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Pharmacology Lab
1. Which of the following is part of the classic opioid overdose triad?
Hypertension
Miosis
Tachycardia
Hyperthermia
Explanation:
The opioid overdose triad consists of miosis, respiratory depression, and decreased level of consciousness. :contentReference[oaicite:0]{index=0}
2. The most dangerous complication responsible for death in opioid overdose is:
Bradycardia
Hypotension
Respiratory depression
Hypothermia
Explanation:
Respiratory depression is the main life-threatening feature of opioid overdose. :contentReference[oaicite:1]{index=1}
3. Non-cardiogenic pulmonary edema is most commonly associated with overdose of:
Heroin
Codeine
Tramadol
Morphine
Explanation:
Non-cardiogenic pulmonary edema is the most common acute lung problem after heroin overdose. :contentReference[oaicite:2]{index=2}
4. Which finding helps differentiate opioid overdose from benzodiazepine overdose?
Coma
Respiratory depression
Hypotension
Miosis
Explanation:
Miosis is characteristic of opioid overdose and is absent in benzodiazepine overdose. :contentReference[oaicite:3]{index=3}
5. Which factor significantly increases the risk of opioid overdose?
Using opioids alone
Mixing opioids with benzodiazepines or alcohol
Short-acting opioid use
Oral route of administration
Explanation:
Combining opioids with other CNS depressants markedly increases overdose risk. :contentReference[oaicite:4]{index=4}
6. Fentanyl patches used in cancer patients increase overdose risk because:
They deliver a potent opioid continuously
They cause rapid tolerance
They block opioid receptors
They induce CYP enzymes
Explanation:
Fentanyl patches provide continuous delivery of a very potent opioid, increasing overdose risk. :contentReference[oaicite:5]{index=5}
7. Ultrametabolizers of CYP2D6 are at higher risk of toxicity from:
Morphine
Methadone
Codeine
Naloxone
Explanation:
Codeine is a prodrug converted by CYP2D6 into morphine; ultrarapid metabolizers may develop toxicity at normal doses. :contentReference[oaicite:6]{index=6}
8. The combination of heroin and cocaine is known as:
Candy flip
Flipping
Body packing
Speedball
Explanation:
Speedball is the combination of heroin and cocaine, which increases overdose risk. :contentReference[oaicite:7]{index=7}
9. The first step in management of suspected opioid overdose is:
Assess airway, breathing, and circulation
Administer naloxone immediately
Order toxicology screen
Give flumazenil
Explanation:
Initial management always begins with ABC assessment. :contentReference[oaicite:8]{index=8}
10. Naloxone acts as a:
Partial agonist
Competitive opioid antagonist
Non-competitive antagonist
Inverse agonist
Explanation:
Naloxone is a competitive opioid receptor antagonist used in overdose. :contentReference[oaicite:9]{index=9}
11. Why is naloxone titrated slowly in opioid-dependent patients?
To increase bioavailability
To prolong its duration
To reduce severe withdrawal symptoms
To prevent hypotension
Explanation:
Rapid reversal may precipitate acute withdrawal; gradual titration minimizes this risk. :contentReference[oaicite:10]{index=10}
12. Lack of response after 10 mg naloxone suggests:
Severe opioid overdose
Long-acting opioid use
Naloxone resistance
Another cause or co-ingestant
Explanation:
Failure to respond suggests that opioid overdose alone is unlikely. :contentReference[oaicite:11]{index=11}
13. Naloxone infusion is preferred in overdose of:
Short-acting opioids
Long-acting opioids
Benzodiazepines
Alcohol
Explanation:
Long-acting opioids require continuous naloxone infusion to prevent relapse. :contentReference[oaicite:12]{index=12}
14. Which route of naloxone administration is commonly used pre-hospital?
Intranasal
Oral
Subcutaneous
Inhalational
Explanation:
EMS personnel frequently administer naloxone intranasally or IM. :contentReference[oaicite:13]{index=13}
15. Which drug is the antidote for benzodiazepine overdose?
Naloxone
Naltrexone
Flumazenil
Methadone
Explanation:
Flumazenil is a benzodiazepine receptor antagonist. :contentReference[oaicite:14]{index=14}
16. Which is NOT part of the coma cocktail?
Glucose
Thiamine
Naloxone
Flumazenil
Explanation:
Flumazenil is not routinely included in the coma cocktail. :contentReference[oaicite:15]{index=15}
17. Naltrexone differs from naloxone because it:
Is used acutely
Has delayed onset of action
Is a partial agonist
Causes respiratory depression
Explanation:
Naltrexone has delayed onset and is unsuitable for acute overdose. :contentReference[oaicite:16]{index=16}
18. Naltrexone is primarily used for:
Maintenance treatment of opioid dependence
Acute opioid overdose
Pain management
Sedation
Explanation:
Naltrexone is used in recovery and relapse prevention, not acute overdose. :contentReference[oaicite:17]{index=17}
19. Children are more sensitive to opioids mainly due to:
Low body fat
High renal clearance
Immature hepatic metabolism
Reduced receptor sensitivity
Explanation:
Immature liver metabolism increases opioid toxicity risk in children. :contentReference[oaicite:18]{index=18}
20. The main mechanism of the “cocaine vaccine” is:
Blocking dopamine receptors
Inhibiting cocaine metabolism
Enhancing cocaine excretion
Preventing cocaine from crossing the blood-brain barrier
Explanation:
The vaccine induces antibodies that bind cocaine, preventing CNS entry and euphoria. :contentReference[oaicite:19]{index=19}