Drugs For Control Of Pain

Question 1

F

Answer 1

F

Question 2

Neuropathic Pain

Answer 2

Constant

Direct nerve injury

Question 3

Nociceptive Pain

Answer 3

Stimulation of free nerve endings responsible for pain

Usually acute

Somatic vs visceral

Question 4

Somatic pain

Answer 4

A delta nerve fibers

Myelinated->quick nerve response (sharp)

Question 5

Visceral pain

Answer 5

C nerve fibers

Unmyelinated-> slow pain response (dull)

Question 6

Substance P

Answer 6

Transmission of pain message to brain

Neurotransmitter in brain

Question 7

Endogenous opioids

Answer 7

Endorphins,dynorphins, enkephalins

Counteract effects of substance P

Question 8

Opioid analgesics

Answer 8

Act within CNS

Opioid receptors (+)

Question 9

Non-opioid analgesics

Answer 9

Act on nociceptor level

Anti-inflammatory

Question 10

Drugs for Pain:Opioids

Answer 10

Morphine-like molecules

Opiate-natural, from poppy plant
Opiods- natural/synthetic drug
Narcotic- opioids that produce analgesia+ cns depression

Question 11

Opioid receptors

Answer 11

Mu, kappa, and delta

*mu and kappa are major drug targets for analgesia

Question 12

High efficacy opioid agonist drugs

Answer 12

Morphine(astramorph,duramorph)
Fentanyl(duragesic)
Hydromorphone(dilaudid)
Methadone(dolophine)

Question 13

Morphine(astramorph,duramorph)

Fentanyl(duragesic) moa

Answer 13

Strong mu receptor agonist

Very potent and metabolized quickly

Question 14

Hydromorphone(dilaudid) moa

Answer 14

Strong mu receptor agonist

Only used for acute pain bc of addiction potential

Question 15

Methadone(dolophine) moa

Answer 15

Strong mu receptor agonist

Tx opioid addiction and detoxification bc of long duration of action

Question 16

Low eficacy opioid agonist drug

Answer 16

Codeine

Mu receptor (+)

Weak pro-drug of morphine

Question 17

Mixed efficacy opioid agonist drug

Answer 17

Buprenorphine(suboxone)

Partial mu (+) kappa (-)

Tx opioid dependence

Question 18

Opioid side effects

Answer 18

Decr GI motility
Nausea/emesis
Sedation/respiratory depression
Euphoria

Question 19

Combination Drugs

Answer 19

Opioid agonist with centrally-acting analgesic

Vicodin (hydrocodone/acetaminophen)
Percocet (oxycodone/acetaminophen)
-mod/severe pain

Tylenol T3 (acetaminophen/codeine)
-used after appendectomy or wisdom teeth removal

Question 20

Opioid withdrawal

Answer 20

Physical dependence lasts about 7 days and symptoms include diarrhea, nausea/vomiting, myalagia

Psychological dependence is the intense craving

Question 21

Methadone maintenance

Answer 21

Not as eiphoria inducing as morphine/heroin

Does not cure dependency

Question 22

Buprenorphine (suboxone) withdrawl tx

Answer 22

Addition of naloxone prevents pt from abusing again which causes withdrawal symptoms

Question 23

Opiod antagonist

Answer 23

Naloxegal (movantik)

Naloxome (Narcan)

Question 24

Naloxegal (movantik) moa

Answer 24

PEGylated mu receptor (-)

Knocks other opioids of mu receptors in the gut

Tx opioid induced constipation bc of dec gi motility

Question 25

Naloxone (Narcan) moa

Answer 25

(-) all opioid receptors Tx: opioid overdose

Question 26

Other causes of pain

Answer 26

Prostoglandins -tissue damage | Histamine -inflammation

Question 27

NSAIDS moa/drugs

Answer 27

COX 1 and 2 inhibitors ``` Naproxen sodium (aleve) Aspirin (acetylsalicylic acid) Ibuprofen (advil, motrin) Diclofenac (voltaren) Indomethacin (indocin) ketolorac (toradol) ```

Question 28

Selective Cox 2 (-)

Answer 28

Celecoxib (celebrex) Tx arthritis

Question 29

Acetaminophen (tylenol) moa

Answer 29

Unclear, thought to inhibit COX in CNS Centrally acting

Question 30

Tension Headaches drugs

Answer 30

Aspirin Ibuprofen Acetaminophen(tylenol)

Question 31

Migraine Drugs

Answer 31

Triptans: sumatriptan(imitrex) Moa- 5HT 1 (+) which constricts blood vessels in brain Ergot alkaloids: ergotamine (ergostat) Moa- 5HT 1 (+) which constricts blood vessels in brain

Question 32

Intractable Pain Drugs

Answer 32

Not easy to relieve, usually nerve/neuropathic pain/ SZ drugs Carbamazepine (tegretol) Gabapentin (neurotonin) Pregabalin (lyrica) Valporic acid (depakene)

Question 33

Carbamazepine (tegretol) moa

Answer 33

Na+ channel blocker

Question 34

Gabapentin (neurotonin) moa

Answer 34

Blocks voltage gated Ca+ channels

Question 35

Pregabalin (lyrica) moa

Answer 35

Blocks voltage gated Ca+ channels

Question 36

Valporic acid (depakene) moa

Answer 36

Na+ channel desensitization (+) GABA (-) Ca+ channels

Question 37

Other Drugs for Pain Management

Answer 37

Anaesthetic nerve blockers Corticosteroids Tricyclic antidepressants-amitriptyline (Elavil) moa: (-) NET and SERT and positive ion channel blockade