Endogenous opioid peptides are found in the central nervous system (CNS) and in peripheral tissue. Which of the following is an endogenous opioid peptide that is a neurotransmitter that is released by the brain to alleviate pain and promote pleasure?
Endorphins
Dynorphins
Enkephalins
Nalbuphines
The Correct Answer is A
Endogenous opioid peptides are naturally produced neurotransmitters within the body that modulate pain perception and emotional responses. They bind to opioid receptors in the central and peripheral nervous systems, producing analgesia and a sense of well-being. These substances play a key role in the body’s natural pain control system and are released during stress, exercise, and pleasurable activities. Different types exist, but some are more strongly associated with pain relief and euphoria.
Rationale:
A. Endorphins are the primary endogenous opioid peptides responsible for analgesia and the sensation of pleasure or euphoria. They are released by the brain and pituitary gland and bind predominantly to mu-opioid receptors, reducing pain transmission. Their release is stimulated by stress, exercise, and excitement, contributing to the “runner’s high” and natural pain suppression mechanisms.
B. Dynorphins are endogenous opioids that primarily bind to kappa receptors and are involved in modulating pain and stress responses. However, their effects are often associated with dysphoria rather than pleasure. While they contribute to pain regulation, they are not the main peptides linked to euphoria and positive emotional states.
C. Enkephalins are endogenous peptides that function as neurotransmitters in pain modulation, particularly at the spinal cord level. They help inhibit pain signals by acting on delta receptors but have a more localized and shorter duration of action. They are less associated with systemic pleasure and euphoria compared to endorphins.
D. Nalbuphine is not an endogenous peptide but a synthetic opioid agonist-antagonist medication. It is used clinically for pain management and works by interacting with opioid receptors in the CNS. Since it is externally administered and not naturally produced by the body, it does not belong to the category of endogenous opioid peptides.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Abortive therapy for migraine headaches includes selective serotonin receptor agonists such as Sumatriptan, which work by causing cerebral vasoconstriction and reducing neurogenic inflammation. These medications are effective in stopping acute migraine attacks but have significant cardiovascular effects due to their vasoconstrictive properties. Because of this mechanism, patient history must be carefully screened for conditions that increase risk of reduced coronary blood flow.
Rationale:
A. Renal disease is not a primary contraindication for sumatriptan use, although dose adjustments may be considered in severe impairment. The drug is primarily metabolized hepatically and does not significantly worsen renal perfusion. Therefore, renal disease is not the most concerning history finding in this context.
B. Diabetes is a chronic condition that increases cardiovascular risk over time, but it is not an absolute contraindication to sumatriptan therapy. While diabetic patients require careful cardiovascular assessment, diabetes alone does not directly interact with the vasoconstrictive mechanism of triptans.
C. Coronary artery disease is a major contraindication to sumatriptan use because Sumatriptan causes vasoconstriction of coronary vessels. In patients with preexisting coronary artery disease, this can precipitate myocardial ischemia or infarction. Therefore, this history is the most concerning and requires avoidance or extreme caution.
D. Asthma is not a primary contraindication for sumatriptan use. While some medications can trigger bronchospasm, triptans do not significantly affect airway tone. The main safety concern for sumatriptan remains its cardiovascular effects rather than respiratory complications.
Correct Answer is A
Explanation
Antipsychotic medications, including low-potency agents, require adequate time to demonstrate full therapeutic effects on psychotic symptoms. Antipsychotics work primarily by modulating dopamine pathways, but clinical improvement, especially in hallucinations, delusions, and thought disturbances, may take several weeks. Early treatment response is often gradual, with some symptoms improving before others. Evaluation of effectiveness should consider duration of therapy, adherence, and expected pharmacologic onset.
Rationale:
A. It is too early to see a full therapeutic response because antipsychotic medications typically require 2–6 weeks or longer to show significant improvement in psychotic symptoms. Early partial response may be subtle, especially in negative symptoms or cognitive changes. At only 2 weeks, continued therapeutic effect is still expected as dopamine receptor adaptation continues over time.
B. Refractory illness refers to treatment-resistant psychosis, which is diagnosed only after adequate trials of multiple antipsychotics at therapeutic doses and durations. A 2-week trial is insufficient to determine treatment failure. Labeling the illness as refractory at this stage would be premature and clinically inaccurate.
C. Nonadherence cannot be assumed without evidence such as missed doses, inconsistent serum levels, or patient report. While noncompliance is a common issue in psychiatric treatment, the question provides no indication of medication refusal or poor adherence. Clinical evaluation should first consider expected drug response timelines.
D. Increasing to a stronger medication is not indicated at this stage because therapeutic response has not yet had adequate time to develop. Premature medication escalation may increase side effects without improving outcomes. Standard practice is to allow sufficient trial duration before changing antipsychotic potency or class.
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