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Pharmacology HOSA > Analgesics > Flashcards

Analgesics Flashcards

1
Q

Salycilates properties

A

Antipyretic, analgesic, anti-inflammatory

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2
Q

Salicylate MOA

A

antipyretic: Decrease body temperature by dilating peripheral blood vessels, analgesic: inhibit prostaglandins,

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3
Q

Salicylate indications

A

Prolong bleeding time, mild-moderate pain, maintain pregnancy, rheumatoid arthritis, osteoarthritis, rheumatic fever, reducing elevated body temperature

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4
Q

Salicylate ex

A

Aspirin, magnesium salicylate, sodium salicylate

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5
Q

Aspirin interactions

A

Valproic acid, beta blockers, ACE inhibitors, diuretics, anticoagulants

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6
Q

Acetaminophen classification

A

Nonsalicylate

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7
Q

Acetaminophen side effects

A

Leading cause of acute liver failure, potentially hepatoxic, skin eruptions, urticaria, hemolytic anemia, hypoglycemia, pancytopenia, jaundice

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8
Q

Acetaminophen considerations

A

Often found in other medications, preferred for elderly, may alter blood glucose test results

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9
Q

NSAIDs classification

A

Nonsalicylates

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10
Q

NSAIDs interactions

A

Decreased effectiveness of diuretics, anticoagulants increase risk of bleeding, increased effectiveness of lithium and possible lithium toxicity, increased effectiveness of cyclosporine, increase effectiveness of hydantoins, decreased effectiveness of antihypertensive drugs, increased risk of renal impairment with long term acetaminophen use

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11
Q

NSAIDs aren’t for people with

A

Impaired renal function, heart failure, increased risk of cardiovascular disease, relieve postoperative pain from a coronary artery bypass graft (CABG), 3rd trimester of pregnancy, lactation,

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12
Q

NSAIDs side effects

A

Dyspepsia (mild digestion disorder), nausea, heartburn, epigastric pain (upper, central, abdomen)

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13
Q

Topical analgesics indications

A

Strains and sprains

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14
Q

Topical analgesics ex

A

Camphor, menthol, methyl salicylate, methyl nicotinate, trolamine sacilylate, capsacin

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15
Q

Topical analgesics aren’t for people with

A

Anticoagulation therapy

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16
Q

Topical analgesics considerations

A

Don’t put tight bandages on area, don’t use with heating devices

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17
Q

NSAIDs MOA

A

Block COX enzymes, inhibit prostaglandin synthesis

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18
Q

NSAIDs indications

A

Mild-moderate pain, headaches, migraines, osteoarthritis, rheumatoid arthritis, sprains and strains, toothache, primary dysmenorrhea, fever

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19
Q

COX-1 primary side effects

A

GI- related

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20
Q

COX-2 primary side effects

A

Cardiovascular related

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21
Q

NSAIDs- COX-1 ex

A

Flurbiprofen, ketorolac (more GI side effects), ketoprofen, tolmetin, aspirin

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22
Q

Non-selective NSAIDs ex

A

Ibuprofen, naproxen

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23
Q

COX-2 selective NSAIDs ex

A

Indomethacin (more GI side effects), sulindac, piroxicam, mefenamic acid, meloxicam, diclofenac (more heart related side effects), celecoxib (more heart related side effects), etodolac

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24
Q

NSAIDs restrictions

A

Don’t use before or after heart surgery, most aren’t for kids under 18 (except ibuprofen), elderly more likely to have life threatening side effects

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25
Q

NSAIDs side effects

A

Can increase risk of heart attack or stroke, edema, hyperkalemia, high blood pressure, palpitations, heart failure, asthma, decreased neutrophil, hives, vertigo, seizures

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26
Q

Opioids MOA

A

Bind to mu, delta, or kappa receptors in CNS (change how patients perceived pain in the brain)

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27
Q

Opioid classes

A

Phenanthrenes, phenylheptylamines, phenylpiperdines

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28
Q

Opioids adminsitration

A

Well absorbed through subcutaneous, IM, oral, or transdermal patch, undergo 1st pass metabolism, excreted by kidneys

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29
Q

When to give opioids for analgesic purposes

A

Sever constant pain with terminal illnesses or cancer

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30
Q

What opioid for acute pulmonary edema

A

IV morphine

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31
Q

What opioid for diarrhea

A

Phenylpiperdines or synthetic opiates because of selective GI effects

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32
Q

Opioids for cough- adminstration and what drugs

A

Use of opioids for cough had decreased, but can use codeine, or dextrometorphan

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33
Q

When to give opioids for anesthesia

A

Most common use, used as adjunctive therapy, epidural, or in high risk surgeries to decrease cardiovascular depression

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34
Q

Opioids side effects general

A

Respiratory depression, decreased GI motility, miosis, pruritus, rash, urticaria, sweating, pain at injection site, and local tissue irritation

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35
Q

Opioids main concern

A

Tolerance and dependency

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36
Q

Strong opioid Agonists ex

A

Phenanthrenes: morphine, hydromorphone; phenylheptylamines: methadone; phenylpiperdines: fentanyl, meperidine

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37
Q

Mild to moderate opioid Agonists ex

A

Phenanthrenes: codeine, oxycodone, hydrocodone; phenylheptylamines: propoxyphene; phenylpiperdines: diphenoxylate, loperamide

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38
Q

Opioid mixed receptor actions

A

Nalpuphine, butorphanol, pentazocine

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39
Q

Opioid antagonists ex

A

Naloxone, naltrexone

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40
Q

Opioid antagonists MOA

A

Block effects of opioids by competitive binding (reverses all effects, not just a specific side effect)

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41
Q

Anesthesia considerations

A

Stop taking herbal supplements 2-3 weeks before surgery, discontinue aspirin and blood thinners before surgery

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42
Q

Cyclooxygenase

A

Enzyme responsible for prostaglandin synthesis, and contributes to integrity of stomach lining, pain and inflammation

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43
Q

Dysmenorrhea

A

Painful cramping during menstruation

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44
Q

Dysuria

A

Painful or difficult urination

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45
Q

Ecchymosis

A

Bruise like subcutaneous hemorrhage

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46
Q

5th vital sign

A

Inclusion of pain inquiry when temperature, pulse, respirations, and blood pressure readings are taken

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47
Q

Referred pain

A

Pain felt in an area remote from the site of origin, possibly along the same dermatome

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48
Q

Oliguria

A

Reduced urine output

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49
Q

Phenylketonuria (PKU)

A

A genetic birth defect causing the amino acid phenylalanine to build up toxic levels in the body

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50
Q

Polyuria

A

Increased urination

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51
Q

Purpura

A

Excessive skin hemorrhage causing red-purple patches under the skin

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52
Q

Somnolence

A

Excessive drowsiness or sleepiness

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53
Q

Stomatitis

A

Inflammation of a cavity opening, such as the oral cavity

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54
Q

Transient ischemic attack (TIA)

A

Temporary interference with blood supply to the brain causing symptoms related to the portion of the brain affected (ie temporary blindness, aphasia, dizziness, numbness, difficulty swallowing, or paresthesias), they may last a few moments to several hours, after which no neurological damage is evident

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55
Q

3 types of pain intensity scales

A

Simple descriptive pain intensity scale, 0-10 numeric pain intensity scale, visual analog scale (VAS)

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56
Q

Celecoxib risks

A

Increased risk of serious cardiovascular thrombosis, myocardial infection, and stroke

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57
Q

Which NSAIDS aren’t used for rheumatoid arthritis or osteoarthritis

A

Ketorolac, mefenamic, and meloxicam

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58
Q

Celecoxib contraindications

A

Allergy to sulfonamides, and history of cardiac disease or stroke

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59
Q

Ibuprofen contraindications

A

Hypertension, peptic ulceration, GI bleeding

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60
Q

Arthrotec combined what 2 drugs

A

Diclofenac and misoprostol

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61
Q

Arthrotec contraindications

A

Pregnancy

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62
Q

NSAIDs precautions

A

Pregnancy (cat B), elderly , bleeding disorders, renal disease, cardiovascular disease, and hepatic impairment

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63
Q

Migraine headache meds ex

A

Prophylactic treatment includes drugs from the following categories: beta blockers, CCBs, antidepressants, or anti epileptics, drugs include sumatriptan (most end in Triptan)

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64
Q

Maigraine headache meds actions

A

Activation of the 5-HT receptors causes vasoconstriction and reduces neurotransmission

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65
Q

Migraine headache meds adverse reactions

A

Dizziness, nausea, fatigue, pain, dry mouth, flushing, coronary artery vasospasm, cardiac arrhythmia, tachycardia, and myocardial infarction

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66
Q

Migraine headache meds contraindications

A

Allergy to selective serotonin Agonists

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67
Q

5-HT Agonists contraindications

A

Ischemic heart disease (ex: angina or myocardial infarction), TIAs, uncontrolled hypertension, people taking MAOIs

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68
Q

Migraine headache meds precautions

A

Hepatic or renal function impairment, elderly, patients requiring dialysis, pregnancy (cat C), lactating

69
Q

Ergot derivatives NSAIDs contraindications

A

HIV patients taking protease inhibitors, people taking macrolides

70
Q

5-HT Agonists interactions

A

Cimetidine and oral contraceptives increase effectiveness of 5-HT agonist

71
Q

Migraine headache sufferers with PKU should avoid

A

Rizatriptan and zolmitriptan

72
Q

Conduction block

A

Type of regional anesthesia produced by injection of a local anesthetic drug into or near a nerve trunk, (ex: epidural, transsacral, and brachial)

73
Q

General anesthesia

A

Sensation free state of entire body

74
Q

Local anesthesia

A

Provision of a pain free state in a specific body area

75
Q

Neuroleptanalgesia

A

Altered state of consciousness or sensation

76
Q

Preanesthetic drug

A

Pertaining to status before administration of an anesthetic drug

77
Q

Regional anesthesia

A

Injection of a local anesthetic around nerves to block sensation

78
Q

Spinal anesthesia process

A

Type of regional anesthesia produced by injection of a local anesthetic drug into the subarachnoid space of the spinal cord, results in a loss of feeling and movement in lower extremities, lower abdomen, and perenium

79
Q

Topical anesthesia use

A

Surface of the skin, open area or mucous membrane, may be used to desensitize the skin or mucous membrane to the injection of a deeper local anesthetic

80
Q

Topical anesthesia administration

A

Can use a cotton swab or spray directly on area, can also be dispensed transdermally for chronic pain relief

81
Q

Local infiltration anesthesia uses

A

It’s the injection of a local anesthetic drug into tissues. Common in dental procedures, suturing of small wounds, or making an incision in a small area

82
Q

Local infiltration anesthesia administration

A

In palliative care, can be given subcutaneously through a pump

83
Q

Spinal anesthesia use

A

Surgeries for lower limbs, such as a total knee replacement or hip surgery

84
Q

Epidural

A

Injection of local anesthetic in space surrounding the dura of the spinal cord

85
Q

Transsacral block (aka caudal block)

A

Injection of a local anesthetic into the epidural space at the level of the sacrococcygeal notch

86
Q

Brachial plexus block

A

Injection of a local anesthetic into the brachial plexus

87
Q

Epidural use

A

Obstetrics

88
Q

Transsacral block use

A

Obstetrics

89
Q

Brachial plexus block use

A

Surgery of arm or hand

90
Q

Preparing patient for local anesthesia

A

Explain process, ask allergy history, clean area with antiseptic, shave area, possible require patient to fast

91
Q

Anesthetics can be mixed with what to provide local vasoconstriction

A

Epinephrine

92
Q

Combined epinephrine and anesthetic contraindication

A

When local anesthetic is used on an extremity

93
Q

Local anesthetics ex

A

articaine, bupivacaine, chloroprocaine, lidocaine, mepivacaine, prilocaine, ropivacaine

94
Q

Preanesthetic drug ex

A

Opioid or anti anxiety, cholinergic blocking, antiemetic

95
Q

Opioid or anti anxiety drug use as a preanesthetic

A

To decrease anxiety and apprehension immediately before surgery

96
Q

Cholinergic blocking drug as a preanesthetic use

A

Decrease secretions of the upper respiratory tract

97
Q

Antiemetic drugs as a preanesthetic use

A

Decrease incidence of nausea and vomiting during the immediate postoperative recovery period

98
Q

Preanesthetic Drugs aren’t for

99
Q

Preanesthetic opioids ex

A

Fentanyl, meperidine, morphine

100
Q

Preanesthetic barbiturates ex

A

Secobarbital

101
Q

Preanesthetic cholinergic blocking drugs ex

A

Atropine, glycopyrrolate, scopolamine

102
Q

Anti anxiety drugs with antiemetic properties preanesthetics ex

A

Hydroxyzine

103
Q

Anti anxiety drugs preanesthetics ex

A

Diazepam, lorazepam, midazolam, chlordiazepoxide

104
Q

Sedative Drugs preanesthetic ex

A

Droperidol

105
Q

How is general anesthesia most commonly achieved

A

With anesthetic vapors of volatile liquids, which are inhaled a vapors or by nitrous oxide

106
Q

Stage 1 of general surgical anesthesia

A

Analgesia (induction): begins with administration and lasts until consciousness is lost

107
Q

Stage 2 of general surgical anesthesia

A

Delirium : patient may move and mumble incoherently, muscles are rigid, patient is unconscious and can’t feel pain, and noises are exaggerated

108
Q

Stage 3 of general surgical anesthesia

A

Surgical analgesia : divided into 4 planes. Plane 1 is light and plane 4 is deep, at plane 2 or 3, the patient is ready for the procedure

109
Q

Stage 4 of general surgical anesthesia

A

Respiratory paralysis : rare and dangerous stage of anesthesia, respiratory arrest and cessation of all vital signs may occur

110
Q

General anesthesia drugs ex

A

Barbiturates (methohexital),etomidate, propofol, benzodiazepines (midazolam), ketamine, nitrous oxide (gas), sevoflurane (volatile liquid), isoflurane (volatile liquid), desflurane (volatile liquid), fentanyl, droperidol, remifentanil

111
Q

General anesthesia muscle relaxants ex

A

Cisatracurium,pancuronium, succinylcholine

112
Q

Which drugs are used together to accomplish neuroleptanalgesia

A

Fentanyl and droperidol

113
Q

Aggregation

A

Clumping if blood elements

113
Q

Jaundice

A

Yellow discoloration of the skin because of liver disease

114
Q

Pancytopenia

A

Reduction in all cellular elements of the blood

115
Q

Prostaglandins

A

Fatty acid derivative found in almost every tissue and fluid of the body that affects the uterus and other smooth muscles, also thought to increase the sensitivity of peripheral pain receptors to painful stimuli

116
Q

Reye syndrome

A

Acute and potentially fatal disease of childhood, associated with a previous viral infection

117
Q

Salicylism

A

Adverse reaction to a salicylate characterized by dizziness, impaired hearing, nausea, vomiting, flushing, sweating, rapid and deep breathing, tachycardia, mental confusion, lassitude, drowsiness, respiratory depression, coma

118
Q

Acute pain

A

Brief, and lasts less than 3-6 months, usually subsides when the injury heals

119
Q

Chronic pain

A

Lasts more than 6 months and is often associated with specific diseases (cancer, sickle cell anemia, etc)

120
Q

How can the sensation of pain be modified

A

At the site (peripherally) when the cause is treated, or by modifying the signal in the brain (centrally)

121
Q

Aspirin MOA

A

Prolong bleeding time by inhibiting aggregation of platelets, more potently inhibits prostaglandin synthesis

122
Q

Aspirin uses

A

Decrease risk of myocardial infarction in those with unstable angina or previous myocardial infarction, reduce risk of transient ischemia of the brain because of fibrin platelet emboli, help maintain pregnancy in special at risk populations (low dose only)

123
Q

Salicylate side effects

A

Gastric upset, heartburn, nausea, vomiting, anorexia, GI bleeding (significant blood loss over time)

124
Q

Allergy to salicylates signs

A

Hives, rash, angioedema, bronchospasm with asthma like symptoms

125
Q

Salicylates contraindications

A

Allergy to NSAIDs, bleeding disorders or tendencies (GI bleeding, blood dyscrasias, anticoagulants, antineoplastic Drugs), pregnancy (cat C) and lactation

126
Q

Aspirin pregnancy cat

127
Q

Aspirin contraindications

A

Children or teens with influenza or chickenpox because it can be associated with reye syndrome

128
Q

Salicylates precautions

A

Lactation, hepatic or renal disease, pre existing hypothrombinemia, vitamin K deficiency, GI irritation (peptic ulcers), mild diabetes, gout

129
Q

Aspirin overdose results in

A

Salicylism

130
Q

Salicylates interactions

A

Anticoagulants increase risk of bleeding, increased serum level of NSAIDs, activated charcoal decrease absorption of salicylates, antacids decrease effects of salicylates, carbonic anhydride inhibitors increase risk for salicylism

131
Q

Differences between aspirin and acetaminophen

A

Aspirin is a salicylate, and possesses anti inflammatory and anticoagulant properties that acetaminophen doesn’t have

132
Q

Acetaminophen uses

A

Mild to moderate pain, reduce fever, managing pain and discomfort with arthritic disorders, aspirin allergy and works with people who have bleeding disorders (bleeding ulcer, hemophilia), people on anticoagulants or who have recently had minor surgery

133
Q

Acetaminophen overdose signs

A

Nausea, vomiting, confusion, liver tenderness, hypotension, cardiac arrhythmias, jaundice, and acute hepatic and renal failure

134
Q

Acetaminophen pregnancy cat

135
Q

Acetaminophen precautions

A

Severe or recurrent pain, or high and continued fever

136
Q

Acetaminophen interactions

A

Barbiturates, hydantoins, isoniazid, and rifampin increase risk of toxicity and decrease effect of acetaminophen, decreased effectiveness of loop diuretics, alcohol

137
Q

Agonist-antagonist

A

Drug with birth agonist and antagonist properties

138
Q

Cachectic

A

Malnourished, in poor health, physically wasted

139
Q

Compounding medications

A

Made under the super ion of a licensed pharmacist, combining, mixing, or altering the ingredients of a drug to create a medication tailored to the needs of an individual patient

140
Q

Miosis

A

Constriction of the pupil of the eye

141
Q

Opioid naive

A

No previous use or infrequent use of opioid medications

142
Q

Partial Agonists

A

Agent that binds to a receptor but produces a limited response

143
Q

Patient controlled analgesia

A

Drug pump and delivery system that allows patients to administer their own analgesic medication intravenously within a preset protocol

144
Q

Tolerance

A

The body’s physical adaptation to a drug

145
Q

Mu receptor effect with opioids

A

Supraspinal analgesia, respiratory and physical depression, miosis, reduced GI motility

146
Q

Delta receptor opioid responses

A

Dysphoria, psychotomimetic effects (hallucinations), respiratory and vaso otro stimulations caused by drugs with antagonist activity

147
Q

Kappa receptor opioid response

A

Sedation and miosis

148
Q

Most widely used opioid

A

Morphine sulfate

149
Q

Moderate to severe pain opioids ex

A

Meperidine and levorphanol

150
Q

Moderate pain opioids ex

A

Hydrocodone, codeine, pentazocine

151
Q

Opioids uses

A

Decrease anxiety and sedate patient before surgery, support anesthesia, promote obstetric analgesia, relieve anxiety in patients with dyspnea associated with pulmonary edema, control pain for extended periods without apparent loss of motor, sensory, or sympathetic nerve function, relieve myocardial infarction pain, manage opiate dependence, severe diarrhea and intestinal cramping, severe and persistent cough

152
Q

Opioids CNS side effects

A

Euphoria,weakness, headache, lightheadedness, dizziness, sedation, miosis, insomnia, agitation, tremor, increased intracranial pressure, impairment of mental and physical tasks

153
Q

Opioids respiratory system reactions

A

Depression of both rate and depth of breathing

154
Q

GI system opioid side effects

A

Nausea, vomiting, dry mouth, biliary tract spasms, constipation, anorexia,

155
Q

Cardiovascular opioid side effects

A

Facial flushing, tachycardia, bradycardia, palpitations, peripheral circulatory collapse

156
Q

Opioids side effects genitourinary

A

Urinary retention or hesitancy, spasms of the ureters and bladder spinchter

157
Q

Opioid side effect considerations

A

Respiratory system will adapt to side effects of opioids, but the GI system won’t

158
Q

Opioids contraindications

A

Acute bronchial asthma, emphysema, upper airway obstruction, head injury, increased intracranial pressure, convulsive disorders, severe renal or hepatic dysfunction, acute ulcerative colitis

159
Q

Opioids pregnancy cat

A

C, not recomendé use during pregnancy or labor because they may prolong labor or cause respiratory depression in the infant

160
Q

Oxycodone pregnancy cat

161
Q

Opioids precautions

A

Elderly, opioid naive people, biliary surgery, lactating, undiagnosed abdominal pain, supraventricular tachycardia, prostatic hypertrophy, and renal or hepatic impairment

162
Q

Opioids interaction

A

Alcohol, antihistamines, antidepressants, sedatives, and phenothiazines increase risk of CNS depression, opioid Agonist-antagonists increase risk of opioid withdrawal symptoms, barbiturates can cause respiratory depression, hypotension, or sedation

163
Q

Antagonist

A

Substance that counteracts the action of something else

164
Q

Cell surface receptor

A

Area built into the cell membrane which binds with chemical signs and causes a response by the cell

165
Q

Opioid antagonists uses

A

Postoperative acute respiratory depression, reversal of opioid adverse effects, suspected acute opioid overdosage

166
Q

Opioid antagonists side effects

A

Nausea, vomiting, sweating, tachycardia, increased blood pressure, tremors

167
Q

Opioid antagonists

A

Pregnancy (cat B), infants of opioid dependent mothers, patients with an opioid dependency or cardiovascular disease

168
Q

Opioid antagonists interactions

A

Prevent that action of opioid antidiarrheals, antitussives, and analgesics

Pharmacology HOSA (37 decks)

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