Science Quiz / Gayer Anesthetics & Opioids

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Can you name the Gayer Anesthetics & Opioids ?

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Refers to the detection of noxious stimuli or stimuli that are capable of damaging tissue.
A syndrome of sustained burning pain (allodynia and hyperpathia) after traumatic nerve lesion.
Pain syndrome characterized by abnormal reaction to stimulus.
Pain initiated or caused by a primary lesion, dysfunction, or transitory perturbation in either peripheral or central nervous system
Greek word for juice--crude substance made from resin of opium poppy. Contains 20 distinct alkaloids.
Drugs derived from opium, morphine, codeine, and semisynthetic congeners
Greek for stupor, term that is currently associated with mainly strong opiate analgesics
Name an Endogenous Opioid Peptide
Endogenous Opioids are found in brain and spinal column (efferent pain modulation and afferent perception), adrenal medulla and neural plexuses of the _______
Endogenous Opioids come from larger ______ proteins such as POMC, proenkephalin-A and proenkephalin-B
Name an opioid mechanism to reduce nociception.
Pain inhibitory efferents that originated from the PAG synapse onto _______ neurons. These neurons are inhibitory neurons and when activated decrease the afferent nerve transmissio
Most clinically useful opioids interact with this receptor because of its role on both pre-synaptic and post-synaptic neurons
Floating sensation, no anxiety or distress
Useful in pathological cough, patients with endotracheal tube, secretions may develop and cause atelectasis. Tolerance develops.
Opioids can cause ______ release resulting into pruritus such as flushing, warm skin, sweating, itching.
Opioids can _____ urinary retention in postoperative patients and may aggravate ureteral colic due to renal calculus.
MPTP is converted in dopaminergic neurons by MAO into a toxic free radical that destroys dopaminergic neurons. This reaction was discovered after several young adults developed ___
Morphines are ______ in the liver during first pass.
Phenylpiperidines (fentanyl, meperidine) are extensively oxidized (CYP3A4) in the _______ and gut (fentanyl), little excretion of parent mol.
Alternative route of administration for opioids.
Name a mechanism for tolerance for morphine.
_______ syndrome: “exaggerated rebound from acute pharmacological effects” Resemble increased activity of the autonomic nervous system
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Mixed agonists-antagonists administration with pure agonists treatment: may diminish analgesia, or induce _______
An agent that relieves pain without causing loss of consciousness
Spinal mechanism inhibits _____ stimulation to the brain. It is the basis for spinal analgesia.
Supraspinal mechanism stimulate 'pain-inhibitory' neuronal ______
__ fibers are slow, unmyelinated, fibers that produce slower onset dull throbbing pain (
Afferent input to brain is reduced by inhibitory (opioid) _________
Efferent output can reduce ______ inputs
____ opioid receptor activation hyperpolarizes postsynaptic neurons reducing probability of firing.
All three receptor types are located on ________sensory neurons and mu is located on the post synaptic afferent neuron.
Activation of post-synaptic mu receptors leads to the opening of potassium channels (same as with M2 receptors in the heart). The outflow of potassium results in _______
Increases in intracellular calcium triggers synaptic vesicle docking and fusion with the membrane and ___ release.
Electrically stimulating the periaqueductal gray area or injecting morphine into it can lead to a decrease in ______ signal
The ____ opioid receptor is responsible for loss of respiratory drive. One advantage of kappa agonists is they are associated with less respiratory depression and addiction.
Activation of ______ is associated with vomiting and dysphoria
The _____ opioid receptor is associated with addiction and not the Kappa.
_______ is an expected consequence of opioid neurotransmission based on the general inhibitory tone activation of this pathway produces in the brain.
Diagnostic sign of opioid overdose.
______ rigidity: relieved by opioid antagonists and prevent by neuromuscular blockade.
Name a mixed agonist and antagonist of opioid receptors.
Morphine-6-glucuronide is more potent than the parent molecule; accumulates in _____ failure; prolongs and enhances analgesia, poor CNS penetration
I.V. morphine relieves dyspnea due to ____ ventricular failure
Not all opioid effects are susceptible to ______. Starts with first dose, manifest after 2-3 weeks of use, mostly with frequent large doses Ketamine can block tolerance development
Name an acute symptom of physiologic dependence.
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Opioids have drug interactions with what other drugs?
_____ agonist have less abuse potential. Use in patient were your worried about respiratory depression
Name a pure opioid antagonist. high affinity for mu receptors. lower affinity for kappa and delta, still they can reverse actions there, too.
Opioid antagonist that is well absorbed orally, but strong first-pass effect. Duration up to 48 h.
Newest opioid antagonist, available for I.V. only. Duration longer than naloxone.
Opiod antagonist that has poor oral efficacy. Glucuronidation. Duration: 1-2 h when given I.V.
The rise in intracellular calcium is the trigger for synaptic vesicle docking and _____. This type of sensory neurons release classic neurotransmitters, like glutamate, in small ve
Local anesthetics are tertiary amines so the pH can determine the ____ state
Local anesthetics are all weak _____. Both ionized and neutral states are required for activity.
Local anesthetics block the inside of ______ channels. To do this they must pass through the membrane in their uncharged state.
Using______ to constrict blood vessels decreases systemic absorption and increases the concentration available for nerve block. In addition, it can activate alpha-2 presynaptic rec
Esters are rapidly hydrolyzed by a ______ in blood
_______ are hydrolyzed (slower) by cyt. P450 in liver
Small ___ pain fibers have high firing frequency rates (more open sodium channels) as compared to large A motor neurons (less open channels) and is the reason why epidural anesthes
Myelinated neurons are more _______ to blockade as compared ot unmyelinated
Large doses of prilocaine yield o-toluidine, which oxidizes hemoglobin to methemoglobin. Treat with I.V. _____ blue or vit. C.
_____ Anesthesia: SC injection in location that anesthetize the region distal to injection with consideration for neuroanatomy E.g. blocks for hand and arm surgery
______ Anesthesia: Injection in the vicinity of peripheral nerve endings, major nerve trunks, and at the spinal cord. Used to induce complete, temporary local anesthesia. Drugs with low pKa work faster (more in hydrophobic state)
_____ nerve block: injection into CSF
______ nerve block. Small tube or catheter placement into epidural space.
Local anesthetics block _____ channels because in this state they have access to their binding pocket.
local anesthetics can have actions on other excitable _______
Name a type of nerve that is blocked during nerve block anesthesia.

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