Case Study LO

Question 1

How can hepatotoxicity be prevented + treated in paracetamol overdose?

Question 2

Advice to ensure effective use of analgesics

Question 3

Outline common NSAID side effects + their pharmacological basis

Question 4

What strategies used to prevent GI side effects of NSAIDs + what is their pharmacological basis?

Question 5

How do the binding of COXIBS to the COX enzyme differ from non-selective NSAIDs?

Question 6

What are the consequences for analgesic effectiveness + side effects?

Question 7

How does mood influence pain?

Question 8

Why did the pharmacist say if there is any blood in stools they should stop taking ibuprofen?

Answer 8

SSRIs interact with NSAIDs to cause bleeding

SSRIs inhibit transport of serotonin into platelets, leading to impaired platelet aggregation + ability for haemostasis + increase GI bleeding risk

Question 9

What is a sprain + how does it cause pain?

Answer 9

Sprain = injury in a joint caused by a ligament being overstretched beyond its capacity

A muscular tear caused in the same manner = strain

Where ligament is torn, immobilisation+ surgical repair is necessary

Ligaments = tough, fibrous tissue that connect bones to other bones

Question 10

What is the difference between a sprain + strain?

Answer 10

Sprain = twisted/torn ligament

Strain = overstretched/torn muscle

Question 11

What are the symptoms + signs of a sprain?

Question 12

Difference between primary and secondary dysmenorrhea?

Question 13

How do prostaglandins contribute to dysmenorrhea symptoms?

Question 14

Name different ibuprofen formulations

Question 15

Treatment options for dymenorrhea

Question 16

What is opioid’s molecular target + MOA?

Answer 16

Various subtypes

Opioids cause excitable cell hyperpolarisation via GPCR receptors which leads to decrease cAMP formation.

Closing of Ca2+ channels and opening of K+ channels lead to decrease neurotransmitter release

Question 17

Discuss common opioid side effects + explain pharmacological basis

Question 18

Describe mechanism used to control release from formulations

Question 19

What is IV PCA?

Answer 19

Method of pain relief that allows a patient to self administer small doses of analgesic agent as required

Programmable infusion pumps that deliver opioid meds IV

PCA = used for pain following trauma + w/ cancer

Question 20

Drugs commonly used for IV PCA

Answer 20

Morphine

Fentanyl

Oxycodone

Tramadol

Ketamine

Question 21

What dosing parameters in IV PCA can be varied to alter analgesia?

Question 22

What is the pharmacokinetic rationale for increasing bolus dose + adding background infusion?

Question 23

Outline pharmacokinetics of oxycodone + morphine

Question 24

Clinical implications of oxycodone

Question 25

Describe pathophysiology of opioid-induced nausea + vomiting

Question 26

What are the molecular targets for ondansetron + cyclizine?

Answer 26

Ondansetron = selective serotonin 5-HT3 receptor antagonist

Cyclizine = piperazine- derivative antihistamine used as antivertigo/antiemetic agent

Question 27

Pharmacological effects of Senna + Docusate Sodium in managing opioid-induced constipation