Opioid Analgesics

1. A patient with signs of poisoning by morphine was delivered to emergency department. What drug should be used in this case for gastric lavage?

*A. Potassium permanganate.

B. Sodium hydrocarbonate.

C. Nitrofural (furacilinum).

D. Solution of sodium chloride.

E. Boric acid.

2. A patient in postoperative period received promedolum (trimeperidine). In the result of drug interruption the serious psychical and physical disturbances developed in patient. What is this complication called?

*A. Abstinence.

B. Idiosyncrasy.

C. Tachyphylaxis.

D. Phenomenon of feedback.

E. Tolerance.

3. An unconsciousness patient was delivered to the hospital. The skin is cold, pupils are narrow, the breathing is complicated and periodic, blood pressure is low, and the bladder is overflowed. What group of drug is the reason of this poisoning?

*A. Opioid analgesics.

B. Tranquilizers.

C. Nonopioid analgesics.

D. M-cholinoblockers.

E. Neuroleptics.

4. The acute spastic pain has developed in patient with urolithiasis. For prevention of pain shock the doctor has introduced to patient atropine with opioid analgesic, which has not spasmogenic action. Call this opioid analgesic.

*A. Promedolum (trimeperidine)

B. Tramadolum

C. Pyritramide

D. Morphine hydrochloride

E. Ethylmorphine hydrochloride

5. The doctor prescribed promedolum to patient with nonresectable tumor of stomach. After some time the patient has noted the decrease of analgesic action and duration of drug action. What is the reason of this phenomenon?

*A. Tolerance

B. Tachyphylaxis

C. Psychical dependence

D. Cumulation of promedolum

E. Decrease of drug reabsorption in kidneys.

6. Patient in the unconscious state was admitted to the emergency room. Skin is cold, pupils are delayed, breathing is heavy, with cycles of the Cheyne-Stokes type, blood pressure is decreased, urinary bladder is overloaded. Poisoning with what substance is the most likely?

*A. Narcotic analgesics

B. Non-narcotic analgesics

C. Sedatives

D. M-cholinergic antagonists

7. A 70-year-old man, who suffered from chronic bronchitis, was prescribed drug for the cough – codeine. What is the mechanism of anticoughing effect of this drug?

*A. Central effect

B. Reflex

C. Local effect

D. Peripheral effect

E. Competitive action

8. A patient was prescribed a narcotic analgesic, which is derivative of cyclohehanol, agonist-antagonist of opiate receptors, a little weaker than morphine. It does not influence the digestive tract, has some analgesic action, is characteristic of nonnarcotic analgesics; it is not recommended for children under 14. What is this drug?

*A. Tramadolum

B. Promedolum

C. Morphini hydrochloridum

D. Codeini phosphas

E. Omnoponum

9. A patient with manifestations of acute poisoning with morphine has been taken to a resuscitation unit. What drug is it necessary to use as an antidote for gastric lavage?

*A. Potassium permanganas

B. Natrii hydrocarbonas

C. Furacilinum

D. Sodium chloridum

E. Acidum boricum

10. In 2-3 hours after the parenteral introduction of a drug a patient became comatose. Cheyne-Stokes respiration was observed, pupils became abruptly miotic, the knee reflex was kept. What drug could lead to the poisoning?

*A. Morphine

B. Diazepamum

C. Aminazinum

D. Ethyl alcohol

E. Phenobarbitalum

11. An unconscious patient has been taken to a hospital. His skin is cold, pupils are miotic, breathing is complicated (Cheyne-Stokes type), arterial pressure is low, the urinary bladder is overfilled. The diagnosis is poisoning with morphine. What drug is it necessary to give as an antidote?

*A. Naloxonum

B. Bemegridum

C. Cytitonum

D. Unithiolum

E. Sodium thiosulfas

12. A 35-year-old parturient woman has a pain syndrome connected with the delay of the first labor stage. What drug is necessary to be used for relieving the pain?

*A. Promedolum

B. Analginum

C. Morphine

D. Codeine

E. Paracetamolum

13. An emergency team has taken to a reception ward a patient demonstrating drowsiness, cyanosis, and infrequent cogged-wheel breathing, sharply miotic pupils. Knee reflexes are kept. The traces of injections are revealed on his arms. What drug causes poisoning characterized by the above-mentioned symptom?

*A. Morphine

B. Atropine

C. Proserinum

D. Phenobarbital

E. Aminazinum

14. A 30-year-old patient after a traffic accident was delivered to a hospital with a hip bones fracture. The patient has low arterial pressure, weak pulse, and increased pain reaction to the least touch in the place of damage. What is necessary to use to prevent the traumatic shock of this patient?

*A. Morphine

B. Paracetamolum

C. Pentazocinum

D. Analginum

E. Papaverine

15. A 25-year-old woman is hospitalized with signs of acute poisoning with morphine. What antidote is necessary to be given to the patient?

*A. Naloxone

B. Unithiolum

C. Atropine

D. Lobeline

E. Aethimizolum

16. A patient with poisoning with morphine has been delivered to a hospital. It is known that in case of acute poisoning with morphine a specific antagonist naloxone is used. What factor provides the development of antagonistic action?

*A. Competition for binding with opiate receptors

B. Direct excitation of respiratory center

C. Reflex excitation of respiratory center

D. Sharp acceleration of morphine metabolism

E. Decrease of sensitivity of the organism to morphine

17. Morphine hydrochloride solution has been introduced subcutaneously to a patient with traumatic shock to provide analgesia. What is the mechanism of analgesic effect of this drug?

*A. Interacting with opiate receptors

B. Blockade of peripheral sensitive receptors

C. Change of pain emotional coloring

D. Abnormality of afferent nerves impulses conduction

E. Inhibition of pain mediators formation on peripheral tissues

18. A patient suffering from urolithiasis is hospitalized because of an attack of renal colic. What emergency drug is to be prescribed in this case?

*A. Promedolum

B. Analginum

C. Paracetamolum

D. Furosemide

E. Contrycal

19. For anesthesia of labor a doctor prescribed an analgesic. What analgesic is the most expedient to use in this case?

*A. Promedolum

B. Analginum

C. Morphine

D. Phentanylum

E. Paracetamolum

20. A 15-year-old boy with manifestations of acute poisoning with narcotic analgesics was prescribed a specific antagonist of morphine hydrochloride. What is this drug?

*A. Naloxone

B. Tetacinum-calcium

C. Pentazocini hydrochloridum

D. Unithiolum

E. Bemegridum

21. Prescribe to patient a drug – a synthetic substitute of morphine, which has a sedative effect, does not spasm muscles and sphincters of the digestive tract, slightly influences the center of respiration, and reduces the tone of neck of uterus.

*A. Promedolum

B. Omnoponum

C. Phentanylum

D. Paracetamolum

E. Analginum

22. An unconscious patient is hospitalized to a resuscitation unit with symptoms of acute morphine poisoning: hypothermia, Cheyne-Stokes respiration, hypotension, bradycardia, acute miosis. Which of the listed drugs will be the most effective in this case?

*A. Naloxone

B. Cordiaminum

C. camphora

D. Aethimizolum

E. Coffeinum-natrii benzoas

23. The 26-year-old patient in coma is brought in intensive care unit. The temperature is 35⁰C. The skin is cold. Mucous membranes are cyanotic. Sharply miotic pupils are observed. Breath is oppressed, as Chejn-Stoks type. What drug is cause of poisoning?

*A. Morphine

B. Proserinum

C. Adrenaline

D. Atropine

E. Anaprilinum

24. The 60-year-old patient suffers from incurable cancer of lung with multiply metastases. Choose the drug for pain relief in this patient.

*A. Morphine

B. Diclofenac sodium

C. Analginum

D. Fentanyl

E. Paracetamol

25. The 20-year-old patient is delivered to urgent unit with poisoning with opium. What the most effective drug should be administered to him?

*A. Naloxone

B. Atropine

C. Aethimizolum

D. Active carbon

E. Potassium permanganate

26. The victim with fractures of hip and of ribs is delivered to emergency room after road accident. What drug should be administered to patient for prevention of pain shock?

*A. Morphine

B. Analginum

C. Nitric oxшde

D. Diazepam

E. Tramadol

27. The patient with myocardial infarction is delivered to resuscitation unit. What drug should be administered to patient for prevention of painful shock?

*A. Morphine

B. Analginum

C. Paracetamol

D. Celecoxib

E. Naloxone

28. The parturient woman is delivered to obstetrics department. The doctor administered to woman the opioid analgesic for pain relief. Indicate this drug.

*A. Promedolum

B. Acetylsalicylic acid

C. Analginum

D. Celecoxib

E. Diclophenac sodium

29. The patient with serious trauma is delivered to emergency room. For prevention of painful shock, a doctor administered to him opioid analgesic. Indicate this drug.

*A. Morphine

B. Paracetamol

C. Piroxicam

D. Acetylsalicylic acid

E. Celecoxib

30. The antagonist of opioid analgesics was administered to patient with significant signs of opioid intoxication. Indicate this drug.

*A. Naloxone

B. Morphine

C. Promedolum

D. Omnopon

E. Fentanyl

31. The patient with morphinism is delivered to narcological unit. In result of examination, a doctor indicated the decreasing of morphine action. Indicate the name of phenomenon of weakening of drug action in result of repeated drug administration.

*A. Tolerance (accustoming)

B. Material cumulation

C. Functional cumulation

D. Antagonism

E. Summation

Non-Steroid Antiinflammatory Drugs