3. Analgesics Flashcards

1
Q

Where do we see prostaglandins in the body? Locally or throughout the body?

A

Locally

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2
Q

____ is thought to sensitize nerve endings to the action of bradykinin (seen in ACE inhibitors), histamine, and other chemical mediators.

A

PGE2

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3
Q

What are the common adverse side effects of Acetaminophen?

A

Nausea, rash and headache

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4
Q

what other serious side effects can Acetaminophen produce?

A
Acute hepatotoxicity (>4g/tid)
Acute renal tubular necrosis, chronic analgesic nephropathy.
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5
Q

What is the drug interactions of Lidocaine Topical in the presence of Acetaminophen?

A

Additive methemoglobinemia. This drug increases the oxygen binding affinity. Therefore, oxygen is refuse to leaves, which then leads to hypoxia.

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6
Q

What is the mechanism of action of Ibuprofen?

A

inhibits COX, reducing PG (inflammation) and TXA2 (platelet aggregation) synthesis.

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7
Q

What is the drug interactions of ASA NSAIDs and Acetaminophen in the presence of Ibuprofen?

A

Additive hemorrhagic risk

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8
Q

What is the drug interactions of Cyclosporine and Acetaminophen in the presence of Ibuprofen?

A

Additive nephrotoxicity

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9
Q

What is the indications for Celecoxib?

A

Arthritis, Ankylosing Spondylitis, Dysmenorrhea, Acute pain

Dosing [50-400mg]… 200mg qd-bid

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10
Q

the mechanism of actions of Celecoxib is selectively inhibits ____ and reduces ____ synthesis.

A

COX-2, PG

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11
Q

Which NSAIDs has Black Box Warnings?

A

CV: Stroke, CHF, MI
GI: Bleed, ulceration/perforation

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12
Q

What is the drug interactions of NSAIDs (esp Ketorolac), Corticosteroids in the presence of Celecoxib?

A

Hemorrhage

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13
Q

What is the drug interactions of Azoles in the presence of Celecoxib?

A

impaired metabolism

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14
Q

T/F Celecoxib is contraindicated in sulfonamide allergies.

A

True. Same as with Furosemide.

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15
Q

T/F Celecoxib is contraindicated in sulfonamide allergies.

A

True. Same as with Furosemide.

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16
Q

Neurogenic pain responds best to ________ or ________.

A

anticonvulsants (anti-seizure), antidepressants (tricyclic antidepressant “non-selective”)

17
Q

Which drug is the most prescribed Opiods?

A

Hydrocodone/Acetaminophen

18
Q

What is the dosing for Hydrocodone/Acetaminophen?

A

5mg/500mg

1-2 tabs q4-6h; max 8 tabs/day

19
Q

What is the mechanism of Hydrocodone?

A

Act through G-Protein-Coupled Mu, Kappa & Delta ‘opioid’ receptors; inhibit adenylyl cyclase activity; enhance K+ outflow; hyperpolarize nerves affecting neuronal excitability and muscle tone
Stimulate prolactin and growth hormone release

20
Q

T/F It’s ok to give patients Opioids when they have blunt trauma to the head.

A

False. It will elevate intracranial pressure, enhanced with head trauma.

21
Q

What are the notable adverse effects of Hydrocodone?

A

CNS: drowsiness (tolerance in about 1 wk), mood changes (quick tolerance); elevated intracranial pressure, enhanced w/ head injury
CV: bradycardia/tachycardia; orthostatic hypotension
Respiratory: dose-related respiratory depression at brain stem respiratory center

22
Q

What is the classic side effect of Opioids?

A

Constipation. Ileum portion of the large intestine is paralyzed.

23
Q

T/F Opioids don’t cause flushing throughout the body.

A

False. It does.

24
Q

Tramadol have a similar mechanism of action with which of the drugs?

A

SNRI. inhibitor of NE/5-HT reuptake

25
Q

What is the most common side effect of Tramadol?

A

Pruritus is the common side effect of this drug.

26
Q

Tramadol causes orthostatic hypotension just like which analgesics?

A

hydrocodone

27
Q

Can Tramadol cause breathing problems?

A

Yes. Bronchospasm is one of the notable adverse effects of this drug.

28
Q

Acetaminophen act by inhibiting ______ and enhancing ______ release.

A

COX, 5-HT (attenuated pain mediator generation)

29
Q

Acetaminophen regulates body temperature by acting centrally at the __________, which inhibits ____synthetase.

A

Hypothalamus, PG

30
Q

Hydrocodone mainly act as a _____ and _____.

A

Painkiller, cough suppressant

31
Q

What is the drug interactions with anticholinergic in the presence of Hydrocodone/acetaminophen?

A

Additive constipation

32
Q

What is the drug interactions between argon if anhydrase inhibitors (CAI) with hydrocordone/acetaminophen?

A

Acetaminophine inhibits renal excretion of CAI, leading to CNS toxicity, metabolic acidosis.

33
Q

Tramadol is a central acting ______ opioid analgesic.

A

Synthetic