Opiates & Cannabinoids
A postoperative patient develops analgesia and respiratory depression due to decreased Ca²⁺ influx and increased K⁺ efflux in spinal neurons.
What is the mu opioid receptor?
A chemotherapy patient develops severe nausea and vomiting due to serotonin acting on ligand-gated ion channels in the area postrema. A drug is given that prevents Na⁺ influx and K⁺ efflux at this receptor.
What is ondansetron?
A woman with galactorrhea and amenorrhea is treated with a drug that stimulates inhibitory dopamine receptors in the pituitary.
What is bromocriptine?
A trauma patient requires rapid paralysis for intubation and develops fasciculations and hyperkalemia after drug administration.
What is succinylcholine?
A patient with generalized tonic-clonic seizures is given an IV drug that immediately stops the seizure but must be followed by another agent to prevent recurrence.
What is a benzodiazepine (lorazepam or diazepam)?
An opioid causes mydriasis instead of miosis due to anticholinergic activity.
What is meperidine?
A depressed patient develops hypertension and tachycardia due to increased synaptic norepinephrine and serotonin from reuptake blockade.
What are SNRIs?
A Parkinson patient receives a drug that blocks peripheral conversion of levodopa to dopamine, increasing CNS dopamine levels.
What is carbidopa?
A cosmetic procedure drug blocks SNARE proteins and prevents acetylcholine release at the neuromuscular junction.
What is botulinum toxin?
A patient undergoing surgery develops sudden muscle rigidity, rising CO₂, tachycardia, and hyperthermia after receiving inhaled anesthetics and succinylcholine.
What is malignant hyperthermia?
An opioid-dependent patient is given a partial agonist and immediately develops withdrawal symptoms.
What is buprenorphine?
A patient with PTSD nightmares is given a drug that blocks alpha-1 receptors, reducing sympathetic tone during sleep.
What is prazosin?
A patient with Parkinson disease is given a drug that inhibits COMT and crosses the blood–brain barrier to reduce dopamine breakdown centrally.
What is tolcapone?
A patient receiving a non-depolarizing paralytic during surgery has paralysis reversed by increasing acetylcholine at the NMJ.
What is neostigmine?
A patient with chronic pain develops pinpoint pupils, constipation, and respiratory depression after dose escalation of medication.
What is a mu-opioid receptor agonist?
A cannabinoid receptor produces analgesia without psychoactive effects and is located mainly in the periphery.
What is the CB2 receptor?
A patient treated for IBS-C receives a partial agonist that increases GI secretion and peristalsis via serotonin receptors.
What is tegaserod?
A patient with schizophrenia develops fewer extrapyramidal symptoms on a drug that partially stimulates dopamine receptors while blocking serotonin receptors.
What is aripiprazole?
A surgical patient develops hypercarbia, muscle rigidity, and rising temperature after inhaled anesthesia.
What is malignant hyperthermia?
A patient with schizophrenia recently started on haloperidol presents with severe rigidity of both arms and legs, altered mental status, diaphoresis, and a very high temperature.
What is neuroleptic malignant syndrome?
A patient treated for opioid use disorder has QT prolongation and NMDA receptor blockade.
What is methadone?
A patient with tyramine toxicity presents with severe hypertension and headache and is treated acutely with benzodiazepines or this calcium channel blocker.
What is diltiazem?
A patient with tremor, rigidity, and bradykinesia has degeneration of dopamine neurons in the substantia nigra affecting this pathway.
What is the nigrostriatal pathway?
A patient treated for muscle spasticity develops hypotension and bradycardia due to reduced sympathetic tone from alpha-2 receptor activation.
What is tizanidine?
A patient treated for Parkinson disease is given an MAO-B inhibitor and later develops agitation, myoclonus, hyperreflexia, and fever after starting an SSRI.
What is serotonin syndrome?