1 Anti-inflammatory (non-opioid)

Question 1

pain threshold

Answer 1

level of stimulus needed to create painful sensation

Question 2

pain tolerance

Answer 2

amount of pain a person can endure without having it interfere with normal functioning

Question 3

analgesic

Answer 3

prescribed for the relief of pain

Question 4

opioid aka

Answer 4

narcotic aka

Question 5

acute pain

Answer 5

mild, moderate, severe

typically associated with specific tissue injury

Question 6

chronic pain

Answer 6

vague origin, onset with prolonged duration

Question 7

nociceptor pain

Answer 7

pain originating from tissue injury

somatic and visceral pain

Question 8

somatic pain

Answer 8

bone & muscle

Question 9

visceral pain

Answer 9

organ

Question 10

neuropathic pain

Answer 10

• unusual sensory disturbance often involving neural supersensitivity
• due to injury or disease of the peripheral or central nervous system

Question 11

antipyretic effect

Answer 11

lowers elevated body temperature

Question 12

OTC NSAIDS (x3)

Answer 12

aspirin
ibuprofen
naproxen

Question 13

aspirin contraindications

Answer 13

• contraindicated for any elevated temperature, due to danger of Reye’s Syndrome
• children under 2yo (or 12 yo according to book?!)

Question 14

Reye’s Syndrome

Answer 14

• childhood illness associated with ASA
• neurologic problems (encephalopathy, liver degeneration) associated with viral infection treated with salicylates

DON’T GIVE ASPIRIN TO CHILDREN UN

Question 15

Inhibition of COX-1

Answer 15

Decreases protection of stomach lining

Decrease platelet aggregation

Question 16

Inhibition of COX-2

Answer 16

Decreases inflammation and pain

Question 17

Cyclooxygenase

Answer 17

Converts arachadonic acid into prostaglandins and their products

• promotes thromboxane synthesis

Question 18

Prostaglandin effects

Answer 18

• activation of inflammatory response
• fever
• vasodilation
• relax smooth muscle
• increased capillary permeability
• sensitization of nerve cells to pain
• proliferation of WBC to damaged tissues
• induces labor, other reproductive processes
• clotting and anti-coagulation
• inhibit gastric acid synthesis, increase mucus secretion-
• increase blood flow in kidneys
• promote constriction of bronchi (asthma)

Question 19

Salicylic acid

Answer 19

Important active metabolite of aspirin (acetylsalicyclic acid -> prodrug to SA)

Question 20

Metabolite

Answer 20

Any substance produced during metabolism or may also refer to product remaining after drug is broken down

Question 21

7 groups of NSAIDs

Answer 21

FIRST GEN

1. Salicylates
2. Para-chlorobenzoic acid derivatives, or indoles
3. Phenylacetic acids
4. Propionic acid derivatives
5. Fenamates
6. Oxicams

SECOND GEN
7.Selective COX-2 inhibitors

Question 22

Aspirin aka

Answer 22

Acetylsalicylic acid, ASA

Question 23

Acetominophen aka x2

Answer 23

Paracetamol

APAP (N-acetyl-p-aminophenol)

Question 24

2nd generation NSAIDs

Answer 24

COX-2 inhibitors

Question 25

Good for fever

Answer 25

Aspirin, ibuprofen, acetominophen

Question 26

COX-1

Answer 26

- protects stomach lining - promotes platelet aggregation - in all tissues

Question 27

COX-2

Answer 27

Triggers pain and inflammation | - at site of tissue injury

Question 28

5 cardinal signs of inflammation

Answer 28

``` H eat E dema L oss of function P ain R edness ```

Question 29

NSAID effects

Answer 29

- reversibly inhibit COX-1 and COX-2 enzymes - decrease formation of prostaglandin - inhibit chemotaxis (lymphocyte activity, neutrophil aggregation)

Question 30

NSAID indications

Answer 30

- analgesic (CNS & peripheral effect) - antipyretic (CNS effect) - antiinflammatory (act locally) - antiplatelet (irreversible; CVA & MI prophylaxis - mostly COX-1 inhibitors)

Question 31

salycylism

Answer 31

aspirin toxicity

Question 32

salycylism S&S

Answer 32

- headache - tinnitus - diaphoresis - disequilibrium - CNS alterations - hyperventilation s/t acid-base disturbances - nausea, vomiting - dehydration - cardiovascular collapse: coma, convulsions, death

Question 33

salycylism treatment

Answer 33

- decrease absorption (charcoal, emetics, gastric lavage) ONLY EFFECTIVE IF RECENTLY INGESTED - supportive measures: F&E support, sodium bicarbonate - enhance excretion: alkalinize urine, force diuresis, hemodialysis

Question 34

ASA MOA

Answer 34

Protein bound in blood (harder to get rid of)

Question 35

Drugs to watch out for due to potential salicylism

Answer 35

Alkaseltzer Lortab Percodan

Question 36

Acetaminophen major metabolism pathway

Answer 36

Converts APAP to nontoxic form

Question 37

Acetaminophen minor metabolism pathway

Answer 37

CyP450 converts to toxic <--- ETOH SLOWS DOWN

Question 38

APAP MOA

Answer 38

Inhibits prostaglandin in CNS

Question 39

APAP max dosage

Answer 39

10-15 mg/kg/dose | 4g/day (2 if alcoholic)

Question 40

Celebrex

Answer 40

Celecoxib, COX-2 inhibitor (2nd gen NSAID)

Question 41

Celebrex indications

Answer 41

Osteoarthritis, rheumatoid arthritis

Question 42

Mucomyst

Answer 42

acetylcysteine hepatoprotective, APAP antidote restores glutathione

Question 43

Mucomyst indications

Answer 43

- protect nephropathy during IV contrast procedure | - APAP overdose