lecture 21: Opioids
1) Pattern of use: what is a chipper? What does being a chipper prove? What is
needle freak? How many times a day cans a true addict use it?
2) Metabolism: T/F extensive first pass metabolism. T/F different opioids have the
same metabolism enzymes. What is oxymorphone? What are the opiods that
produce no active metabolites?
3) Does poppy seed give you a positive test for opium? What’s in them? What the
new threshold in ng/ml? T/F even this updated number can give you +.
4) Mechanism: what are the four different types of endogenous opioid receptors and
their respective receptors to which they bind? What is the precursor protein to
each family? T/F parts of morphine mimic this protein. What are the three ways it
can function as? What is their main role? T/F it is involved in placebo responses?
5) Opioids receptors: what are the three receptors? In what form do they exist in?
Which receptor handled most of the effect and what are they? Which receptor
causes some analgesis effect only? Which one causes dysphoria and some
6) All of the above receptors, when activated what do they do? What do they do pre
synaptically? What do they do postsynaptically? Overall, what do they do? What
NT do they increase in NA and how?
7) Explain the function of opioid receptor in the absence of mu receptors? (Where
are they located? what does this neuron release to which they are bonded? When
this NT is released what happen to the postsynaptic nerve?
8) In the presence of heroine,▯ which has to convert to morphine , it bind to mu
(opiate receptor) what happen then? What is the overall result of this on the post
9) What do the human scanning studies in addict show? Do we know exactly what
happen to the Dopamine levels? Do some data show increase in dopa?
10) Opioids and dopamine release: T/F morphine produce more dopamine level
then nicotine. Btw morphine and nicotine, which one is hard to quit? What does
David Nutt propose about the rule of dopamine?
11) Tolerance: what effect does tolerance develop to? How much more dose can
addicts take as compare o normal dose? What happen if they stop ▯ then resume
12) Mechanism of tolerance: what types of changes do you see ( i.e. mu receptors,
adenylate cyclase inhibition, other neurotransmitter level). T/F down regulation of
mu receptor is always seen in tolerance?
13)Damage: what is the most damage due to? Is it due to the taking heroine itself?
What is having analgesic affect a bad thing?
14) Overdose: what are the threetriad symptoms you want to look for inpatient in
15) Overdose: when you change a supplier what can happen and why? How can
change in environment cause overdose? For those undergone treatment, when is
the risk of overdose? Looking