Drugs for Pain

Question 1

aspirin

Answer 1

• NSAID IRREVERSIBLY inhibits COX-1 and 2
• leads to decreased PG and TxA2
• long lasting inhibition of platelets
• risk of ulcers (loss of PG in GI), bleeding, Reye syndrome in children with viral illness

Question 2

ibuprofen

Naproxen

Answer 2

• NSAID reversibly inhibits COX-1 and 2
• leads to decreased PG synth
• used for pain, fever, inflammation
• risk of fetal renal dysfunction and oligohydramnios, MI, stroke, GI bleed

Question 3

celecoxib

Answer 3

• NSAID SELECTIVE COX-2 inhibitor
• decreased formation of PG
• used for pain, fever, and inflammation
• risk of fetal renal dysfunction and oligohydramnios, SERIOUS risk of MI and stroke, GI bleed

Question 4

amitriptyline

Duloxetine

Answer 4

-Increased risk of Suicide in young

Question 5

pregabalin

Answer 5

-Used for seizures and Neuropathic Pain

Question 6

Tramadol Warning

Answer 6

CYP 450, CNS/Respiratory Depression, Withdrawl Syndrome

Question 7

ketamine

Answer 7

• noncompetitive NMDA receptor antagonist
• cataleptic like state with dissociation from environment
• used for pain and induction of general anesthesia

Question 8

dexmedotomidine

Answer 8

• selective alpha 2 receptor agonist in the brainstem

- used for general anesthesia maintenance and pain

Question 9

ziconotide

Answer 9

• binds to N-type voltage sensitive Ca channels located on nociceptive afferent nerve of the dorsal horn
• risk of severe psychiatric symptoms

Question 10

lasmiditan

Answer 10

• selective 5-HT1F agonist

- Decrease Trigeminal stimulation

Question 11

ubrogepant

Answer 11

• calcitonin gene relate peptide receptor antagonist

- inhibits pathologic dilation of intracranial arteries for migraine

Question 12

dihydroergotamine

Answer 12

• ergot alkaloid
• binds many receptors
• constricts blood vessels, and is used for migraine
• inhibitor of CYP3A4