1. According to your text, as many as _________ of patients in moderate to severe pain receive less than adequate
doses of prescription narcotic analgesics.
a. 25 percent
b. 51 percent
c. 65 percent
d. 73 percent
2. Besides controlling pain, opium can also
a. control diarrhea.
b. decrease cholesterol.
c. increase concentration.
d. decrease congestion.
3. The invention of ___________ made it possible to rapidly and painlessly introduce morphine directly into the body.
a. the capsule
b. codeine
c. the hypodermic needle
d. the nasal aspirator
4. By the year 1900, approximately ________ of all Americans were thought to be addicted to narcotics.
a. 0.3 percent
b. 4 percent
c. 3 percent
d. 1 percent
5. By the time the Harrison Narcotics Act was passed in 1914
a. narcotics abuse was reaching its peak in the United States.
b. narcotics abuse had been on the decline for about 10 years.
c. narcotics abuse was limited to smoking opium by Chinese immigrants.
d. physicians were no longer able to prescribe narcotics to patients.
6. Morphine, the active agent in opium, was first isolated in the year
a. 1861.
b. 1906.
c. 1914.
d. 1806.
7. In research, volunteers who are not in pain but are given a therapeutic dose of narcotic analgesics usually report
feeling
a. dysphoria.
b. euphoria.
c. mania.
d. pain.
8. The _________ region of the brain has a large number of opioid receptor sites.
a. hippocampus
b. frontal cortex
c. medulla
d. amygdalae
9. The methadone molecule is structurally similar to the ________ molecule.
a. codeine
b. sigma
c. morphine
d. heroin
10. Which of the following narcotic analgesics was developed for long-term pain management?
a. Codeine
b. Oxycodone
c. Morphine
d. Fentanyl
11. Which of the following is a symptom of heroin abuse?
a. Ataxia
b. Emotional liability
c. Slurred speech
d. Nodding off
12. Chronic opioid abuse often results in significant __________ for the user.
a. pain
b. “flashes”
c. constipation
d. insomnia
13. Whatisa“chipper?”
a. An occasional heroin user
b. A methadone addict
c. A recovered heroin addict
d. Someone who crushes Oxycontin capsules to disengage their time-release effects
14. Which of the following is an accurate statement about the science of pain control?
a. There is no objective measure of pain.
b. The AST blood test provides a way to measure the average level of pain the individual has experienced in the
past week, but cannot be more accurate than this.
c. Similar levels of acute trauma will cause the exact same level of pain for different individuals.
d. Chronic pain is more easily assessed than is acute pain.
15. Which of the following statements is true?
a. Thelegaldefinitionof“narcotic”isbasedonthepharmacologicalcharacteristicsofthatcompound.
b. Thelegaldefinitionof“narcotic”isnotbasedonthepharmacologicalcharacteristicsofthatcompound.
c. Thereisnolegalterm“narcotic;”thecorrectlegaltermis“acompoundthatproducesmorphinelikeeffects.”
d. Thelegaltermfor“narcotic”appliestoeverycompoundthatalterstheindividual’ssenseofconsciousness.
16. According to your text, research has demonstrated
a. 73 percent of patients report adequate levels of pain control when asked.
b. 56 percent of patients experiencing pain achieve adequate levels of analgesia using oral medications alone.
c. 73 percent of patients in mild to moderate pain do not receive adequate analgesia.
d. the public understands how to control pain better than do physicians.
17. TheEnglishword“opium”canbetracedto__________andmeans“poppyjuice.”
a. Latin
b. Greek
c. Old English (used prior to 1300 a.d.)
d. India
18. One function of endogenous opioid molecules released in the amygdala is the
a. suppressionofthe“fightorflight”response.
b. initiation of a pleasure response when we do something right.
c. suppression of the pleasure response.
d. increase in respiration so we will remember what we did more clearly.
19. Current theory suggests that narcotic analgesics relieve pain by their ability to
a. mimic the actions of opioid peptides.
b. counter the effects of the opioid peptides.
c. activate the release of serotonin in the amygdala.
d. activate the release of massive amounts of acetylcholine in the basal ganglia.
20. Narcotic analgesics currently in use tend to preferentially activate the _____ receptor site in the brain.
a. mu
b. epsilon
c. sigma
d. delta
21. The active agent in codeine is
a. codeine itself, without other compounds being involved.
b. morphine obtained from biotransformation of codeine.
c. able to bind at the opioid sigma receptor site to initiate the blockade of pain signals.
d. best absorbed when this compound is injected into muscle tissue.
22. Which of the following analgesic compounds has the longest elimination half life?
a. Morphine
b. Demerol
c. Methadone
d. Codeine
23. Tolerance to the respiratory depressant effects of narcotic analgesics
a. does not completely develop, even with continual use.
b. requires 3 months of continual use to completely develop.
c. is seen only with longer lasting compounds.
d. is seen only in older patients placed on narcotic analgesics.
24. The danger of iatrogenic addiction is
a. estimated to be about 1 in every 14,000 cases when the narcotic analgesic is used for short term control of
pain.
b. estimated to be about 1 in every 1,000 cases when the narcotic analgesic is used for short term control of
pain.
c. estimated to be about 1 in every 1,400 cases when the narcotic analgesic is used for short term control of
pain.
d. determinedinpartbythepatient’sageandsex.
25. According to your text, narcotic abuse most commonly involves
a. heroin.
b. demerol.
c. the diversion of prescribed medications in the U.S.
d. Dilaudid®.
26. A long-term opioid addict
a. will rarely experience constipation since the opioids do not influence the muscle (meiotic) movements of the
gastrointestinal tract.
b. will become totally tolerant to the respiratory depressant effects of their drug of choice.
c. willachievethe“rush”or“flash”experiencebyswitchingtoanotherclassofdrugs.
d. is prone to constipation due to the effects of narcotics in the gastrointestinal tract.
27. Addiction to a narcotic
a. can develop after just a few days of continuous use.
b. requires at least 6 months of continuous use before it develops.
c. is seen only in cases of intravenous drug abuse.
d. is most often seen in heroin addiction.
28. According to your text, one in three to one in four opioid abusers will
a. develop cardiomyopathy.
b. become addicted.
c. develop classic pinpoint pupils.
d. call for early refills of prescribed medications to support their addiction.
29. The uncomplicated narcotic withdrawal syndrome
a. is usually fatal unless supervised by a physician.
b. usually is no more uncomfortable than a bad case of the flu.
c. raisestheindividual’sriskforviralinfectionssuchasinfluenza.
d. is more intense in oral abusers of narcotics.
30. ​Describethecurrentmedicalusesfornarcoticanalgesics.
31. ​Explainhowthedistributionofopioidreceptorsacrossthebrainresultsinthewiderangeofeffects.
32. ​Discussthereasonsbehindandtheneedfordevelopingsyntheticopioidnarcotics.
33. ​Discusstheinfluencesonneuroadaptationtonarcoticanalgesics.
34. ​Whyisheroinconsideredmorepotentthanmorphine,fromwhichitisderived?