Drugs Flashcards
Lidocaine
Amide LA (Na+ channel blocker) ALSO: adjuvant analgesic
Bupivacaine
Amide LA (Na+ channel blocker)
Morphine
Opioid Agonist (Mu) phenanthrene
Hydrocodone
Opioid Agonist (Mu) phenanthrene
Oxycodone
Opioid Agonist (Mu) phenanthrene
Codeine
Opioid Agonist (Mu) phenanthrene
Tramadol
Opioid Agonist (Mu) phenanthrene, LESS INTENSE OPIOID as it blocks NET for NE reuptake and thus prolongs action of NE
Fentanyl
Opioid Agonist (Mu) UNLIKE all others as is phenylpiperidine
Buprenorphine
Opioid PARTIAL Agonist (Mu)
Nalaxone
Opioid ANTagonist
Naproxen
NSAID [Non-selective COX-1/COX-2 Inhibitor]
Celecoxib
NSAID [COX-2 selective inhibitor]
Acetaminophen
COX-2 inhibitor in CNS
Ketamine
NMDA receptor antagonist
Adjuvant Analgesics
TCAD, anticonvulsants, lidocaine
Migraine Abortive
NSAIDs: Ibuprofen, Naproxen, Acetaminophen
5HT1d agonist: Sumatriptan (ADR Coronary Vasospasm)
Ergot: Dihydroergotamine (DHE) (2nd line after triptans) ADR: vasc occlusion, gangrene, NOT with B-blockers
DHE (Dihydroergotamine)
Ergot Compound (5-HT agonist) ADR: nausea
Migraine Prophylactics
B-blockers, CCBs, ACEi
Anticonvulsants
Antidepressants (SSRIs, TCADs)
Alzheimer’s
Cholinesterase Inhibitor: Donepezil
NDMA glutamate antagonist: Memantine
Wernicke’s Encephalopathy
Thiamine
Opioid Effects
Block PREsynaptic VGCC so inhibits NT release
Activate GIRK K channel so membrane hyperpolarization
[B-gamma subunit]
Inhibits cAMP synthesis
SO: inhibits ascending pain pathway
Activates descending PAG pathway by TURNING off GABA (disinhibition)
Opioid types
Morphine and phenanthrenes
Meperidine and phyenylpiperidines (no constipation, not antitussive)
Methadone and phenylheptamines
Mixed agon/antagon (buprenorphine)
Opioid agonist (competitive) - naloxone (NARCAN) must be IV
Multi modal for mod-severe pain
To accompany opioids: LA, Ketamine (NMDA antag v.important), Clonidine (poss dry mouth)
