Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm exam 5 chapters > Ch 24 > Flashcards

Ch 24 Flashcards

1
Q

drugs that relieve pain without causing loss of consciousness

A

Analgesics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

the most effective pain relievers available

A

Opioid analgesics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

medications in the opioid analgesics family

A

morphine
fentanyl
codeine
oxycodone (OxyContin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

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

A

opioid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

a more specific term that applies only to compounds present in opium

A

opiate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the 3 families of peptides that have opioid -like properties

A

enkephalins
endorphins
dynorphins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what 3 categories do the opioid analgesics fall into?

A

1) pure opioid agonists
2) Agonist-antagonist opioids
3) pure opioid antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what effects do pure opioid agonists produce?

A 
analgesia
euphoria
sedation
resp depression
physical dependence
constipation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

prototype of the strong opioid agonists

A

Morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Prototype of the moderate to strong agonists

A

Codeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

List the 4 agonist-antagonist opioids available

A

Pentazocine
nalbuphine
butorphanol
buprenorphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When administered alone, the agonist-antagonist opioids produce

A

analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

when an agonist-antagonist opioid is given with a pure opioid agonist, these drugs can

A

antagonize analgesia caused by the pure agonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what drug is considered the prototype for the agonist-antagonist opioid group

A

Pentazocine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

which drug class in the opioid analgesic grouping is manly used for reversal of resp and CNS depression caused by overdose with opioid agonists?

A

pure opioid antagonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the prototype drug for pure opioid antagonists

A

Naloxone (Narcan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what pure opioid antagonist is used to treat opioid induced constipation

A

methylnaltrexone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

pharm effects of morphine

A 
analgesia
sedation
euphoria
resp depression
cough suppression
suppression of bowel motility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

side effects of morphine

A 
urinary retention
emesis
orthostatic hypotension
miosis
biliary colic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

The time course for resp depression after PO morphine begins up to ___ minutes after ingestion

A

90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what populations are most sensitive to resp depression with morphine

A

very young
older adults
those with resp disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what should be avoided while taking morphine to prevent further resp supression

A

alcohol
barbiturates
benzodiazepines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

potential complications of constipation secondary to opioid use is

A

fecal impaction
bowel perforation
rectal tearing
hemorrhoids

24
Q

Goal for management of constipation secondary to opioid use

A

produce a soft, formed stool every 1-2 days

25
Q

Principal nondrug measures to combat constipation secondary to opioid use

A

physical activity

increased intake of fiber and fluids

26
Q

prophylactic treatment for constipation secondary to opioid use

A

a stimulant laxative such as senna to counteract reduced bowel motility plus Miralax (osmotic laxative)

27
Q

rescue therapy for constipation secondary to opioid use

A

strong osmotic laxative such as lactulose or sodium phosphate

28
Q

last resort for constipation secondary to opioid use

A

methylnaltrexone (Relistor)

29
Q

Can methylnaltrexone (Relistor) cross the blood brain barrier?

A

no and hence does not reverse opioid induced analgesia

30
Q

classic triad of signs for opioid overdose

A

coma
resp depression
pinpoint pupils

31
Q

what are the 4 different routes that fentanyl can be given?

A

parenteral
transdermal
transmucosal
intranasal

32
Q

what schedule med is fentanyl

A

II

33
Q

Fentanyl is metabolized by

A

CYP3A4 (isoenzyme of cytochrome P450)

34
Q

where should a fentanyl patch be applied

A

skin of the upper torso

35
Q

what is the time line for fentanyl patch

A

reaches effective levels in 24 hours

levels remain steady for another 48 hours

36
Q

age weight min for transdermal Fentanyl

A

should not be used in children younger than 2 years or children younger than 18 who weigh less than 110 lbs

37
Q

fentanyl overdose risk for transdermal patch

A

If resp depression develops, it may persist for hours after patch removal, due to continued absorption of fentanyl from the skin

38
Q

Transmucosal fentanyl rules

A

approved only for breakthrough cancer pain in patients at least 18 years old who are already taking opioids around the clock and have developed some degree of tolerance, defined as needing, for 1 week or longer, at least: 60mg of oral morphine a day, or 30 mg of oral oxycodone a day or 25mg of oral oxymorphine a day or 8mg of oral hydromorphone a day or 25mcg of fentanyl per hour or an equianalgesic dose of another opioid .

39
Q

if a patient switches from one transmucosal product to another…..

A

dosage of the new product must be titrated to determine a strength that is safe and effective

40
Q

what is Methodone (Diskets, Dolophine, Methadose) used for

A

pain and to treat opioid addiction

41
Q

what test should be run before a pt is placed on Methodone (Diskets, Dolophine, Methadose)

A

This drug can cause QT prolongation
Pt should receive an ECG before treatment, 30 days later and annually thereafter. If the QT interval exceeds 500ms, stopping or reducing the methodone should be considered

42
Q

Black box warning Methodone (Diskets, Dolophine, Methadose)

A

QT prolongation
Torsades de pointes

If pt has existing QT prolongation or a family history of long QT syndrome and in those taking other QT prolonging drugs consider not using

resp depression that can be fatal

43
Q

what schedule drugs are Hydromorphone, Oxymorphone, Levorphanol

A

II

44
Q

what is the difference between a moderate to strong opioid agonist and morphine which is a strong opioid agonist?

A

both produce analgesia, sedation and euphoria
the both can also cause resp depression, constipation, urinary retention, cough suppression and miosis.

The differences are quantitative: the moderate to strong opioids produce less analgesia and resp depression than morphine and have a somewhat lower potential for abuse

45
Q

codeine alone is classified under what schedule?

A

II

46
Q

Codeine combo such as norco is under what schedule

A

III

47
Q

codeine used in cough syrups is what schedule

A

V

48
Q

Blackbox for codeine

A

In the liver about 10% of each dose of codeine undergoes conversion to morphine. The enzyme responsible is CYP2D6 (The 2D6 isoenzyme of cytochrome P450) Among ultrarapid metabolizers, which carry multiple copies of the CYP2D6 gene, codeine is unusually effective and has led to death in some children. Severe toxicity can also develop in breastfed infants whose mothers are taking codeine. The cause is high levels of morphine in breast milk, due to ultrarapid codeine metabolism.

49
Q

Oxycodone (oxycontin, Roxicodone) and Hydrocodone has analgesic actions equivalent to those of

A

codeine and is a schedule II

50
Q

Codeine
Oxycodone
Hydrocodone
Tapentadol

fall into what class?

A

Moderate to strong opioid agonists

51
Q

which moderate to strong opioid agonists causes less constipation than traditional opioids

A

Tapentadol (Nucynta)

52
Q

pain medications in the Agonist-Antagonist Opioid Category

A

Pentazocine (Talwin)

Buprenorphine (Butrans)

53
Q

what Agonist-antagonist opioid can be pre-treated with Narcan to prevent toxicity. However it cannot readily reverse toxicity bc it binds very tightly to its receptors and hence cannot readily be displaced by narcan

A

Buprenorphine (Butrans)

54
Q

What is Buprenorphine approved for

A

analgesia and opioid addiction

55
Q

Cardiac precautions for Buprenorphine

A

prolongs QT interval
should not be used by patients with long QT syndrome or a fam history of long QT or by patients using QT prolonging drugs

56
Q

Risk for adverse effects of Buprenorphine may be increased by

A

psychosis
alcoholism
adrenal corticoid insufficiency
severe liver or renal impairment

57
Q

opioid agonist with less constipation than traditional opioids

A

Tapentadol

Pharm exam 5 chapters (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions