Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Analgesics > Flashcards

Analgesics Flashcards

1
Q

An analgesic is…

A

an agent that relieves pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pain is a subjective experience.

A

“Pain is defined as whatever the patient says it is, wherever and whenever the patient says it is.”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pain Scale:

A

Generally 1-10

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pain Threshold

A

Physical element

how much pain is your body used to; what you’re feeling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Pain Tolerance

A

Psychological element

in your head, what can you live with; easier to affect; experience

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Can have chronic pain with…

A

… acute flare-ups

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Adjuvant Therapy

A

Assist primary agents in relieving pain = smaller doses

  • decrease side effects
  • approaches pain stimulus from another mechanism = synergistic effect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Synergistic

A

work together to achieve a better outcome; other ways to deal with pain - ice, heat, massage, relaxation technique
-Pharm - an anti-depressant might increase pain tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Drug Tolerance

A

chemical; need progressively high doses to maintain same analgesic effect

having to bump up the dose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Drug Dependence

A
  • Psychological: pattern of compulsive drug use; euphoria rather than pain relief
  • Physical: sudden withdrawal of medication = withdrawal symptoms
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Rebound Pain

A

Pain has returned and is worse than it was before

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Withdrawal Symptoms

A
  • Rebound pain, tachycardia, elevated BP, mental agitation

- Opioid withdrawal: anxiety, irritability, chills, hot flashes, joint pain, N/V, abdominal cramps, diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Moral/Ethical Considerations

A
  • Placebos

- Chronic pain/terminal pain: fear of addiction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Administration

A
  • PO, IM, IV, topical

- PCA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

PCA

“Patient Controlled Analgesia”

A

Smaller doses that can be given more frequently that stabilize pain more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Analgesic Agents

A

Opioids (narcotics); non-opiods (non-narcotics); NSAIDs, others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Opioid Analgesics

Narcotics

A
  • All considered “controlled substances”
  • From the opium poppy plant
  • Multiple opioid receptors: mu, kappa, sigma, delta, epsilon
  • Endorphins: (endogenous morphine) natural internal mechanism of pain control
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Controlled Substances

A

Dr. must write the order, no refills

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Opioid Receptors are?

A
  • Mu
  • Kappa
  • Sigma
  • Delta
  • Epsilon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Endogenous Morphine would be considered

A

A ‘Runner’s High”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Opioid Agonists

Narcotics

A

Fall under the category of Opioid Analgesics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Opioid Agonists mechanism of action?

A
  • Achieve beneficial effects by their actions on the CNS

- Also act outside the CNS, which is where unwanted effects occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Opioid Agonists indications?

A
  • Alleviate sever to moderate pain (top of the charts, strongest)
  • Cough suppressant - codeine, hydrocodone
  • Antidiarrheal preparations (prescribe the drug for its side effect)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Opioid Agonists contraindications?

A
  • Allergy
  • Severe asthma, respiratory insufficiency
  • Conditions involving elevated intracranial pressure (ICP)
  • Pregnancy

This drug decreases breathing
ICP - watch neuro signs
LOC will be down already and opioids decrease LOC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Opioid Agonists side effects and adverse effects?

All of the side effect

A
  • Euphoria, “high”, dizzy, lightheadedness, sedation
  • Hypotension, flushing, palpitations
  • N/V, constipation, urinary retention
  • Respiratory depression, aggravation of asthma
  • Dependence; physical and psychological; large amounts, extended period
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Opioid Agonists side effects and adverse effects?

NEED TO KNOW

A
  • Sedation
  • Constipation
  • Respiratory Depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Opioid Agonists interactions?

A
  • Co-administration with alcohol, antihistamines, barbiturates, benzodiazepines, phenothiazines, or other CNS depressants = additive respiratory depressant effects
  • With MAOIs = respiratory depression and hypotension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Opioid Agonists Examples

A
  • Morphine
  • Dilaudid (hydromorphone)
  • Demerol (meperidine) - not used often anymore
  • Codeine - has to go thru 1st pass effect - ORAL ONLY
  • Oxycontin (oxycodone)
  • Ultram (tramadol) - mild narcotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Opioid agonists bind with…

A

… opioid receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

The receptor that generally causes the “happiness” effect?

A

Mu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Ultram (tramadol)

A

In some states it’s a controlled substance

Was originally classified as a “non-narcotic analgesic”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Combination Opioid Analgesics
(very common; PO narcotics)

(Opioid Analgesics)

A
  • Narcotics combined with aspirin (ASA) or acetaminophen (APAP, tylenol)
  • Work synergistically with the narcotics, use less narcotic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Combination Opioid Analgesics Examples

A

-Tylenol #3: Codeine with Tylenol
-Percocet: Oxycodone with Tylenol
-Percodan: Oxycodone with ASA
(Only one that still is combined with aspirin)
-Vicodin/Lortab: Hydrocodone with Tylenol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Patient Education for Combination Opioid Analgesics

A

When on combination meds, must instruct them to not take any other OTC aspirin or tylenol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Opioid Partial Agonists (agonist-antagonists)

half & half

(Opioid Analgesics)

A
  • Bind to mu receptors and compete with agonists - block mu receptors
  • Potent synthetic analgesics
  • Misuse potential and addiction liability is less
  • Antagonistic activity can produce withdrawal symptoms in opioid dependent patients
36
Q

Opioid Partial Agonists Examples

A
  • Stadol
  • Nubain
  • Talwin
37
Q

Opioid Antagonist

Opioid Analgesics

A

Naloxone Hydrochloride (Narcan)

*only reverse opioids

38
Q

Naloxone Hydrochloride (Narcan)

A

-Pure opioid antagonist; blocks opioid receptors
-Does not produce sedan or respiratory depression (reverses all of it)
-Drug of choice:
*complete or partial reversal of opioid induced
respiratory depression
*diagnosis of suspected opioid overdose
-Very short half life

39
Q

Narcan very short half life…

A

… Could come back and seem fine, but could go back to unresponsiveness

40
Q

Narcan is an emergency med that works…

A

…within minutes

41
Q

Narcan Scenario:

A

Come into ER unresponsive and they suspect overdose on narcotics, they give you an opioid antagonist (Narcan)

42
Q

Opioid Dependence

A

-Methadone - an opioid; no euphoria but prevents withdrawal symptoms

  • Should also be on withdrawal counseling
  • Suboxone - new opioid dependent drug
43
Q

NonOpioid Analgesics

Non-narcotic analgesics

A

Acetaminophen (Tylenol) : APAP

44
Q

Acetaminophen (Tylenol) APAP

NonOpioid Analgesic

A
  • Analgesic, antipyretic
  • NOT an anti-inflammatory
  • Very few allergies
45
Q

Acetaminophen (Tylenol): APAP indications

NonOpioid Analgesic

A
  • Fever

- Mild to moderate pain

46
Q

Be careful with Acetaminophen (Tylenol): APAP because…

A

…Patients may say they are allergic to tylenol because they really want a narcotic

47
Q

Acetaminophen (Tylenol): APAP overdose

A
  • Potentially lethal drug when overdosed

- Causes hepatic necrosis (kills your liver); hepatic toxicity; nephropathy (kidney)

48
Q

Acetaminophen (Tylenol): APAP antidote?

A

Antidote: Acetylcysteine (Mucomyst)

  • Oral that you have to drink
  • Smells like rotten eggs
  • Drink a cup of it every hour
  • Must put a lid on it with a straw because of the smell
49
Q

Acetaminophen (Tylenol): APAP overdose fact:

A

One of the most deadly drugs to overdose on

50
Q

Anti-Inflammatory Agents

A
  1. Steroids

2. NSAIDs

51
Q

Steroids are what kind of agent?

A

Anti-inflammatory agents

52
Q

Steroid indications

anti-inflammatory agent

A
  • Bronchial inflammation
  • Allergic inflammation
  • Joint inflammation

-Have lots of side effects, only used in specific cases and for short term therapy

53
Q

NSAIDs are what kind of agent?

A

Anti-inflammatory agents

54
Q

NSAIDs acronym?

A

not-steroidal anti-inflammatory drugs

55
Q

NSAIDs (x1)

A
  • Most commonly prescribed drugs; 70 million prescriptions each year
  • 23 different agents
  • Patients may respond better to one agent than to another (a lot of inter-client variability)
  • Possess analgesic, anti-inflammatory, anti-rheumatic, and antipyretic activity
56
Q

NSAIDs (x2)

A
  • Used for the relief of mild to moderate pain
  • Most common and first drug - salicylic acid = acetylsalicylic acid = aspirin; most widely used drug in the world
  • Potential major toxicologic effects = GI intolerance, bleeding, and renal (kidney) impairment with long therm therapy
57
Q

Main side effect of aspirin is?

A

GI upset

58
Q

NSAIDs mechanism of action?

A

-“Prostaglandin inhibitors” - part of inflammatory process
-Prostaglandins and leukotrienes
*major contributors to the symptoms of
inflammation; including pain, fever and H/A
-Products of arachidonic acid pathway (pain pathway)

59
Q

NSAIDs indications?

A
  • Pain, gout; inflammation; fever
  • Vascular headaches, platelet inhibition; rheumatoid arthritis, osteoarthritis; inflammatory syndromes
  • When used concomitantly with opioids; less side effects from opioid (dosage is less)
  • Specific drugs work better for some things
60
Q

NSAIDs contraindications?

A
  • Allergy
  • Conditions that include risk of bleeding: peptic ulcer disease
  • Not advised for pregnancy in 3rd trimester because risk of bleeding
61
Q

NSAIDs side effects and adverse effects?

A
  • GI distress

- Precipitate acute or chronic renal failure

62
Q

NSAID side effect scenario..

A

…If you see the beginning of renal failure and they are on an NSAID, you need to question why they are taking it

63
Q

NSAIDs interactions?

A
  • Alcohol, anticoagulant, steroids = increased GI distress
  • Hypotensive agents, diuretics = reduced hypotensive and diuretic effects

*if you go on a steroid you will want to stop your NSAID use

64
Q

NSAIDs toxicity and overdose?

A

Chronic Intoxication = (short-term high doses; long term high or lower doses) hearing loss, tinnitus; metabolic acidosis and respiratory alkalosis; hypoglycemia

65
Q

NSAIDs antidote?

A

No drug antidote, supportive
-Activated charcoal - absorb; fluids, electrolytes, and bicarb; increase elimination; hemodialysis

activated charcoal = it’s charcoal, black, thick, gets everywhere; blocks EVERYTHING (any overdose)

66
Q

NSAID examples?

A
  1. Salicylates
  2. Ibuprofen and Ibuprofen like
  3. COX-2 Inhibitors
67
Q

Salicylates are an example of?

A

NSAIDs

68
Q

Salicylates

NSAID example

A
  • Aspirin (acetylsalicylic acid, ASA)
    • First ever NSAID
    • Only NSAID with anti-platelet abilities
69
Q

Ibuprofen and Ibuprofen like are examples of?

A

NSAIDs

70
Q

Ibuprofen and Ibuprofen like

NSAID examples

A

-Motrin (ibuprofen)
-Orudis (ketoprofen)
-Naprosyn, Aleve (naproxen)
-Toradol (Ketoralac) - can be given IM & IV, only
NSAID that can
-Clinoril (sulindac)
-Indocin (indomethacin)

71
Q

COX-2 Inhibitors are an example of?

A

NSAIDs

72
Q

COX-2 Inhibitors

NSAID example

A

-Celebrex (celecoxib)

  • Are NSAIDs but specifically block COX-2 receptors
  • Treats really bad arthritis pain, but need to be monitored closely for heart issues

Weigh pros (arthritis pain) and cons (heart attack/issues)

73
Q

Agents to treat migraines?

A
  1. Triptans

2. Ergot alkaloids

74
Q

Triptans are used to?

A

Treat migraines

75
Q

Triptans (serotonin agonists)

A

-Drugs of choice
Oral, SQ, intranasal
-Thought to act by constricting certain intracranial vessels

76
Q

Triptans (serotonin agonists) side effects?

A
  • Dizziness
  • Drowsiness
  • Rarely severe
77
Q

Triptans (serotonin agonists) contraindications?

A
  • Recent MI
  • Hypertension
  • Angina
  • DiabetesBecause of vasoconsrictive properties
78
Q

Ergot Alkaloids are used to?

A

Treat migraines

79
Q

Ergot alkaloids (adrenergic, dopaminergic & serotonin agonists)

A
  • Only for those unresponsive to triptans
  • Multiple actions and side effects
  • Multiple routes of admin: PO, SL, SQ, suppository, Nasal spray
80
Q

Headaches may be caused by?

A

Maybe some sort of vasodilation in the brain, so blood rushes into the brain, but there is no where for it to go.

81
Q

Miscellaneous Agents

A

Antineurolgics (therapeutic classification) still in post-marketing surveillance

82
Q

Antineurolgics mechanism of action?

A

Work differently in the CNS to decrease excitatory neurotransmitter release (also anticonvulsants)

Originally used to treat seizures

83
Q

Antineurolgics indications?

A
  • Nerve pain
  • Peripheral neuropathy
  • Fibromyalgia
84
Q

Antineurolgics contraindications?

A

Allergy

85
Q

Antineurolgics side effects?

A
  • Dizziness
  • Ataxia (unstable gate)
  • Drowsiness
  • Fatigue
  • Peripheral edema
86
Q

Antineurolgics Examples?

A
  • Neurontin (gabapentin)

- Lyrica (pregabapentin)

87
Q

Antineurolgics can lead to…

A

People develop a drug tolerance, quickly, to antineurolgics

Pharmacology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions