32.1 Morphine analgesia differs from that produced by
aspirin in the following respect(s):
A. It has a higher ceiling
B. It covers both perception as well as psychic processing of the pain
C. Visceral and ischaemic pain is relieved better than somatic inflammatory pain
D. All of the above are correct
32.2 Morphine produces analgesia by acting at:
A. Peripheral pain receptors
B. A spinal site
C. Supraspinal sites
D. Both spinal and supraspinal sites
32.3 In man sedation caused by morphine is characterised by:
A. Little or no motor incoordination
B. Initial excitement
C. Rise in seizure threshold
D. All of the above
32.4 The subjective effects of morphine include the following except:
A. Dysphoria in many uninitiated individuals
B. Euphoria in dependent subjects
C. Visual hallucinations
D. Detachment to self and surroundings
32.5 Actions of morphine include the following except:
A. Vagal stimulation
B. Miosis
C. Antiemetic
D. Postural hypotension
32.6 Morphine induced fall in blood pressure involves the
following factors except:
A. Direct cardiac depression
B. Direct reduction of vascular tone
C. Vasomotor centre depression
D. Histamine release
32.7 Instead of depressing, morphine stimulates:
A. Vasomotor centre
B. Edinger Westphal nucleus
C. Temperature regulating centre
D. Cough centre
32.8 Morphine induced constipation involves the following
mechanisms except:
A. Increase in tone and decrease in propulsive activity of intestinal muscles
B. Antivagal action
C. Spasm of gastrointestinal sphincters
D. Reduction of gastrointestinal secretions
32.9 In a comatose patient suspected of poisoning, which
of the following findings would be against the drug
being morphine:
A. Mydriasis
B. Marked respiratory depression
C. Cyanosis
D. Fall in blood pressure
32.10 The following is not true of morphine:
A. Its 2-glucuronide metabolite is an active analgesic
B. Its active metabolite penetrates blood-brain barrier better than morphine
C. Its oral: parenteral activity ratio is 1:4
D. It undergoes enterohepatic cycling
32.11 The antidote of choice for morphine poisoning is:
A. Nalorphine
B. Nalbuphine
C. Naltrexone
D. Naloxone
32.12 What is true of tolerance occurring in regular opium abusers:
A. Tolerance develops to all actions of morphine
B. No tolerance occurs to euphoric and sedative actions of morphine
C. No tolerance occurs to constipating and miotic actions of morphine
D. Lethal dose of morphine is not significantly increased
32.13 Morphine dependence is characterized by:
A. Marked drug seeking behaviour
B. Physical dependence without psychic dependence
C. Physical as well as psychic dependence
D. Both ‘A’ and ‘C’ are correct
32.14 Use of morphine in the following category of patients
does not carry any special risk:
A. Ischaemic heart disease patients
B. Bronchial asthma patients
C. Elderly male patients
D. Biliary colic patients
32.15 Morphine is contraindicated in head injury because:
A. It does not relieve the pain of head injury
B. It can raise intracranial tension
C. It can cause constipation
D. It is liable to cause addiction
32.16 Choose the correct statement about codeine:
A. It has a lower oral: parenteral activity ratio than morphine
B. It is devoid of abuse liability
C. It is a weaker analgesic than morphine
D. It is a more potent antitussive than morphine
32.17 The following is true of pethidine except:
A. At equianalgesic doses it causes less respiratory depression than morphine
B. It is less constipating than morphine
C. It is a poor antitussive
D. In overdose it often produces excitatory effects
32.18 Norpethidine produced as a metabolite of pethidine is
responsible for the following effect:
A. Euphoria
B. Excitement
C. Analgesia
D. Respiratory depression
32.19 The following opioid is more potent than morphine:
A. Pethidine
B. Fentanyl
C. Dextropropoxyphene
D. Tramadol
32.20 Indicate the opioid analgesic that is used as
transdermal patch for chronic and cancer pain:
A. Morphine
B. Pentazocine
C. Fentanyl
D. Tramadol
32.21 The distinctive feature(s) of methadone compared to morphine is/are:
A. High oral bioavailability
B. High plasma protein and tissue binding
C. Delayed and milder withdrawal symptoms in
dependent subjects
D. All of the above
32.22 The following opioid analgesic is similar to codeine in
pharmacological profile but is less constipating:
A. Methadone
B. Buprenorphine
C. Butorphanol
D. Dextropropoxyphene
32.23 Select the analgesic which acts through opioid as well
as additional spinal monoaminergic mechanisms:
A. Tramadol
B. Ethoheptazine
C. Dextropropoxyphene
D. Alfentanil
32.24 An opioid analgesic is preferred over aspirin like
analgesic in the following condition:
A. Acute gout
B. Burn
C. Toothache
D. Neuralgia
32.25 Morphine affords symptomatic relief of dyspnoea in
acute left ventricular failure by the following
mechanisms except:
A. Bronchodilatation
B. Depression of respiratory centre
C. Reduction in cardiac preload
D. Shift of blood from pulmonary to systemic circuit
32.26 Morphine has high affinity for the following opioid receptor(s):
A. μ (Mu)
B. κ (Kappa)
C. δ (Delta)
D. All of the above
32.27 Features of μ (Mu) opioid receptor include the following except:
A. Acts by inhibiting cAMP formation
B. Mediates miotic action
C. Mediates low ceiling respiratory depression
D. Mediates high ceiling supraspinal analgesia
32.28 Nalorphine is nearly equipotent analgesic as morphine,
but is not used clinically as an analgesic because:
A. It causes more marked respiratory depression
B. It has higher abuse potential
C. It antagonises the action of morphine
D. It produces prominent dysphoric effects
32.29 Which of the following is an agonist-antagonist type
of opioid analgesic:
A. Pethidine
B. Pentazocine
C. Fentanyl
D. Buprenorphine
32.30 Select the opioid analgesic which acts primarily
through κ (kappa) opioid receptor:
A. Pentazocine
B. Methadone
C. Buprenorphine
D. Pethidine
32.31 The following opioids are κ (kappa) receptor analgesics except:
A. Buprenorphine
B. Butorphanol
C. Nalbuphine
D. Pentazocine
32.32 Choose the correct statement about pentazocine:
A. It causes bradycardia and fall in blood pressure
B. Its subjective effects are pleasurable at low doses but turn unpleasant at high doses
C. It induces vomiting frequently
D. It substitutes for morphine in dependent subjects
32.33 Pentazocine differs from morphine in that:
A. It is inactive by the oral route
B. It does not produce physical dependence
C. It has a lower ceiling of analgesic effect
D. Its action is not blocked by naloxone
32.34 The following is true of buprenorphine:
A. It is an agonist-antagonist type of opioid analgesic
B. Its subjective effects are different from those of morphine
C. Naloxone is largely ineffective in reversing its effects
D. It produces mydriasis
32.35 The following are pure opioid antagonists except:
A. Nalmfene
B. Nalbuphine
C. Naloxone
D. Naltrexone
32.36 Select the correct statement about Naloxone:
A. It equally blocks μ, κ and δ opioid receptors
B. It blocks μ receptors at lower doses than those needed for others
C. It blocks κ receptors at lower doses than those needed for others
D. It blocks δ receptors at lower doses than those needed for others
32.37 Which action of morphine is incompletely reversed by naloxone:
A. Analgesia
B. Respiratory depression
C. Sedation
D. Miosis
32.38 Lower dose of naloxone is required to:
A. Antagonise the actions of nalorphine
B. Antagonise the actions of pentazocine
C. Precipitate withdrawal in mildly morphine dependent subjects
D. Precipitate withdrawal in highly morphine dependent subjects
32.39 Select the opioid antagonist that is preferred for long
term opioid blockade therapy of post addicts:
A. Nalorphine
B. Naloxone
C. Naltrexone
D. Nalbuphine
32.40 The following is not true of naltrexone:
A. It produces agonistic actions of its own in the
absence of morphine
B. It is active orally
C. It has a long duration of action
D. It can reduce craving for alcohol in chronic
alcoholics
32.41 The following statement is true about endogenous opioid peptides:
A. They activate only μ opioid recepors
B. They do not occur in peripheral tissues
C. They mediate stress induced analgesia
D. Naloxone fails to antagonise their action
Ans:
32.1D 32.2D 32.3 A 32.4 C 32.5 C 32.6 A 32.7 B 32.8 B 32.9 A 32.10 B 32.11D 32.12 C 32.13D 32.14 A 32.15 B 32.16 C 32.17 A 32.18 B 32.19 B 32.20 C 32.21D 32.22D 32.23 A 32.24 B 32.25 A 32.26 A 32.27 C 32.28D 32.29 B 32.30 A 32.31 A 32.32 B 32.33 C 32.34 C 32.35 B 32.36 B 32.37 C 32.38D 32.39 C 32.40 A 32.41 C
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