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BNPH700 > Analgesic > Flashcards

Analgesic Flashcards

1
Q

What different analgesic medications are there?

A

Paracetamol
NSAID
Opioids Agonist
Opioid Antagonist
Synthetic Opioid

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2
Q

What are the 4 steps of the pain pathway?

A

Transduction
Inflammatory mediaters are released and activate
the first neuron , sends message for pain

Transmission
Neurons are firing (A delta fast, C slow)

Perception of pain

Modulation
Alters a pain signal as it is transmitted along the pain pathway

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3
Q

How many opioid receptors are there and what are they called?

A

Mu
Kappa
Delta

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4
Q

What is an example of an opioid agonist?

A

Morphine
Loperamide
Codeine

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5
Q

What is the indication of use for opioid medications, specifically Morphine?

A

Typically, Opioids are prescribed for the short-term treatment of moderately severe or severe pain, such as pain experienced following surgery or an injury. They can be prescribed for palliative care and chronic pain.

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6
Q

What is the MOA for opioid medications?

A

Spinal level: stimulates opioid receptor and inhibits substance p release from the dorsal horn neurons.

Supraspinal: closes dorsal horn gate inhibiting afferent transmission to cortex. Alter pain perception and response.

Stimulates mu receptors

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7
Q

What are some adverse drug reactions associated with Opioid medications?

A

Respiratory depression, Excessive sedation, Dysphoria, Constipation, Nausea & vomiting, Tolerance and Dependence, (histamine release) itch, bronchoconstriction, urinary retention, Euphoria

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8
Q

What patient education would you provide to someone who is on opioid medications?

A

Do not drink alcohol
This medication may be addictive with prolonged use, talk to Dr. if you feel it isn’t working for you anymore
Has sedation effects and may make you more sleepy than normal
This medication can make you constipated

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9
Q

What are some cautions/contraindications associated with opioids?

A

Interacts with alcohol, Monoamine oxidase inhibitor. Opioid antagonist. Avoid in head injury

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10
Q

What are the KEY monitoring requirement associated with opioids?

A

Bowels
Resp rate
Sedation
Nausea/Vomiting (input/output)

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11
Q

What slow releasing types of morphine are available?

A

m-Elson capsules, LA Morph tablets

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12
Q

What are some immediate releasing type of morphine which are available?

A

Severdol tablets or RA Morph solution

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13
Q

What must be available for IV morphine administration?

A

Naloxone and oxygen

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14
Q

How do morphine infusions occur? and what monitoring requirements are required?

A

Through a pump. Monitoring of respiratory rate as well as sedation recorded hourly throughout the infusion as can cause respiratory depression and sedation.

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15
Q

What is the indication of use for Loperamide?

A

Acute and chronic diarrhoea

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16
Q

What is the MOA for Loperamide?

A

Loperamide is synthetic opioid that binds to the opiate receptor in the gut wall. Consequently, it inhibits the release of acetylcholine and prostaglandins, thereby reducing propulsive peristalsis, and increasing intestinal transit time. Loperamide increases the tone of the anal sphincter, thereby reducing incontinence and urgency. Slows down the movement of the gut

17
Q

What are some adverse drug reactions associated with Loperamide?

A

Nausea, abdominal cramps, dizziness, drowsiness, urticaria (a raised, itchy rash that appears on the skin)

18
Q

What are some contraindications/cautions associated with Loperamide?

A

.

19
Q

What patient education would you provide to someone on Loperamide?

A

.

20
Q

What opioid antagonist can reverse opioid overdose?

A

.

21
Q

What is the MOA for Naloxone?

A

Reverse effect of opioid
- Half life of one hour which is shorter than opoid agonists

22
Q

What are some adverse drug reactions associated with Naloxone?

A

.

23
Q

What is an example of a Synthetic Opioid?

A

.

24
Q

What is the indication of use for Tramadol?

A

… weak opioid

25
Q

What is the MOA for Tramadol?

A

Stimulates mu receptors
Also Inhibits the reuptake of nor adrenaline and serotonin

26
Q

What are some adverse drug reactions associated with Tramadol?

A

Less risk of respiratory depression, euphoria, or addiction. Nausea and vomiting.
reduced seizure threshold, risk of serotonin toxicity (contraindicated when on MAOI’s or hx of seizures)

27
Q

What are some contraindications/precautions associated with Tramadol?

A

.

28
Q

What is a example of a Non-Steroidal anti-inflammatory drugs (NSAIDs)

A

Diclofenac sodium (Diclax SR, Voltaren)
Ibuprofen (Brufen)
Ketoprofen (Oruvail)
Mefenamic acid (ponstan)
Naproxen (Naprosyn)
Sulindac
Tenoxicam
Indomethacin

29
Q

What is the indicator of use for NSAIDS (Ibuprofen)?

A

Analgesic- mild to moderate pain
Antiplatelet
Ant inflammatory
antipyretic

30
Q

What is the MOA for NSAIDs?

A

Inhibit cyclooxygenase (COX) enzyme and therefore prostaglandin production
Prostaglandins have several physiological actions including the mediation of pain and inflammation and increasing body temperature.

31
Q

What are some contraindications for NSAIDs?

A

.

32
Q

What are some adverse drug reactions associated with NSAIDs?

A

Dizziness, drowsiness
Cognitive dysfunction, Renal impairment 2° ↓ blood flow, Hypersensitivity with asthmatics, Local gastric erosion + systemic effect, Potential for vasoconstriction

33
Q

What patient education would you provide to someone on NSAIDs?

A

Take with food
Do not administer with Aspirin
NSAIDs can alter the effect of other drugs eg digoxin, warfarin

34
Q

What is the indicator of use for paracetamol (acetaminophen)?

A

Analgesic
Opioid sparing
Antipyretic (??)

35
Q

What is the MOA for paracetamol?

A

Mechanism of action unclear!
Has both local and central action
Local action – COX inhibition
Central action- inhibition of prostaglandin synthesis in the CNS

36
Q

What are some adverse drug reactions associated with paracetamol?

A

weak anti-inflammatory effect
 ADRs rare (at recommended dosage)
 decreased risk of GI upset
 can be used by children
 can be used in pregnancy

37
Q

What is an adjuvant analgesic and can paracetamol be one?

A

“…any drug that has a primary indication other than pain but is analgesic in some painful conditions”

no

38
Q

What patient education would you provide to someone who is taking paracetamol?

A

Recommended daily adult dose = 4g
Available in IV formulation (Perfalgan)
Many cough and cold formulations contain Paracetamol
Different strengths of paediatric liquid formulations can cause errors in dosing
Overdose can cause hepatic necrosis

39
Q

How do you reverse Acute Hepatotoxicity for a paracetamol-induced overdose?

A

Acute hepatotoxicity can be reversed with acetylcysteine (parvalax), this drug works by preventing the hepatotoxic metabolites of Paracetamol from working.

BNPH700 (9 decks)

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