1. Pharmacology ii Tutoring
Brandy Hollums

2. Narcotics analgesics

3. Which of the following patients is not experiencing nociception pain?
A. 20 yo pregnant AAF with GSW to the head
B. 45 yo WM avid hiker with hypothermia
C. 36 yo AAF with spinal nerve damage
D. 21 yo WM on workman’s comp from an acid burn
C. Neuropathic pain

4. Which of the following patients would not benefit from narcotics?
A. 20 yo pregnant AAF with GSW to the head
B. 45 yo WM avid hiker with hypothermia
C. 36 yo AAF with spinal nerve damage
D. 21 yo WM on workman’s comp from an acid burn
C. Neuropathic pain

5. Which of the following is the emotional component of pain?
A. Nociception
B. Neuropathic
C. Affective C.

6. True or false 1. Chronic pain is an excessive, noxious feeling
2. An example of acute pain is a burn from a hot pan
3. An example of acute pain is “phantom limb”
4. Allodynia is synonymous with tolerance
False-acute pain
True
False-chronic pain-pain that outlast the precipitating injury
False-allodynia is the opposite of tolerance-receptors MORE sensitized

7. Which of the following is not involved In the immediate response to pain?
A. Effector organ, i.e. muscle
B. Brain
C. Sensory neuron
D. Integrator neuron B,

8. Which of the following describes C neurons?
A. Unmyelinated and responds to dull, burning pain
B. Myelinated and responds to dull, burning pain
C. Unmyelinated and responds to sharp, localized pain
D. Myelinated and responds to sharp, localized pain A.

9. Which of the following describes a-delta neurons?
A. Unmyelinated and responds to dull, burning pain
B. Myelinated and responds to dull, burning pain
C. Unmyelinated and responds to sharp, localized pain
D. Myelinated and responds to sharp, localized pain D.

10. Which of the following describes where opiates act to cause analgesia?
A. Brain stem
B. Spinal cord
C. Thalamus
D. Limbic system B.

11. Which of the following is not a useful opioid use?
A. Anesthesia
B. Pulmonary edema
C. Diarrhea
D. Recreational D.

12. Where do opioids primarily act?
A. Kappa
B. Delta
C. N/O FQ
D. Mu D.

13. Which of the following is not true of inhibitory g-protein coupled receptors?
A. Inhibit adenylyl cyclase
B. Inhibit calcium channels
C. Open K channels (hyperpolarize)
D. Close K channels D,

14. Which opioid site of action is responsible for the addiction component of opioids?
A. Spinal Cord
B. Brain Stem
C. Limbic System
D. Periaqueductal gray C.

15. Which neurotransmitter is responsible for opioid euphoria/high?
A. Serotonin
B. Dopamine
C. Norepinephrine
D. Epinephrine B.

16. Which of the following projects from the spinal cord and leads to inhibition by the action of opioids?
A. Cingulate cortex
B. Substantia gelatinosa
C. Periaqueductal gray
D. Substantia gelatinosa C.

17. In which situation would morphine be Best used?
A. Neuropathic Pain
B. Acute Pain
C. Chronic Pain C.

18. Which of the following is not a neuroendocrine effect of morphine?
A. Increased prolactin release
B. Decreased testosterone
C. Increased cortisol
D. Inhibits GnRH C.

19. Which of the following receptors Is most involved in the euphoric response from morphine?
A. Mu
B. Delta
C. Kappa
D. N/OFQ A.

20. Which receptor is not currently targeted because there no agonists available to cross BBB?
A. Mu
B. Delta
C. Kappa
D. N/OFQ B

21. What is the triad of symptoms associated with acute opioid toxicity?
A. Coma
B. Low respiration
C. Cold clammy skin
D. Pupils symmetrical and pinpoint C.

22. Which of the following is usually only seen with high doses of morphine?
A. pupillary constriction
B. seizures and convulsions
C. constipation
D. nausea and emesis

23. Which is a symptom of addiction?
A. Irritability
B. Sweating
C. Craving
D. Insomnia
C. Psychological and physical are two different things!

24. Which of the following is a mechanism for acute tolerance?
A. receptor internalization
B. receptor aleration
C. receptor down-regulation
D. receptor phosphorylation D.

25. What is not true of opioid antagonist for acute opioid toxicity?
A. May precipitate withdrawals
B. Duration of action is shorter than opiate
C. Always prevents relapse with one dose
D. May be administered IV C.

26. Which active metabolite of morphine is more potent that morphine itself?
A. Morphine 6-glucuronide
B. Morphine 3-glucuronide A.

27. Which of the following can be administered with morphine to reduce sedative effects?
A. NSAIDS
B. Laxatives
C. Acetaminophen
D. Amphetamine D.

28. True or false? 1. PCA increases the risk of addiction
2. Headache is a normal therapeutic use of morphine
3. Morphine allows for improved breathing in dyspneic patients
F, F, T

29. Which of the following enhances depressant effects of morphine?
A. phenothiazines
B. MAOI
C. Tricyclic antidepressants
D. amphetamines
A, B, and C

30. Which is not a concern with morphine use?
A. Dyspnea
B. Asthma
C. Hepatic disease
D. Head Injury A.