Analgesics: Part 2

Question 1

Nonaspirin First -Generation NSAIDS have aspirin-like properties with fewer…

Answer 1

GI effects
Renal effects
Hemorrhagic effects

Question 2

Nonasprin First Generation NSAIDS inhibit..

Answer 2

COX 1 and COX 2

reversible inhibition

Question 3

Functions of Nonaspirin First-Genereation NSAIDS

Answer 3

Anti-inflammatories
Analgesia
Antipyretics

Question 4

Ibuprofen examples

Answer 4

Advil

Motrin

Question 5

Ibuprofen is used most for…

Answer 5

Fever
Arthritis
Dysmenorrhea

Question 6

Naproxen

Answer 6

Proonged half-lives

Dosing less frequent

Question 7

Indomethacin (Indocin) is usually used for..

Answer 7

Artritis

Gout

Question 8

Ketorolac trade name

Answer 8

Toradol

Question 9

Ketorolac (Toradol)

Answer 9

Powerful analgesic

Short term therapy (<5 days)

Question 10

Ketorolac (Toradol) is often used for..

Answer 10

Great adjunct therapy after C-section to limit narcotics

Question 11

Celecoxib (celebrex)

Answer 11

Selective COX-2 Inhibitor

Question 12

What does Celecoxib do?

Answer 12

Suppresses inflammation

Less GI side effects

Question 13

Adverse effects of celecoxib

Answer 13

Cardiovascular events

Renal impairment

Question 14

Celecoxib actually increases the risk of…

Answer 14

Heart attacks

Question 15

Celecoxib drug interactions

Answer 15

Coumadin (increased risk of bleeding)

Question 16

Celecoxib does have a _______ component so if you are allergic you cannot take it

Answer 16

Sulfa

Question 17

Opioids

Answer 17

Any drug, natural or synthetic, that has actions similar to those of morphine

Question 18

Opioid receptors

Answer 18

Mu

Kappa

Question 19

Mu receptors

Answer 19

Analgesia
Respiratory depression
Euphoria
Sedation

Question 20

Narcotics go in and..

Answer 20

Mimic our own endogenous pain relievers

Question 21

Usually pain is relieved in the body by..

Answer 21

Endorphins and enkephalins going in and activating pain relief

Question 22

Kappa receptors

Answer 22

Analgesia

Sedation

Question 23

Pure opioid agonists

Answer 23

Morphine
Meperidine (Demerol)
Fentanyl

Question 24

Agonist-antagonists

Answer 24

Butorphanol (Stadol)

Nalbuphine (Nubain)

Question 25

Pure opioid antagonists

Answer 25

Naloxone (Narcan)

Question 26

How do agonists-antagonists work?

Answer 26

Agonist activates receptor, antagonist blocks receptor

Question 27

Agonist-antagonists are _______ to the kappa receptors and _________ to the mu receptors

Answer 27

Agonists | Antagonists

Question 28

Why would agonists-antagonists be bad for addicts?

Answer 28

It would cause withdrawal

Question 29

Therapeutic use of morphine

Answer 29

Pain relief (Post-op, cancer, constant, dull pain)

Question 30

Morphine mechanism of action

Answer 30

Mimic actions of endogenous opioid peptides at mu receptors

Question 31

Morphine is administered...

Answer 31

PO, IM, IV, sublingual

Question 32

Is morphine lipid soluble?

Answer 32

No, crosses blood brain barrier minimally

Question 33

Morphine is inactivated by..

Answer 33

Hepatic metabolism

Question 34

Morphine has a _____ first pass effect

Answer 34

Large

Question 35

Roxanol

Answer 35

Trade name for morphine, can be given sublingually to bypass liver

Question 36

Adverse effects of morphine

Answer 36

``` Respiratory depression Constipation Orthostatic hypotension Urinary retention Emesis Elevation of intracranial pressure Sedation ```

Question 37

Morphine has huge ___ -_______ effects

Answer 37

Anti-cholinergic

Question 38

Relistor (Methylnaltrexone bromide)

Answer 38

Treats constipation caused by long term opioid use

Question 39

How is Relistor administered?

Answer 39

Subcutaneous injection every day | Produces results quickly

Question 40

Tolerance

Answer 40

Large dose is required to produce the same response that could formally be elicited by a smaller dose

Question 41

Physical dependence

Answer 41

Abstinence syndrome will occur if drug is abruptly discontinued

Question 42

Symptoms of withdrawal

Answer 42

Sweating, anorexia, irritability, nausea

Question 43

Drug interactions - Morphine

Answer 43

CNS depressants Anticholinergic drugs Hypotensive drugs Opioid antagonists

Question 44

Morphine-CNS depressants

Answer 44

Alcohol | Benzodiazepines

Question 45

Anticholinergic drugs - morphine

Answer 45

Antihistamines | Tricyclic antidepressants

Question 46

Hypotensive drugs - morphine

Answer 46

Ace inhibitors | Calcium channel blockers

Question 47

Opioid antagonists- morphine

Answer 47

Naloxone

Question 48

Signs of morphine toxicity

Answer 48

Pinpoint pupils Respiratory depression Coma