Analgesics: Part 1

Question 1

Analgesics

Answer 1

Drugs used for the relief of pain

Question 2

Non-opioid analgesics

Answer 2

Mild to moderate pain
Tylenol (acetaminophen)
NSAIDS

Question 3

Opioid analgesics

Answer 3

Moderate to severe pain

Narcotics

Question 4

Pain threshold

Answer 4

Level of stimulus needed to create a painful sensation

Question 5

Acetaminophen (Tylenol) uses

Answer 5

Analgesia

Antipyretic

Question 6

Acetaminophen CANNOT be used for..

Answer 6

Inflammation

Platelet aggregation

Question 7

Acetaminophen mechanism of action

Answer 7

Inhibits prostaglandin synthesis in the CNS

Question 8

Adverse effects of Tylenol

Answer 8

Rare at therapeutic doses

Question 9

Acetaminophen drug interactions

Answer 9

Alcohol

Warfarin

Question 10

If you take routing Tylenol, you should not…

Answer 10

Drink alcohol

Question 11

Acute toxicity of acetaminophen

Answer 11

Liver damage –> Hepatic necrosis

Question 12

Treatment for toxicity of acetaminophen

Answer 12

Acetylcysteine (Mucomyst)
If given 4-8 hours after overdose it will bind to Tylenol and allow it to be excreted from the body
100% prevention of severe liver injury

Question 13

Major pathway of acetaminophen

Answer 13

Therapeutic doses

Acetaminophen > Nontoxic metabolite

Question 14

Acetaminophen minor pathway

Answer 14

Overdose, acetaminophen > toxic metabolite (causes necrosis)

Question 15

1st generation drugs with anti-inflammatory properties (NSAIDS)

Answer 15

Aspirin
Ibuprofen
Naproxen

Question 16

2nd generation drugs with anti inflammatory properties (NSAIDS)

Answer 16

Celecoxib (Celebrex)

Question 17

NSAIDS stands for..

Answer 17

Nonsteroidal Anti-inflammatory Drugs

Question 18

Cyclooxygenase (COX)

Answer 18

Enzyme that converts arachidonic acid into prostaglandins

Question 19

Prostaglandins can cause…

Answer 19

Pretty profound inflammation

Question 20

COX 1

Answer 20

Beneficial

• Protects gastric mucosa
• Supports renal function
• Promotes platelet aggregation

Question 21

COX 2

Answer 21

Mediates inflammation

Sensitizes receptors to painful stimuli

Question 22

NSAIDS block…

Answer 22

COX 1 and COX 2 (hard on gut, kidneys and lately aggregation)

Question 23

First generation NSAIDS are widely used to..

Answer 23

Treat inflammatory disorders, mild to moderate pain and suppress fever

Question 24

First generation NSAIDS can have serious side effects because…

Answer 24

They cannot inhibit COX 2 without inhibiting COX 1

Question 25

Side effects of first generation NSAIDS

Answer 25

GI ulcers Bleeding tendencies Renal impairment

Question 26

Naproxen

Answer 26

Has a longer half-life (Aleve) | Take it once and it lasts all day

Question 27

Aspirin is used for ____ to ______ pain

Answer 27

Mild | Moderate

Question 28

Functions of aspirin

Answer 28

Nonselective COX inhibitor Anti-pyretic Protection against thrombotic disorders

Question 29

Aspirin: COX-2

Answer 29

Decreases pain, inflammation & fever

Question 30

Aspirin: COX-1

Answer 30

Protects against stroke and heart attack

Question 31

Therapeutic uses of aspirin

Answer 31

``` Suppression of inflammation Analgesia Reduction of fever Dysmenorrhea(menstrual cycle) Suppression of platelet aggregation Cancer prevention ```

Question 32

Aspirin: cancer prevention

Answer 32

Really high doses can reduce the risk of colorectal cancer

Question 33

Adverse affects of aspirin

Answer 33

``` GI effects Bleeding Renal impairment Salicylism Reye's Syndrome ```

Question 34

Salicylism

Answer 34

Deposits salycilates in ears which causes ringing in the eats, sick to stomach, excessive sweating, headache, nausea

Question 35

Reye's Syndrome

Answer 35

Use of aspirin for children with influenza or chicken pox

Question 36

Reye's Syndrome child mortality rate

Answer 36

20-30%

Question 37

Clinical features of Reye's Syndrome

Answer 37

Encephalopathy | Fatty liver degeneration

Question 38

Should a child ever take aspirin?

Answer 38

NO

Question 39

Aspirin drug interactions

Answer 39

Warfarin Glucocorticoids Alcohol Ibuprofen

Question 40

Aspirin-warfarin

Answer 40

Gastric hemorrhage

Question 41

Aspirin-glucocorticoids

Answer 41

Gastric ulcers

Question 42

Aspirin - alcohol

Answer 42

Gastric bleeding

Question 43

Aspirin- Ibuprofen

Answer 43

Decreases anti-platelet effects of aspirin

Question 44

Alcoholics should not take ______ or ______ for hangovers

Answer 44

Tylenol | Aspirin