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Nanju > Ch 24 Pain Meds > Flashcards

Ch 24 Pain Meds Flashcards

1
Q

What is fever the result of

A

It is the result of fever inducing substances called pyrogens

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2
Q

What does fever activate

A

Fever causes activation of monocytes/ macrophages, which in turn secrete cytokines, which increase the synthesis and secretion of prostaglandin in the hypothalamus, this in turn causes the hypothalamus to reset the body temp

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3
Q

What are the classic signs of inflammation

A

Swelling, heat, redness, pain, loss of function

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4
Q

What do prostaglandins modulate

A

They modulate some components of inflammation, body temp, pain transmission, platelet aggregation, and many other body actions.

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5
Q

Cox 1

A

Synthesizes prostaglandins that are involved in the regulation of. Oral cell activity

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6
Q

Cox 2

A

Appears to produce prostaglandins mainly at sites of inflammation

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7
Q

Where does the sensation of peripheral pain begin

A

It begins in averted neurons called nociceptors, these receptors are activated by chemical mediators, such as prostaglandins, histamine,bradykinin, and serotonin.

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8
Q

The risk of platelet aggregation increases in who

A

Patients who smoke and have hypercholesterolemia

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9
Q

What are the 2 major types of migraine headaches

A

Migraine with aura

Migraine without aura

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10
Q

How do migraine headaches begin

A

It is postulated that migraines begin when intracranial blood vessels dilate.

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11
Q

What is the drug treats inflammation and fever

A

acetylsalicylic acid ( Aspirin)
salicylates are used in managing conditions ranging from a simple headache to MI
they are used primarily as anti inflammatory drugs but are also used extensively as analgesics.

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12
Q

What is the Pharmacotherapeutics of aspirin

A

Treats mild to moderate pain, prevents platelet aggregation

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13
Q

What are contraindications and precautions of aspirin

A

Hypersensitivity
peptic ulcer disease
Bleeding disorders
Children with illness

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14
Q

What are adverse effects of aspirin

A 
Renal failure
Abnormal bleeding 
GI upset
Drowsiness
Confusion
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15
Q

During what stage in pregnancy is aspirin contraindicated

A

In the last trimester

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16
Q

When giving aspirin for its cardiovascular properties, what type of aspirin should you use

A

Use uncoated aspirin

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17
Q

What is aspirin contraindicated in children with illness

A

It is contraindicated in children with varicella or flu like illness because it is assoc with the occurrence of REYE SYNDROME

18
Q

What are NSAIDS

A

They are grouped by chemical class
They all inhibit COX and prostaglandin synthesis
They all carry a black box warning stating that they increase the risk if MI and stroke

19
Q

What is the prototype NSAID

A

Ibuprofen

20
Q

What is ibuprofen used for

A 
Arthritis
Mild to moderate pain
Primary dysmenorrhea 
Migraine headaches
Fever
21
Q

When does ibuprofen peak

A

1-2 hours

22
Q

What is the paharmacodynamics of ibuprofen

A

It inhibits synthesis or release Of prostaglandins

23
Q

Ibuprofen is contraindicated in who

A

GI DISEASE

24
Q

What are adverse effects of ibuprofen

A

GI upset & bleeding
Hepatotoxicity
Acute renal failure
Increased risk of CVA or MI with prolonged use

25
Q

How can one maximize the therapeutic effects of Ibuprofen

A

Give with milk or food to decrease gastric distress

26
Q

What is a para-aminophenol derivative

A

It is an analgesic and antipyretic avail in the U.S

27
Q

What is the prototype para-amino phenol derivative

A

Acetaminophen (Tylenol)

28
Q

What is acetaminophen used for

A

Fever or mild pain

29
Q

When does acetaminophen peak

A

In 60 min

30
Q

What are contraindications and precautions of acetaminophen

A

Hepatic disease
Viral hepatitis
Alcoholism

31
Q

What are drug interactions of acetaminophen

A 
Activated charcoal
Antacids
Ethanol 
Hydantoins
Warfarin
Sulfinpyrazone
32
Q

What specific lab tests should be coordinated with .ong term use of acetaminophen

A

Coordinate periodic CBC
Platelet count
Liver and renal function tests

33
Q

Who is acetaminophen contraindicated in

A

A person with hepatitis C, it is contraindicated in ppl with impaired liver/ hepatic function.

34
Q

What are serotonin selective drugs

A

They are used to relieve pain and inflammation related to migraine headache
They are NOT useful for other types of headache or inflammation that occurs anywhere else in the body
These drugs are called “Tristan’s” because the generic names end in such

35
Q

What is the prototype serotonin selective drugs

A

Sumatriptan ( imitrex)

They are considered the first line in therapy for acute migraine headaches and cluster headaches

36
Q

How is sumatriptan administered

A

Orally
Intranasally
SC
Metabolized in the liver and excreted in the kidneys

37
Q

What are contraindications and precautions of sumatriptan

A

CAD

Ischemic cardiac disease

38
Q

What are adverse effects of sumatriptan

A 
Coronary artery vasospasm 
Cardiac dysrhythmias 
Angina
Myocardial ischemia
Dizziness
39
Q

What are drug interactions of sumatriptan

A

SSRI

MAOI

40
Q

Where is temperature regulation controlled

A

Temp regulation is a function of the hypothalamus

Nanju (15 decks)

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