Exam 2 drugs

Question 1

Lidocaine

Answer 1

Amide

fast onset, medium lipid solubility, medium potency, 64% protein bound

Topical, infiltration, nerve block, IV, Spinal, Epidural

Shorter duration than bupivacaine

Question 2

Bupivacaine

Answer 2

Amide, High potency, medium onset, high lipid solubility, 95% protein bound

Particularly cardiotoxic

Infiltration, Nerve block, IV, Spinal, Epidural

Longer duration than lidocaine

Question 3

Morphine

Answer 3

Opioid Phenanthrene

IV/IM and oral sustained release

Question 4

Hydrocodone

Answer 4

Opioid Phenanthrene

Antitussive, weak analgesia

Question 5

Oxycodone

Answer 5

Opioid Phenthrene

Equipotent to morphine

Question 6

Codeine

Answer 6

Opioid Phenanthrene

Metabolized by CYP2D6

Less potent than morphine

High oral bioavailability

Question 7

Tramadol

Answer 7

Opioid Phenanthrene

Acts at mu receptors

Also block monoamine uptake, potentiating descending pain pathway

Question 8

Fentanyl

Answer 8

Phenylpiperidine

100x more potent than morphine

Short duration

Fast actng, no histamine release

Requires mechanical ventilation at high doses

IV, oral, transdermal

Question 9

Buprenorphine

Answer 9

Benzomorphans

Partial mu agonist, can precipitate mild withdrawal

Can cause analgesia, can partially antagonize morphine

Long acting

Question 10

Naloxone

Answer 10

Competitive antagonist

Short duration

No oral availability

Used to reverse overdose

Question 11

Naproxen

Answer 11

NSAID

both peripheral and central (spinal)

Migraine-abortive

Question 12

Celecoxib

Answer 12

COX-2 inhibitor

Both peripheral and central (spinal)

Increase risk of acrdiovascular complications such as MI (chronic use)

Question 13

Acetaminophen

Answer 13

COX-2 inhibitor

CNS only

Oral, suppository, IV

Hepatotoxicity

Commonly added to opioids, no tolerance to hepatotoxicity

Migraine-abortive

Question 14

Ketamine

Answer 14

NMDA blocker in ascending pain pathway

Can reduce development of tolerance to long-term opioid use

IV or intranasal

Side effects: hypertension, diplopia, dizziness, arrhythmias, nausea-vomiting, pschotomimetic reactions

Question 15

Antidepressants

Answer 15

NE and 5-HT reuptake inhibitors

Central action

Enhancement of descending inhibitory pathway via PAG

Question 16

Anticonvulsants

Answer 16

Block VSCC, inhibit excess NT release

Central

Question 17

Ibuprofen

Answer 17

NSAID

Peripheral and central

Block prostaglandin synth

IV, oral

GI ulceration, bleeding risk, renal dysfunction

Migraine-abortive

Question 18

Sumatriptan

Answer 18

5-HT1d agonist

Migraine-abortive

Blocks NO and peptide mediated dilatation of extracerebral vessels, neuroinflammation, and pain

Causes vasoconstriction in cereral vessels

Prevents activation of pain fibers in trigeminal nerve

Oral, nasal, SC, poor CNS penetration

Short half life

Question 19

Dihydroergotamine

Answer 19

Migraine-abortive

5-HT1b/1d agonist

Not as effective as triptans, but may be effective when triptans are not

Intranasal and parenteral