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pharm 2 > Analgesics > Flashcards

Analgesics Flashcards

1
Q

What receptors are responsible for the analgesic effects of opiates

A

Mu receptors

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2
Q

What drug class is morphine

A

opioid

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3
Q

What is a narcotic

A

A narcotic is an opioid (opiate) drug- dervived from unripe opium poppy (papaver somniferum)

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4
Q

What is the administration route of morphine

A

PO, PR, IM, IV

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5
Q

In which acute situation is morphine often used

A

acute MI because of the vasodilation, anxiolytic, and pain relief effects

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6
Q

What are common side effects of morphine (7)

A

respiratory depression, miosis, itching, constipation, paralytic ileus, N/V, dependence

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7
Q

What category is morphine

A

category C (may have adverse effects on fetus, but no human studies) Morphine crosses placenta and can cause dependance in fetus

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8
Q

How does Fentanyl (duragesic) differ from morphine

A

It is 80x more potent, which means it has a much greater respiratory depression

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9
Q

how is fentanyl administered

A

transdermal patch, lollipop or lozenge (sublingual), IV

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10
Q

what are side effects of fentanyl

A

constipation and paralytic ileus, N/V, addiction

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11
Q

What drug type cannot be used with fentanyl

A

concomitant CYP450 inhibitors can lead to fatal blood levels of fentanyl (like grapefruit juice)

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12
Q

What can effect the efficacy of the fentanyl patch

A

cutting the patch will mess up the timed release, and heating the patch affects the dose delivered as well

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13
Q

What are the uses of codeine

A

It is an anti-tussive in addition to being an analgesic

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14
Q

How does codeine compare to morphine

A

It is converted to morphine by the body, but is a much weaker analgesic. codeine is much better at cough relief.

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15
Q

what category is codeine

A

category C

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16
Q

what are common side effects of codeine

A

sedation, constipation, itching. ultra-rapid metabolizers can die from normal doses of codeine, essentially a morphine OD

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17
Q

What neuro effect does tramadol (Ultram) have

A

affects dopamine and serotonin as well as weak mu-receptor agonist, which makes the person tolerate pain better, as well as reducing pain

18
Q

how does heroin differ from morphine

A

it is more lipid soluble, and thus crosses BBB and induces a greater euphoric effect. it is 2x as potent, and way more addictive than morphine

19
Q

What is methadone used for

A

opioid used in the controlled withdrawal of heroin and morphine in addicted patients

20
Q

What is Naloxone (narcan) used for

A

opioid OD, reverses coma and respiratory depression

21
Q

What is the MOA of Naloxone (narcan)

A

Opioid ANTAGONIST bind with high affinity to opioid receptors but do not activate the receptor mediated response.

22
Q

What is dextromethorphan

A

The dextro-isomer of codeine

23
Q

How does dextromethrophan differ from codeine

A

It has little to no analgesic, sedative, or GI effects (non constipating)

24
Q

what drug class is Aspirin/ Acetylsalicylic acid (ASA)

A

NSAID

25
Q

Is aspirin a reversible or irreversible COX inhibitor

A

it is irreversible, thus no aspirin 14 days before surgery

26
Q

What is a risk of kids using aspirin

A

Reye’s syndrome, salicylism (dizziness, tinnitus, hyperventilation, craziness)

27
Q

Is ibuprofen (motrin, advil) reversible or irreversible COX inhibitor

A

reversible, so no platelet aggregation issues

28
Q

What drug class is celecoxib (celebrex)

A

NSAID, selective COX-2 inhibitor

29
Q

Why was vioxx (rofecoxib) pulled from the market

A

increased cardiovascular events after 7 months of use

30
Q

What class is acetaminophen (tylenol)

A

NSAID, inhibits COX-3

31
Q

What NEVER mixes with tylenol

A

alcohol

32
Q

What happens in an acetaminophen overdose

A

The byproduct NAPQI builds up in the liver and binds to vital proteins in the lipid bilayer in hepatocytes, causing cell death and necrosis

33
Q

What category is acetaminophen

A

category B

34
Q

How is acetaminophen antidoted

A

N-acetylcysteine administration ASAP

35
Q

What is the maximum dose of tylenol in the absence of any alcohol or liver disease (considered safe adult dose)?

A

4 grams/ 24 hours

36
Q

What is considered an overdose of tylenol?

A

> 7 grams/24 hours

37
Q

indication for celebrex?

A

inflammation, pain, treatment of adenomatous polyps, can also be used in people with peptic ulcers

38
Q

Which analgesic agent would not cause constipation?

A

dextromethorphan

39
Q

What DEA category is Heroin?

A

DEA category CI

40
Q

What are endogenously made opiates called?

A

Opiopeptins : endorphins, enkephalins

pharm 2 (18 decks)

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