.

D. do not cause a loss of consciousness.

Who among the following should be the most cautious when using an opioid drug?

A. Carrie, who has asthma

B. Harry, who has a cough

C. David, who has diarrhea

D. Julia, who has chronic pain

A. Carrie, who has asthma

Constipation is a side effect of opioid use caused by the:

A. spasmogenic activity of opioids on smooth muscle and mu2 receptors in the gastrointestinal (GI) tract.

B.spasmolytic activity on smooth muscle and mu2 receptors in the GI tract.

C. spasmogenic activity on smooth muscle and mu1 receptors in the GI tract.

D. spasmolytic activity on smooth muscle and mu1 receptors in the GI tract.

A. spasmogenic activity of opioids on smooth muscle and mu2 receptors in the gastrointestinal (GI) tract.

A common sign of opioid toxicity is _____.

A. mydriasis B. pinpoint pupils

C. dry eyes D. red eyes

B. pinpoint pupils

Oral formulations of opioid drugs should never be chewed because:

A. chewing could achieve a higher blood level than expected with an increase in side effects.

B. chewing could achieve a lower blood level than expected with a decrease in desired effects.

C. chewing could decrease the absorption of the drug.

D. chewing could result in adverse food-drug interactions.

A. chewing could achieve a higher blood level than expected with an increase in side effects.

When using opioid analgesics, what can a patient do to prevent recurring pain that may be enhanced by psychological factors associated with the anticipation of discomfort?

A. Change medications to avoid tolerance

B. Change medications to avoid physical dependence

C. Adhere to the prescribed schedule

D. Adhere to the stair-step approach to pain management

C. Adhere to the prescribed schedule

Which of the following statements is true of opioid drug administration and disposition?

A. Opioids are not administered on a repeated schedule.

B. Opioids are available for oral and parenteral administration.

C. Oral preparations of opioids are primarily used for surgery and postsurgical recovery.

D. Oral preparations of opioids should be chewed, never swallowed.

B. Opioids are available for oral and parenteral administration.

In the context of opioids, identify an advantage of parenteral administration over oral administration.

A. Lower bioavailability of injected medications

B. Increased metabolism from hepatic drug microsomal metabolizing system

C. Poor absorption in the acidic environment of the stomach

D. Poor absorption in the alkaline environment of the intestines

C. Poor absorption in the acidic environment of the stomach

Identify an adverse effect associated with the use of analgesics.

A. Diarrhea B. Tachycardia

C. Constipation D. Polyuria

C. Constipation

Opioid antagonists should not be given to an opioid addict because:

A. they could promote a fatal asthmatic attack.

B. he or she will resume drug-seeking behavior much faster.

C. they would render the antidote ineffective.

D. withdrawal symptoms will occur.

D. withdrawal symptoms will occur.

Identify a true statement about opioid antitussives.

A. Opioid antitussives are considered to be more potent analgesics than morphine.

B. Opioid antitussives possess a higher addiction liability than morphine.

C. Opioid antitussives have a direct inhibiting effect on the coughing center in the medulla.

D. Opioid antitussives are used to treat the underlying cause of the irritation associated with a cough.

C. Opioid antitussives have a direct inhibiting effect on the coughing center in the medulla.

A drug that suppresses coughing is known as an _____.

A. analgesic B. antitussive

C. antidiuretic D. anesthetic

B. antitussive

_____ is a synthetic antitussive drug and is the only opioid that is not a scheduled drug.

A. Codeine B. Dextromethorphan

C. Hydrocodone D. Oxycodone

B. Dextromethorphan