Chapter 10: Opiods
10. A semisynthetic opioid: a. contains components that occur naturally and other components produced synthetically. b. is a prodrug that produces an opioid drug as an active metabolite. c. is a synthetically made compound identical to the same compound produced naturally. d. is an opioid synthesized from a naturally occurring opioid.
D
12. A fully synthetic compound: a. can be identical to a naturally occurring opioid but is made entirely in a laboratory. b. is developed through a chemical synthesis process. c. is made in a laboratory. d. is not derived from a naturally occurring opioid.
D
13. The ability to develop a fully synthetic compound indicates that: a. the same compound is likely produced in a plant that has yet to be discovered. b. naturally occurring opioids do not have same efficacy. c. compounds will not be affected by enzymes in the liver. d. scientists know to make chemicals that bind to opioid receptors.
D
17. If a student were using a database in order to find articles for a research paper, why might she be unable to find certain key articles? a. There are special databases for opioids. b. Little research has been conducted on opioids, meaning fewer articles to find. c. The Harrison Act prevents the publication of articles about opioids. d. Some authors use the term opiate, and she didn't also search for this term.
D
19. The time an absorbed opioid drug takes to enter the brain is affected by: a. the formulation of the drug used. b. whether or not the drug is synthetic or semisynthetic. c. the affinity of the drug for opioid receptors. d. passage through the blood-brain barrier.
D
21. For many opioids, pharmacological effects continue after catabolism because: a. of the activation of endogenous opioids. b. opioids receptors remain activated after the drug is eliminated from the body. c. the user quickly uses another opioid. d. biotransformation leads to active metabolites that act as opioid compounds.
D
26. Endogenous opioids are: a. neural growth factors. b. enzymes. c. proteins. d. neuropeptides.
D
30. Increased neurotransmission by met-enkephalin and leu-enkephalin would imply increased synthesis of: a. prodynorphin. b. proopiomelanocortin. c. pronociceptin. d. proenkaphalin.
D
35. Opioid receptors are: a. ionotropic receptors. b. protein kinases. c. inwardly rectifying K+ channels. d. G-protein-coupled receptors.
D
39. While the mechanisms through which opioid neurons inhibit the activity of neurons remains unclear, one known mechanism is: a. reduced activity of G-proteins associated with opioid receptors. b. increased influx of Cl-. c. blockade of sodium channels. d. the activation of inwardly rectifying K+ channels.
D
40. Pharmacodynamic tolerance for chronic administration of a opioid includes: a. reduced activity of G-proteins for opioid receptors. b. decreased calcium influx. c. reduction of sodium channels. d. reduction in sodium-potassium pump activity.
D
44. Compared to a full opioid receptor agonist, a partial opioid receptor agonist will: a. bind to only one subtype of opioid receptors. b. will incompletely pass through the blood-brain barrier. c. counteract the effects of a full agonist. d. produce weaker effects.
D
48. Opioids produce reinforcing effects by affecting dopamine and ____________ neurotransmission. a. glutamate b. serotonin c. norepinephrine d. dopamine
D
5. Which of the following is an opioid drug used as a cough suppressant? a. morphine b. hydrocodone c. somniferum d. dextromethorphan
D
57. The "ascending pathway" begins in the: a. heart and terminates in the medulla. b. site of injury and terminates in the spinal cord. c. somatosensory cortex and terminates in the hypothalamus. d. spinal cord and sends pain information to the thalamus.
D
61. What affect on reinforcing effects will the combination of an opioid agonist with an opioid antagonist have? a. The antagonist will produce pain, thereby precluding someone from enjoying the reinforcing effects produced by the agonist. b. There will be no competing effects since they act on different receptors. c. The antagonist will enhance the reinforcing effects of the agonist. d. The antagonist will reduce the reinforcing effects of the agonist.
D
71. Physiological withdrawal symptoms from opioid use are related to the: a. socioeconomic status of an opioid user. b. reasons user become addicted to opioids. c. manner that opioids were typically used. d. physiological effects of opioids.
D
75. An opioid agonist, such as methadone, may be given in outpatient therapy during ____________ detoxification. a. ultra-rapid b. short-term c. rapid d. long-term
D
1. Opioid found in the body are called naturally occurring opioids.
F
10. The rush experienced from using an opioid is called nociception.
F
14. Opioids are effective for neuropathic pain.
F
15. Methadone is used for ultra-rapid detoxification from opioid use.
F
5. Neoendorphins bind to delta opioid receptors.
F
6. A partial opioid receptor agonist binds to only some types of opioid receptors.
F
7. A mixed opioid receptor agonist-antagonist produces the same effects as a partial opioid receptor agonist.
F
11. The activation of opioid receptors in the medulla inhibits pain signals entering the brain.
T
12. Giving an opioid antagonist to an opioid dependent user will produce withdrawal symptoms.
T
13. In a conditioned place preference procedure, lab rats will prefer a chamber where they previously experienced reinforcing effects.
T
2. A semi-synthetic opioid is derived from an opioid found in opium.
T
3. A reason why heroin preferred as a drug of abuse to morphine is that heroin crosses through the blood-brain barrier more quickly than morphine.
T
4. The activation of a G-protein-coupled inwardly rectifying K+ channel reduces the likelihood of an action potential.
T
8. Opioid drugs promote dopamine release in the nucleus accumbens by inhibiting GABA neurons in the ventral tegmental area.
T
9. Activating opioid receptors in the nucleus accumbens produces reinforcing effects.
T
2. A narcotic implies that drugs activating opioid receptors can produce: a. sleep. b. pain. c. stimulant effects. d. cataleptic effects.
a
14. Historically, the earliest uses of opium consisted of using as a: a. medicine. b. means to feel euphoria. c. way to spark philospohical discussions. d. way to prepare soldiers for battle.
A
16. During the 19th century, a number of medical products were sold that contained the opioid: a. morphine. b. hydrocodone. c. desomorphine. d. methadone.
A
22. Morphine-6-glucoronide is a(n): a. active metabolite. b. a common opioid drug of abuse. c. a type of opioid receptor. d. the name of an enzyme used to catabolize morphine and many other opioids.
A
24. Why shouldn't a laboratory technician conclude that a potential new employee might be abusing opioids if morphine-6-glucoronide is found in a sample? a. This is a metabolite produced from many opioids including codeine, which may have been prescribed for a severe cough. b. The compound is made naturally in the body, particularly in those who are highly physically active. c. The metabolite is normally produced with first using an illicit opioid, indicating recreational use rather than abuse. d. The metabolite remains in the body for weeks, indicating that the employee may not be a current user.
A
27. Opioids derive from a longer chain of amino acids called a: a. propeptide. b. receptor. c. gene. d. neurotransmitter.
A
3. The use of the term narcotic for a psychostimulant drug indicates that: a. misuse of the term to describe non-sleep inducing drugs occurs. b. sleep-inducing drugs have stimulant effects. c. narcotic can be appropriately used to describe a wide variety of drug effects. d. narcotic has an incorrect definition.
A
32. The cleavage of endogenous opioids from pronociceptin, proenkephalin, and proopiomelanocortin would increase levels of all of the endogenous opioids except: a. dynorphin B. b. met-enkaphalin. c. neoendorphin. d. beta-endorphin.
A
34. Most of the pharmacological effects of opioids are produced by activating: a. mu and delta receptors. b. delta and kappa receptors. c. ORL-1 receptors. d. kappa and mu receptors.
A
36. The activation of opioid receptors on a neuron: a. inhibit neuronal activity. b. increase neuronal activity. c. stabilize a high rate of action potentials. d. stop sodium-potassium pump activity.
A
38. The activation of an inwardly rectifying K+ channel will cause a(n): a. neuron's membrane to remain in at a resting potential. b. inhibitory postsynaptic potential. c. excitatory postsynaptic potential. d. G-protein to become activated.
A
41. Opioid drugs are classified by: a. receptor actions. b. structures of the brain they act upon. c. speed of drug onset. d. pharmacological effects.
A
47. An opioid drug that is an agonist for delta receptors but antagonist for ORL-1 receptors would be considered a: a. mixed opioid receptor agonist-antagonist. b. partial opioid receptor agonist. c. pure opioid receptor antagonist. d. pure opioid receptor agonist.
A
49. By inhibiting the activity of GABA neurons in the ventral tegmental area, opioids produce a(n): a. increase in dopamine in the nucleus accumbens. b. decrease in dopamine in the ventral tegmental area. c. decrease in endogenous opioids in the ventral tegmental area. d. increase in endogenous opioids in the nucleus accumbens.
A
51. All of the following are ways that opioid agonists can increase dopamine levels in the nucleus accumbens except binding to: a. opioid receptors on dopamine neurons in the ventral tegmental area. b. opioid receptors on GABA neurons in the ventral tegmental area. c. opioid receptors on GABA neurons in the nucleus accumbens. d. opioid receptors on GABA neurons in the nucleus accumbens that terminate in the ventral tegmental area.
A
53. Opioid agonists acting in the nucleus accumbens increase dopamine levels in the nucleus accumbens by: a. inhibiting GABA neurons that terminate on dopamine neurons in the ventral tegmental area. b. binding to opioid receptors on dopamine axon terminals. c. by inhibiting glutamate neurons which no longer inhibit GABA neurons acting on dopamine neurons in the nucleus accumbens. d. inhibiting opioid neurons which terminate in the ventral tegmental area.
A
56. Pain fibers release glutamate and ____________ at postsynaptic terminals on spinothalamic neurons. a. substance P b. GABA c. dopamine d. beta-endorphin
A
66. While highly effective for pain in general, what type of pain is an opioid agonist less effective for? a. Neuropathic pain b. Systematic pain c. Inflammatory pain d. Muscular pain
A
73. Why might a physician be reluctant to prescribe an opioid analgesic for a patient with chronic obstructive pulmonary disease? a. Opioid agonists depress respiratory function. b. Opioid agonists cause memory loss, making someone likely to overdose if the person forgot taking the medication earlier. c. Opioids have high abuse potential. d. Opioids drugs are less effective for pain in those with COPD.
A
74. During long-term detoxification therapy for opioid addiction, withdrawal effects tend to be relatively: a. mild. b. moderate, requiring treatment. c. severe, requiring treatment. d. severe, requiring anesthesia.
A
78. What are drugs such as a benzodiazepine or antidiarreheal medication used for during treatment for opioid addiction? a. To reduce the withdrawal effects from opioid use. b. To reduce the reinforcing effects of opioids. c. To prevent the use of alternative addictive substance. d. To provide low-cost, safer alternatives for opioid use.
A
80. Administering an opioid receptor antagonist for an opioid-addicted user is likely to cause: a. withdrawal effects. b. reinforcing effects. c. no effects. d. antidepresant effects.
A
15. An opium-containing drink intended for medical purposes that became popular in 17th- century Europe was called: a. opioid. b. laudanum. c. narcosis. d. brandy.
B
28. A compound that could prevent the cleavage of propeptides for endogenous opioids would likely: a. lead to greater activation of receptors by propeptides. b. cause a decrease in endogenous opioid neurotransmission. c. have no affect on neurotransmission since the endogenous opioids are contained within the neuropeptide. d. prevent endogenous opioids from crossing the blood-brain barrier.
B
37. The nociceptin receptor is also known as the: a. mu receptor. b. ORL-1 receptor. c. delta receptor. d. kappa receptor.
B
4. Most heroin users had first used:: a. bath salts. b. prescription opioid drugs. c. marijuana. d. hallucinogens.
B
42. An opioid drug that binds only to mu receptors and activates all mu receptors it binds to is a: a. partial opioid receptor agonist. b. pure opioid receptor agonist. c. full opioid receptor agonist. d. pure opioid receptor agonist.
B
43. A partial opioid receptor agonist is one that: a. only activates one type of opioid receptor. b. doesn't activate every opioid receptor it binds to. c. has some of its drug molecules unable to cross the blood-brain barrier. d. may either increase or decrease the activity of a receptor.
B
46. The symptoms of an overdose from an opioid receptor agonist may be reduced if the user is given a(n): a. pure opioid receptor agonist. b. pure opioid receptor antagonist. c. partial opioid receptor agonist. d. mixed opioid receptor agonist-antagonist.
B
50. Opioids produce _____________ effects by activating mu receptors in the nucleus accumbens. a. pain-relieving b. reinforcing c. aversive d. extinguishing
B
54. The communication of pain sensations in the body is referred to: a. dynorphin. b. nociception. c. analgesia. d. chemoception.
B
59. A drug that activated receptors for substance P would likely: a. produce rewarding effects. b. cause pain. c. reduce stress. d. cause confusion and memory loss.
B
60. How does activating opioid receptors in the medulla reduce pain? a. The medulla is the pain center of the brain. b. There is an inhibition of pain signals passing through the medulla to elsewhere in the brain. c. There is a reduction in sympathetic nervous system activity, which makes someone less reactive to pain. d. They produce rewarding effects which counteracts pain signals.
B
62. The initial phase of an opioid agonist's positive subjective effects is called a: a. nod. b. rush. c. euphoria. d. high.
B
63. The phase of subjective effects after opioid use that is described as a "calm, disinterest, and unawareness of surroundings" is called: a. stoned. b. a nod. c. straight. d. calm.
B
67. Idiopathic pain refers to: a. pain associated with drug withdrawal. b. pain from an unknown organic cause. c. pain from a psychological cause. d. pain that is short-lasting but occurs frequently.
B
69. Opioids constrict pupils at analgesic doses, an effect called: a. intraocular pressure. b. miosis. c. dilation. d. hypertension.
B
7. The plant Papaver somniferum contains: a. cannabinols. b. naturally occurring opioids. c. synthetic heroin. d. dextromethorphan.
B
77. A detoxification program for treating opioid addiction involving an opioid receptor antagonist would most likely occur for a(n): a. an outpatient treatment program. b. rapid detoxification program. c. a short-term detoxification program. d. 12-step program.
B
79. Harm reduction programs for opioid use are designed to provide all of the following except: a. administer treatments for various disease. b. treat opioid addiction. c. provide clean needles to reduce the risk of infection. d. provide medical testing for diseases.
B
8. The pharmacological effects of opium are derived from: a. heroin and its active metabolite morphine. b. a combination of morphine, codeine, and thebaine. c. codeine and a minor contribution from thebaine. d. morphine and desomorphine.
B
9. All of the following are naturally occurring opioids except: a. thebaine. b. buprenorphine. c. morphine. d. codeine.
B
11. The synthesis of a semisynthetic opioid implies all of the following except: a. opium is collected from poppy plants. b. a naturally occurring opioid is used in the synthesis process. c. the drug is separated from other compounds found in opium. d. a chemical process is used to develop the drug.
C
18. For a rapid speed of onset, users prefer to administer an opioid drug: a. sublingually and by inhalation. b. subcutaneously and intravenously. c. intravenously and by inhalation. d. intravenously and intramuscularly.
C
20. Why might an opioid with substantial lipid solubility be a preferred recreational substance to an opioid with poor lipid solubility? a. The poor lipid solubility drug doesn't bind well to opioid receptors. b. The poor lipid solubility drug will be metabolized more quickly. c. The poor lipid solubility drug passes more slowly through the blood-brain barrier. d. The poor lipid solubility drug is rapidly eliminated from the body.
C
23. Why might finding morphine in a drug test not necessarily indicate the person is abusing morphine? a. Certain foods contain trace amounts of morphine. b. The person might have taken acetamenophen. c. The person might have taken a prescription cough syrup containing codeine. d. Recreational morphine use is approved in some U.S. states.
C
25. Methadone's long elimination rate: a. prevents the effects of heroin, if a user attempts to use heroin after taking methadone. b. makes it an affordable opioid to use. c. makes it less desirable as a drug of abuse. d. means that it is a naturally occurring opioid compound.
C
29. Increased synthesis of propiomelanocortin would lead to greater activation of opioid receptors by: a. norepinephrine. b. dynorphin A. c. beta-endorphin. d. met-enkaphalin.
C
31. Increased neurotransmission by orphanin FQ would imply increased synthesis of: a. prodynorphin. b. proopiomelanocortin. c. pronociceptin. d. proenkaphalin.
C
33. If an increased synthesis of proopiomelanocortin occurred, which of the following types of receptors would likely see increased activation? a. Kappa receptors. b. ORL-1 receptors. c. Mu receptors. d. Melatonin receptors.
C
45. A pure opioid receptor antagonist: a. cannot counteract an agonist for opioid receptors. b. binds to all opioid receptors but only fails to activate one type of opioid receptor. c. binds to but does not activate opioid receptors. d. is unable to cross the blood-brain barrier.
C
52. The activation of opioid receptors on GABA neurons in the nucleus accumbens: a. causes a disinhibition on endogenous opioid neurons. b. inhibits GABA neurons that have excitatory effects on other GABA neurons. c. inhibits GABA neurons that have inhibitory effects on dopamine neurons. d. disinhibits GABA neurons that terminate in the nucleus accumbens.
C
55. A-delta and C fibers are examples of: a. reward pathways. b. dopamine pathways. c. pain pathways. d. motor pathways.
C
58. The following are ways that opioids can interupt pain signalling except: a. opioid receptors are found on pain fiber terminals. b. activation of opioid receptors in the spinal cord inhibit the release of substance P. c. endogenous opioid levels increase in periaqueductal gray. d. neurons release endogenous opioids in the medulla.
C
6. The slang term robotripping refers to psychedelic effects derived from: a. heroin. b. hydrocodone. c. dextromethorphan. d. codeine.
C
64. In a conditioned place preference procedure, if lab rats prefer a chamber where they had experience the effects of a test compound, this implies that the drug: a. caused an attractive scent in the chamber. b. produces hypnotic effects. c. produces reinforcing effects. d. produced a fear of entering other chambers.
C
65. A neurotransmitter that is involved in the reinforcing effects of opioid agonists is: a. substance P. b. serotonin. c. glutamate. d. neurotensin.
C
68. Severe respiratory depression form opioid use is a sign of: a. use of another substance. b. therapeutic efficacy. c. overdose. d. a comorbid psychological disorder.
C
70. One of the first measures taken to treat opioid overdose in an emergency room is: a. to determine whether the opioid was an illegal substance. b. to determine why the patient was using an opioid. c. to determine if ventilation support should be given. d. to determine a patient's psychiatric history.
C
72. Since an opioid drug produces euphoria, a related withdrawal effect would likely consist of: a. confusion. b. pain sensitivity. c. depression. d. restlessness.
C
76. In the U.S., due to the Drug Addiction Treatment act, specialized clinics are needed for prescribing: a. buprenorphine. b. heroin. c. methadone. d. methamphetamine.
C
1. Opioids action on __________ receptors in the body. a. melatonin b. opioid c. serotonin d. dopamine
b