Ch 24 Pain Meds

Question 1

What is fever the result of

Answer 1

It is the result of fever inducing substances called pyrogens

Question 2

What does fever activate

Answer 2

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

Question 3

What are the classic signs of inflammation

Answer 3

Swelling, heat, redness, pain, loss of function

Question 4

What do prostaglandins modulate

Answer 4

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

Question 5

Cox 1

Answer 5

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

Question 6

Cox 2

Answer 6

Appears to produce prostaglandins mainly at sites of inflammation

Question 7

Where does the sensation of peripheral pain begin

Answer 7

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

Question 8

The risk of platelet aggregation increases in who

Answer 8

Patients who smoke and have hypercholesterolemia

Question 9

What are the 2 major types of migraine headaches

Answer 9

Migraine with aura

Migraine without aura

Question 10

How do migraine headaches begin

Answer 10

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

Question 11

What is the drug treats inflammation and fever

Answer 11

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.

Question 12

What is the Pharmacotherapeutics of aspirin

Answer 12

Treats mild to moderate pain, prevents platelet aggregation

Question 13

What are contraindications and precautions of aspirin

Answer 13

Hypersensitivity
peptic ulcer disease
Bleeding disorders
Children with illness

Question 14

What are adverse effects of aspirin

Answer 14

Renal failure
Abnormal bleeding 
GI upset
Drowsiness
Confusion

Question 15

During what stage in pregnancy is aspirin contraindicated

Answer 15

In the last trimester

Question 16

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

Answer 16

Use uncoated aspirin

Question 17

What is aspirin contraindicated in children with illness

Answer 17

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

Question 18

What are NSAIDS

Answer 18

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

Question 19

What is the prototype NSAID

Answer 19

Ibuprofen

Question 20

What is ibuprofen used for

Answer 20

Arthritis
Mild to moderate pain
Primary dysmenorrhea 
Migraine headaches
Fever

Question 21

When does ibuprofen peak

Answer 21

1-2 hours

Question 22

What is the paharmacodynamics of ibuprofen

Answer 22

It inhibits synthesis or release Of prostaglandins

Question 23

Ibuprofen is contraindicated in who

Answer 23

GI DISEASE

Question 24

What are adverse effects of ibuprofen

Answer 24

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

Question 25

How can one maximize the therapeutic effects of Ibuprofen

Answer 25

Give with milk or food to decrease gastric distress

Question 26

What is a para-aminophenol derivative

Answer 26

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

Question 27

What is the prototype para-amino phenol derivative

Answer 27

Acetaminophen (Tylenol)

Question 28

What is acetaminophen used for

Answer 28

Fever or mild pain

Question 29

When does acetaminophen peak

Answer 29

In 60 min

Question 30

What are contraindications and precautions of acetaminophen

Answer 30

Hepatic disease Viral hepatitis Alcoholism

Question 31

What are drug interactions of acetaminophen

Answer 31

``` Activated charcoal Antacids Ethanol Hydantoins Warfarin Sulfinpyrazone ```

Question 32

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

Answer 32

Coordinate periodic CBC Platelet count Liver and renal function tests

Question 33

Who is acetaminophen contraindicated in

Answer 33

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

Question 34

What are serotonin selective drugs

Answer 34

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

Question 35

What is the prototype serotonin selective drugs

Answer 35

Sumatriptan ( imitrex) | They are considered the first line in therapy for acute migraine headaches and cluster headaches

Question 36

How is sumatriptan administered

Answer 36

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

Question 37

What are contraindications and precautions of sumatriptan

Answer 37

CAD | Ischemic cardiac disease

Question 38

What are adverse effects of sumatriptan

Answer 38

``` Coronary artery vasospasm Cardiac dysrhythmias Angina Myocardial ischemia Dizziness ```

Question 39

What are drug interactions of sumatriptan

Answer 39

SSRI | MAOI

Question 40

Where is temperature regulation controlled

Answer 40

Temp regulation is a function of the hypothalamus