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Pharm > Drugs For Pain > Flashcards

Drugs For Pain Flashcards

1
Q

Types of Anesthesia?

A

General
Local
Regional

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2
Q

Aspects of General Anesthesia?

A 
LOC
Analgesic
Amnesia
Muscle relax
Inhibit reflex
Non-toxic
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3
Q

Stages of anesthesia?

A

Analgesia
Delirium
Surgical Anesthesia
Cardio/respiratory collapse

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4
Q

What are the premedications>

A 
Sedation
Analgesia
Antiemesis
Infection Control
Disease-modifying
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5
Q

Inhaled Anesthetic MOA?

A

Gas in neuronal membrane cause it to expand blocking ion channels

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6
Q

Organ effects of Inhaled Anesthetics?

A 
Cardio: Reduce Contractility/tachycardia 
Pulm: dec RR
CNS:dec metabolic rate inc blood flow
Malignant hyperthermia
Renal: decease GFR
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7
Q

Why dont u give inhaled anesthetic to recent head trauma?

A

Increase blood flow which increase ICP

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8
Q

IV anesthesia MOA

A

Bind to GABA chloride channels

Hypnosis and anesthesia w/o analgesia (give with opiod)

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9
Q

ADR of IV anesthesia?

A

Hangover bc lipid solubility. Bronchospasm/ reflex tachycardia

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10
Q

Given to inhbit movement especially in delicate surgical procedures

A

Neuromuscular blocker

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11
Q

Slow onset but provide basal level sedation

Gives you anterograde amnesia?

A

Benzodiazepines

Midazolam

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12
Q

Produces skeletal muscle movements, thrashing nausea

A

Etomidate

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13
Q

Bind to NMDA receptors inhibiting the excitatory effects of glutamate.

What does it produce?

A

Ketamine

Dissociative anesthesia
HTN
Tachycardia
Hallucinations

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14
Q

Lowers BP w./o myocardia depression. Used for same day surgery.

A

Propofol

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15
Q

What are considerrattions to take for patients going to rehab after surgery?

A

Confused
Woozy
Neuromuscular weakness.

Mucociliary response so want to cough and do breathing.

Neuronal cell death.

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16
Q

Highlights of local and regional anesthesia?

A

Regional at nerve to numb area
Local: topical

Quick recovery, remain conscious, dont mess with organs

Can take time to kick in.

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17
Q

MOA of local anesthetics?

Indication?

A

Block sodium channels: C fiberss then A delta, then motor.

For pain relief for local surgery

18
Q

ADR of local anesthetics

A

Rarely

But sleepy/ light headed/ affect heart

19
Q

What does Epi do with analgesia>?

A

Reduce systemic absorbtion and prolong duration of anaglesia

20
Q

What are chemicals released with tissue injury?

A 
K+
Serotonin
Histamine
Bradykinin
Prostaglandins
Leukotriens.
21
Q

Pain transmission?

A

Via a delta and C fibers in lamina 1.
Release substance P and transmitted to ortex.

Opiods inhibit release of substance P at interneuron.

22
Q

Substance that relieves pain acts on Mu receptor..

What can its action be reversed by?

A

Opiods

Naloxone.

23
Q

Opiod and receptors?

A

Mu: get analgesia/ Bradycardia/ high abuse potential
Delta: lower abuse potential
Kappa: analgesia, sedation, dyspnea,dysphoria

24
Q

All opiod recptors open _____ causing ______

A

Potassium Channels

Hyperpolarization and decrease nerve transmission. (Less substance P)

Cause euphoria which can lead to addiction.

25
Q

Strong Agonist MOA effect?

A

MORPHINE

Bind to Mu and Kappa

Cause analgesia, sedation, euphoria.

26
Q

Uses of strong agonist?

A

Acute pain, chronic cough, vasodilator

27
Q

ADR of strong Agonist?

A 
Sleepy
Vomit
Sweating
Bradycardia
Constipation
Decreaases respiration (can die)
28
Q

Chronic itchin

A

Frictopathia

29
Q

Mild-mod agonists :

A

Bind to Mu and kappa but less than strong.
Block NE and seratonin

Codeine/tramadol

30
Q

Routes of administration for opiods?

A 
Slow release MS-Contin
Patch
IV
Intrathecal
Lollipop
Fixed interval.
Iontophoresis
31
Q

First pass effect of morphine?

A

Large. So metabolized before it reaches systemic circulation.
Oral codeine and oxy preferred over morphine

or use morphine IV

32
Q

Metabolyzing enzymes of opiods?

A

CY2D6 : take active drug and metabolize it to another drugs. May not respond well.

CYP3A4: produce non-active metabolites

33
Q

Develops quickly and pt must continually administer higher does to get same effect

A

Tolerance

34
Q

Pt feels withdrawal. What are signs?

What do you do?

A

Physical dependence.

Anxiety/irritable/hot flash/ basically fever

Give methadone cuz longer half life.

35
Q

Tx for addiction?

A

Give methadone cuz blocks receptors and has longer half life.

Can cause arrhythmias

36
Q

Which is easier?

Withdrawing from long-acting opiod vs short.

A

Long.

37
Q

What does Buprnorphine do?

A

Treat addictions./withdrawal of long-acting opiods.

Bind to m receptor. Agonist at delta but antagonist at kappa.

38
Q

Morphine antagonist?

What is something similar?

A

Displace opiod from receptor. To treat OD.

Naltrexone (longer halfife tho)

39
Q

What is most effective way to treat addiction from chemical standpoint?

A

Combine Naloxone/Buprenorphine.
CALLED SUBOXON
For short-acting opiods.

40
Q

Therapeutic concerns with opiods?

A 
Drowsy/dizzy
Schedule at peak action of opiod
No heat over patch
Prescribe lowest dose possible for no more than 3 days
Use SOAPP (before opiods)
COMM (on opiods)

Pharm (14 decks)

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