Chapter 5 Flashcards
Why is tooth extraction considered a “pain standard”?
Tooth extraction is considered a “pain standard” because it serves as a benchmark for comparing dental pain in clinical studies
How are prostaglandins important for maintaining homeostasis? How are they important in the pain response?
Prostaglandins help maintain homeostasis by regulating various physiological functions such as inflammation, blood flow, and the formation of blood clots. In the pain response, prostaglandins are produced at sites of tissue damage or infection, triggering inflammation and pain signals
What is the prostaglandin synthesis pathway? Which enzymes are involved in the pathway and what reactions do they catalyze?
The prostaglandin synthesis pathway begins with phospholipids being converted into arachidonic acid, which is then acted upon by cyclooxygenase (COX) enzymes to produce prostaglandins. COX-1 and COX-2 are the key enzymes involved in this process
What categories of nonnarcotic drugs exist?
Categories of nonnarcotic drugs include N
SAIDs (Nonsteroidal Anti-Inflammatory Drugs),
salicylates (such as aspirin), and
acetaminophen
What is the mechanism by which salicylates work?
Salicylates, such as aspirin, irreversibly inhibit COX enzymes, thereby reducing the production of prostaglandins, which are responsible for pain, fever, and inflammation
What are the pharmacologic effects of salicylates?
Salicylates relieve pain, reduce fever, decrease inflammation, and reduce clotting. They are primarily administered orally
What are the pharmacokinetics of salicylates?
Salicylates are rapidly absorbed in the stomach and small intestine, bind to plasma proteins, metabolize in the liver through zero-order kinetics, and are excreted via the kidneys
What are the adverse reactions associated with the use of salicylates?
Adverse reactions include
gastrointestinal distress,
bleeding problems,
Reye’s syndrome,
hepatotoxicity,
nephritis,
teratogenicity,
allergic reactions,
and toxicity from overdose (e.g., headache, dizziness, nausea, and vision problems)
What types of drug interactions are associated with salicylates?
Salicylates can interact with antihypertensives, warfarin, probenecid, methotrexate, sulfonylureas, and certain herbs like ginseng, dong quai, and ginger. They can also interact with diseases such as hemophilia
What are the potential doses of salicylates?
For adults, salicylates are taken PRN for pain at 325-650 mg every 4-6 hours, 3000-4000 mg daily for arthritis, or 81 mg daily for heart attack prevention
What is the mechanism by which NSAIDs work? How are NSAIDs different from one another with regard to their mechanism of action?
Most NSAIDs work by reversibly inhibiting COX-1 and COX-2 enzymes, reducing prostaglandin synthesis. Some NSAIDs, like celecoxib (Celebrex®), specifically inhibit COX-2 without affecting platelet clumping
What are the pharmacologic effects of NSAIDs?
NSAIDs reduce pain, fever, and inflammation and decrease blood clotting
What are the pharmacokinetics of NSAIDs?
NSAIDs are absorbed in the stomach and small intestine, have a high plasma protein binding rate (~95%), metabolized in the liver, and are excreted through the kidneys
What are the adverse reactions associated with the use of NSAIDs?
Adverse reactions include ulceration, sedation, convulsions, cardiovascular effects, renal issues, oral issues and allergic reactions (especially cross-allergies with salicylates)
What types of drug interactions are associated with NSAIDs?
NSAIDs can interact with antihypertensives, methotrexate, lithium, digoxin, and patients with asthma
