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Pharamacology > Analgesics > Flashcards

Analgesics Flashcards

1
Q

What is the MOA of Ibuprofen (NSAID)

A

Non-selective reversible inhibition of COX 1 and CoX 2 enzymes resulting in decrease pain

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2
Q

What are some ADRs of Ibuprofen (NSIAD)

A

Gastric irritation
Reduction in GFR leading to fluid retention
Prolonged bleeding time
Increased risk of MI and Asthma attacks

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3
Q

What is some patient education when giving Ibuprofen

A

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

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4
Q

What is the MOA of paracetamol

A

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

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5
Q

What are some ADRs of paracetamol

A

ADRs are rare but potential - weak inflammatory effect

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6
Q

What is some patient education when giving paracetamol

A

Lots of other over the counter medications contain paracetamol in them e.g cold and flu - caution with exceeding daily dose

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7
Q

What is an Opioid agonist

A

Morphine

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8
Q

What is an Opioid antagonist

A

Naloxone

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9
Q

What is the MOA of Morphine

A

activation of descending inhibitory pathways of the CNS as well as inhibition of the nociceptive afferent neurons of the PNS

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10
Q

What are some ADRs of Morphine

A

resp. depression, excessive sedation, dysphoria, constipation, nausea and vomiting, tolerance and dependence

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11
Q

What does Naloxone do?

A

Reverse the effect of an opioid

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12
Q

What assessments should be taken prior to prescribing Ibuprofen and what findings may led to a prescription being contraindicated

A

History of ulcer disease or GI bleeding
use of anticoagulants, steroids or other NSAIDS
Significant co-morbidities

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13
Q

What is the analgesic ladder

A

flowchart for the step-wise pharmacological management of pain
Step 1: 1-3 mild pain
Step 2: 4-6 moderate pain
Step 3: 7-10 severe pain

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14
Q

What are the different types of pain

A

Acute- sudden onset
Chronic - reoccurring difficult to treat
Nociceptive- Stimulation of receptors
Neurogenic - lesions orPNS/CNS
Psychogen

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15
Q

What serious adverse effect is possible from too much morphine. What is to be given?

A

Sedation and resp. depression. Naloxone should be given

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16
Q

Your patient feels sick and may vomit while on Morphine, what antiemetic should ideally be prescribed?

A

Metocloprimide, works on increasing gut motility along with central effect as dopamine antagonist
Avoid ondansetron - leads to constipation as does the opioid

17
Q

What does opioid Sparing mean?

A

Refers to the fact that with a non-opioid is combined with an opioid, the opioid dose can be lowered without compromising pain relief

18
Q

What is the MOA of tramadol

A

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

19
Q

What are some contraindications for Naloxone

A

Patient hypersensitivity to drug

20
Q

What are the contraindications of tramadol and Morphine

A

Conditions associated with increased intracranial pressure
Head injuries

21
Q

What are some contraindications to Ibuprofen

A

Hypersensitivity to aspirin or other NSAIDs
Severe HF
Hx of GI ulceration

22
Q

What are some contraindications for paracetamol

A

Severe hepatocellular insufficiency, hepatic failure, acute liver disease

23
Q

What is some patient education for Morphine and Tramadol

A

Avoid drinking alcohol, drowsiness avoid driving, addictive

24
Q

What is the MOA of Loperamide

A

Binds to opiate receptor in gut wall, reducing propulsive peristalsis, increasing intestinal transit time and enhancing resorption of water and electrolytes

25
Q

What are some ADRs of loperamide

A

nausea, abdominal cramps, dizziness, drowsiness,

26
Q

What are some contraindication of loperamide

A

conditions where peristalsis should be avoided

27
Q

What is some patient education when taking loperamide

A

take as directed
Can be taken with and with our food
Laxatives may react with loperamide

28
Q

What does Endogenous morphine

A

Elicits changes in endorphins

29
Q

Once a patient is given Naloxone what do you watch for

A

Vital signs, sedation score, VIP score

30
Q

Endogenous ligand

A

A small molecule that elicits a conformational change upon binding

Pharamacology (9 decks)

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