Anesthetics II

Question 1

Types of Analgesic Drugs

Answer 1

Anti-inflammatory agents
Opiods (narcotics)
Others
     Acetaminophin (Tylenol)
     Some anticonvulsants
     Some antidepressants

Question 2

Types of anti-inflammatory drugs

Answer 2

Glucocorticoids (“steroids”)
NSAIDS
Others

Question 3

Acetaminophen

Answer 3

Use: Mild-Moderate px
Limit single dose to 650 mg
Limit daily dose to 2600 mg

ACCIDENTAL HEPATIC NECROSIS IS NOT RARE!!!

Caution: known as paracetamol outside of U.S.

Question 4

Antidepressants showing superiority to placebo as an analgesic

Answer 4

Duloxetine SNRI

Despiramine, doxepin & nortriptyline (tricyclic)

Question 5

STUDIES SHOWING ANTIDEPRESSANTS HAVING EQUAL POTENCY TO OPIODS

Answer 5

NONE

Question 6

Anticonvulsants/Membrane Stabilizers: studies showing superiority to placebo

Answer 6

topiramate

pregabalin

Question 7

STUDIES SHOWING anticonvulsants/membrane stabilizers HAVING EQUAL POTENCY TO OPIODS

Answer 7

NONE

Question 8

Opiod receptor types

Answer 8

Mu
Delta
Kappa

Question 9

Mu Opiod receptors

Answer 9

Analgesia
Euphoria
Sedation
Resp depression
Miosis 
dependence

Question 10

Delta Opiod receptors

Answer 10

Analgesia
Sedation
Hormone release

Question 11

Kappa Opiod receptors

Answer 11

Analgesia
Slowed GI transit
Dysphoria
Hallucinations

Question 12

Clinical Utility of Opiods

Answer 12

Analgesia
MOST EFFECTIVE FOR ACUTE PAIN
Less effective for chronic pain

Acute Pulmonary Edema

Cough Suppression

Diarrhea treatment

Question 13

Analgesic indications for opioids

Answer 13

PALLIATIVE & END-OF-LIFE CARE
NON-PALLIATIVE CARE
     Surgery
     Acute injury
     Chronic pain syndromes

Question 14

Opioid alternatives for chronic pain

Answer 14

Some anticonvulsants
Topiramate
GABA analogs such as pregabalin (Lyrica)

Some antidepressants
Tricyclics
SNRI
Atypicals

Question 15

Other alternatives for chronic pain

Answer 15

Physical Therapy
Joint interventions (surgery and/or injections)
Nerve interventions (surgery and/or injections)
Electrical stimulation
Many others

Question 16

DEA drug schedule Class I

Answer 16

NOT AVAILABLE FOR PRESCRIPTION USE… ILLEGAL

Question 17

DEA drug schedule Class II - V

Answer 17

II High potential for abuse
III Less potential for abuse than I & II drugs
IV Low abuse potential compared to schedule III drugs
V lower abuse potential to IV

Question 18

Guidelines for prescribing controlled substances

Answer 18

1. Patient desires treatment for a legitimate illness or condition
2. Practitioner must establish legitimate need through assessment utilizing appropriate dianostic modalities
3. Must be reasonable correlations between what is prescribed and the patient’s legitimate needs

Question 19

Opiods for Postoperative pain (length of time)

Answer 19

3-7 days worth

Question 20

Opioid general types

Answer 20

Agonists
Partial agonists
antagonists

Question 21

the gold standards analgesic for acute severe pain

Answer 21

Morphine sulphate