Analgesic

Question 1

Aspirin

Answer 1

NSAID

Aspirin has analgesic, antipyretic, anti-inflammatory and antiplatelet actions. It is a nonselective NSAID, preventing synthesis of prostaglandins by non-competitively inhibiting both forms of cyclo-oxygenase (COX), COX‑1 and COX‑2.

Question 2

Paracetamol

Answer 2

Not fully determined. Mechanisms involved in its analgesic effect may include inhibition of central prostaglandin synthesis and modulation of inhibitory descending serotonergic pathways. The antipyretic effect is probably due to reduced production of prostaglandins in the hypothalamus. Paracetamol has negligible anti-inflammatory effects.

Question 3

Ibuprofen

Answer 3

NSAID

Have analgesic, antipyretic and anti-inflammatory actions. They inhibit synthesis of prostaglandins by inhibiting cyclo-oxygenase (COX) present as COX‑1 and COX‑2:

inhibition of COX‑1 results in impaired gastric cytoprotection and antiplatelet effects
inhibition of COX‑2 results in anti-inflammatory and analgesic action
reduction in glomerular filtration rate and renal blood flow occurs with both COX‑1 and COX‑2 inhibition.
Most NSAIDs are nonselective, inhibiting both COX‑1 and COX‑2. Although selective COX‑2 inhibitors have little or no effect on COX‑1 at therapeutic doses, they are still associated with GI adverse effects.

Question 4

Buprenorphine

Answer 4

Opioid - Partial agonist

Opioid analgesics act on receptors in the CNS and GIT producing analgesia, respiratory depression, sedation and constipation. They act mainly at mu-opioid receptors in the CNS, reducing transmission of the pain impulse, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.

Question 5

Codeine

Answer 5

Opioid agonist

Opioid analgesics act on receptors in the CNS and GIT producing analgesia, respiratory depression, sedation and constipation. They act mainly at mu-opioid receptors in the CNS, reducing transmission of the pain impulse, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.

Question 6

Fentanyl

Answer 6

Opioid agonist

Opioid analgesics act on receptors in the CNS and GIT producing analgesia, respiratory depression, sedation and constipation. They act mainly at mu-opioid receptors in the CNS, reducing transmission of the pain impulse, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.

Question 7

Hydromorphone

Answer 7

Opioid agonist

Opioid analgesics act on receptors in the CNS and GIT producing analgesia, respiratory depression, sedation and constipation. They act mainly at mu-opioid receptors in the CNS, reducing transmission of the pain impulse, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.

Question 8

Methadone

Answer 8

Opioid agonist

Opioid analgesics act on receptors in the CNS and GIT producing analgesia, respiratory depression, sedation and constipation. They act mainly at mu-opioid receptors in the CNS, reducing transmission of the pain impulse, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.

Question 9

Morphine

Answer 9

Opioid agonist

Opioid analgesics act on receptors in the CNS and GIT producing analgesia, respiratory depression, sedation and constipation. They act mainly at mu-opioid receptors in the CNS, reducing transmission of the pain impulse, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.

Question 10

Oxycodone

Answer 10

Opioid agonist

Opioid analgesics act on receptors in the CNS and GIT producing analgesia, respiratory depression, sedation and constipation. They act mainly at mu-opioid receptors in the CNS, reducing transmission of the pain impulse, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.

Question 11

Pethidine

Answer 11

Opioid agonist

Opioid analgesics act on receptors in the CNS and GIT producing analgesia, respiratory depression, sedation and constipation. They act mainly at mu-opioid receptors in the CNS, reducing transmission of the pain impulse, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.

Question 12

Tapentadol

Answer 12

Opioid agonist

Opioid analgesics act on receptors in the CNS and GIT producing analgesia, respiratory depression, sedation and constipation. They act mainly at mu-opioid receptors in the CNS, reducing transmission of the pain impulse, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.

Binds to mu opioid receptors and also inhibits noradrenaline reuptake.

Question 13

Tramadol

Answer 13

Opioid agonist

Opioid analgesics act on receptors in the CNS and GIT producing analgesia, respiratory depression, sedation and constipation. They act mainly at mu-opioid receptors in the CNS, reducing transmission of the pain impulse, and by modulating the descending inhibitory pathways from the brain. Cough suppression occurs in the medullary centre of the brain.

Binds to mu opioid receptors and also inhibits reuptake of noradrenaline and serotonin.