Exam III Flashcards
T/F:
Meloxicam (MOBIC) is considered to be a propionic acid derivative
False
T/F:
Caffeine potentiates analgesic action of analgesics
True
T/F:
Aspirin should be avoided in children and adolescents up to 18 years of age
True
T/F:
NSAIDS irreversibly inhibit platelet aggregation
True
T/F:
Indomethacin (Indocin) is considered to be an acetic acid derivative
True
T/F:
Ibuprofen (Advil) is considered to be a propionic acid derivative
True
T/F:
Piroxicam (Feldene) is considered to be an Oxicam
True
T/F:
Probenecid decreases the levels of NSAIDs and penicillin
False
T/F:
Fiorinal is an aspirin containing product that given by prescription only
True
T/F:
Hydromorphone is more potent than morphine and better absorbed orally
True
T/F:
A patient who feels nauseated after taking codeine is allergic to it
False
T/F:
The normal maximum dose of acetaminophen is 2 gm
False
T/F:
Aspirin should be avoided in children and adolescents up to 18 years of age
True
T/F:
Mixed opioid agonist-antagonist have more of an abuse potential then pure opioid agonist
False
T/F:
The FDA pregnancy category for opioids is B
False
T/F:
Aspirin and acetaminophen are equal in both potency and efficacy
True
T/F:
Phenacetin was removed from the market in the early 1980s because it cause methemoglobinemia was more toxic then acetaminophen
True
T/F:
It is okay to take aspirin with antihypertensives
False
T/F: Dental pain (e.g., pain after an extraction) is not useful as a method of testing analgesic efficacy
False
T/F:
True opioid allergy is very uncommon
True
Attempts to relieve pain while reducing toxic effects and dependency
Mixed opioids agonist/antagonist
Is the prototype opioid
Morphine
(Dolobid) is a salicylate classified as an NSAIA; that can be administered before dental procedures to delay the onset of postsurgical pain
Diflunisal
Is made of hydrocodone and acetaminophen
Loracet
Stimulates the oxidizing enzymes that metabolize acetaminophen to its toxic metabolite
Alcohol
Is the drug of choice for treatment of dental pain when NSAIA is indicated
Ibuprofen
Naproxen sodium is classified as
Propolonic acid
mg every 4 to 6 hours is the usual analgesic dose of ibuprofen
400-800
What is the MOA aspirin
Inhibition prostaglandin synthesis
Imparts the characteristic vinegar odor to a bottle of aspirin
Acetic acid
What receptors are responsive to morphine
Mu, delta
What receptors are responsive to Naloxone
Mu, delta, kapa
What receptors are responsive to Pentazocine
Kappa
Should avoid Tylenol
Alcoholics
Receptors are involved in producing analgesia
Mu, kappa
Codeine ______ pain threshold. It affects the cerebral_____ to depress the _____ to pain
Raises
Cortex
Reaction
(diphenoxylate) is a opioid used to treat diarrhea
Lomotil
What are the four pharmacologic effects of opioids
Analgesic
Cough suppression
G.I. effect
Sedation and euphoria
What are the four A’s of aspirin
Anti-inflammatory
Analgesic
Antipyretic
Antiplatelet
What are the three main adverse reactions of opioids
Respiratory depression
Nausea and Emesis
Constipation
Use for and adverse effect of while used with aspirin: probenecid (Benemid)
Prevent gout
Increase Acute attack of gout
Use for and adverse effect of while used with asprin: warfarin (Coumadin)
Anticoagulant
Bleeding or hemorrhage
Use for and adverse effect of while used with aspirin: tolbutamide (orinase)
Treat diabetes
Hypoglycemic effect
Use for and adverse effect of while used with aspirin: methotrexate (MTX)
Treat cancer and arthritis
Leads to bone marrow suppression
Use for and adverse effect of while used with aspirin: alcohol
Nontherapeutic
Increase bleeding or hemorrhage
Use for and adverse effect of while used with aspirin: other anti-inflammatory drugs
Pain and arthritis
Increased bleeding
A unique analgesic that has mu opioid agonist action and inhibits the reuptake of norepinephrine and serotonin
Tramadol
Contains 50mg of pentazocine and 0.5mg of naloxone
Pentazocine (Talwin)
The favorite drug of abuse of medical personnel
Meprederine
An orally effective agent reserved for severe pain
Dilaudid
A synthetic agent that is chemically similar to methadone the trade name is
Proproxopine
Darvocet 100
Empirin # 4 is made of
Aspirin and 60mg codine
Tylenol #3 is made of
30mg codeine& Acetaminophen
Codeine #1 is ______mg and _____gr
7.5
1/8
Naloxone is a pure opiate antagonist that is active________.
_________ is a parenteral opioid antagonist used to _______ opioid overdose.
Parenterally
Nalmefemene
Reverse
60 mg codeine has an analgesic strength about the same as ________ of aspirin or acetaminophen or______ of ibuprofen
650mg
200mg
Percocet=_____+______
oxycodone
acetamenophen
Percodan=_______+______
oxycodone
asprin
target organ for the antipyretic effects of Tylenol
hypothalmus
where is the cough center located?
medulla of brain
Vioxx or Celebrex are examples of
COXII inhibitors
an inherited disease occurring primarily in men, with an onset that usually involves one joint, often the big toe or knee
gout
____ and ____ are used to tx acute attacks of gout
NSAIDS
colchine
____ and _____ are used to prevent gout
probenecid
allopuronol
thromboxane A2 works w/ asprin and ____ aggregation
stimulants
most common adverse reactions to asprin
GI effects
vomiting
nausea
bleeding
before administerine butorphanol HCL (Stadol), the nurse asks the pt if he has used opiates. That’s because administering a mixed opioid agonist-antagonist to a pt dependent on opioid agonist-antagonist to a pt dependent on opiod agonists may cause what reactions
withdrawl symptoms
the cause of death from overdose of any central nervous system depressant is usually
respiratory depression
a pt taking one tab of Tylenol #3 will be getting ____ mg of codine
30
pt taking warfarin (comadin) should not be given
asprin
in overdose, acetaminophen adverselhy affects what organ
liver
what should be given to a pt who has inflammation present at the site of pain
ibuprofen
the effects of asprin on the platelets lasts about how long
5 days
____ mechanism of action is primarily peripheral and a prostaglandin systhesis inhibitor
Asprin & NSAIDS
examples of NSAIDS are
ibuprophen, naproxen, advil, motrin
both acetaminophen and asprin have ____ effect
analgesic and antipyretic
asprin acts as an
salicylate
salicylates are not the drug of choice for patients
gastric ulceration, hemmorage, anticoagulant
ibuprofen (motrin) is useful for what
NSAID
the most serious side effect of narcotic analgesics is their ability to
respiratory destress
Darvon compound 65
combo of asa and cafine
percodan
asa
midol caplets
asa
carvocet N 100 combo of
acetaminophen and proxipropene
most effective antitussive medication
codine
analgesic raises pain thresholds (meaning, increasing pain tolerance or reducing pain) without impairing alertness or judgement
salycylate
action of ASA (asprin)
analgesic, antipyretic, antinflammatory, antiplatelet
drug of choice for tx of dental pain when a NSAID indicated
ibuprofen
acetaminophen (tylonol) has what actions
antipyretic analgesic
pure opoid antagoins; its in the dental emergency kit to treat an overdose of narcotic analgesic
codine
you have a pt who presents for a cleaning. while taking vitals you notice he seems to have an increased body temp. he begins to complain of ringing in the ears and is experiencing altered sensorium. what is pt suffering from?
salicylism
drug has anti-inflammatory, antipyretic, analgesic, and antiplatelet actions
aspirin
all of the following meds contain codeine except one. therefore, which of the following would a physician or dentist prescribe for a client in paint who is allergic to codiene
Darvocet
know what Darvocet is made of
propayphenon apslate 100 mg; 4 acetaminophen 650 mg
nonsteroidal anti-inflammatory drugs such as ibuprofen, indomethacin, and naproxen can reduce the pharmacologic effect of
ace inhibitors
aspirin can produce
GI side effects
strongest analgesic effect
ibuprofen 600mg
what is an adverse reaction to the opioids
respiratory depression
which 2 of the following could be given most safety to a pt who is allergic to codeine
ibuprofen, dexatroproxypheric
most efficacious?
oxycodone
drug of choice to tx pt who has taken overdose of opioid
naloxone
can be managed/txed w/ opioids
diarrhea
an overdose of codeine that significantly depresses breathing is tx w/
naloxone
makes sense to mix codeine w/ all except
hydrocodone/ (thyrocodone?)
all are side effects of nonsteroidal anti-inflammatory agents except
fluid loss
opioid agonist can produce all except
fluid retention
does not have a drug interaction w/ the nonsteroidal anti-inflammatory agents
codeine
acute overdose of acetaminophen hurts the
liver
if a person drinks an average of 2 beers daily, how many extra strength acetaminophen tablets can that person take in 1 day w/o going over maximum dose
4 tabs
pt takes aspirin (weak acid) and chews 2 antacids at same time, the absorption of the aspirin would be ____ the absorption that would have occurred if pt had not taken antacids
less than
if an adult has a fever, all of the following except _____ would reduce fever
codeine
allopurinol is used to manage pt with
gout
used to tx acute attack of gout
colchine
true allergy to aspirin occurs in about ____ of population
<1%
an advantage of the NSAIDS over opioids
nonaddictive
pt needs extraction. to ensure pt’s bleeding time will be normal how long should you wait to preform procedure after taken aspirin
36 hrs
what to aspirin, acetaminophen, ibuprofen, and codeine have in common
analgesics
NSAIDS may reduce the antihypertensive effects of all except
calcium channel blocker
pt exhibits excessive sweating (not caused by excessive ambient temp or exercise) could be due to
stimulant of PANS
not caused by parasympatholytics
diarrhea
drug placed in FDA category B it means
animals struggle, no risk, not good habits
prostaglandins used therapeutically for
ulcers caused by NSAIDS
half life of drug is 12 hrs, what % of dosage would remain after 36hrs
12.5%
can produce lithium toxicity in pt taking lithium
naproxen
pharmacology is study of
drugs & medicine
the ___ regulates trade practices of drug companies and prohibits false advertising of foods, OTC drugs and cosmetics
FTC
not approved for efficacy and safety by FDA
vitamins
the ____ of a drug is a function of the amount of drug required to produce an effect
potency
a ____ has affinity for a receptor, combines w/ that receptor, and produces an effect
agonist
the ___ is the strongest bond and not rapidly reversible
covalent
a ___ is a dose-related reaction that is not part of the desired therapeutic effect
side-effect
a ____ is a genetically related abnormal drug response
idiosyncratic
a therapeutic index greater than ___ is needed to produce a therapeutically useful drug
10
codeine is a schedule ____ drug
II
the ___ includes name of drug, dose form, and amount
inscription
the ____ sets requirements for writing prescriptions for drugs frequently prescribed in dental office
control substitute act
action of acetylcholine is terminated by
hydrolysis
tx of an overdose of cholinesterase inhibitors includes ___ and ___
atropine
pralidoxine
action of norepinephrine terminated by
reuptake into presynaptic nerve
dentist prescribed Percodan for pt after difficult extraction, pt arrives w/ family member somewhat confused and short of breath. low bp, slowed heart rate, nausea, pinpoint pupils
adverse reaction
antagonist pharmacological agent that should be used to tx pt in pervious question
naloxone
6 neurotransmitters
norepinephrine/epinephrine dopamine serotonin acetylcholine GABA histamine
pulpitis
neuropathic chronic pain
post-herpetic neuralgia
neuropathic chronic pain
oral dysesthesia
nociceptive acute pain
maxillary sinusitis
nociceptive acute pain
migaines
neuropathic chronic pain
cancer
nociceptive acute pain
fibromyalgia
neuropathic chronic pain
exodontia
nociceptive acute pain
med for neuropathic pain
gabapentin & Neurontin
diaphoresis
perspiration
diflunisal
dolobid
dyspepsia
“upset stomach”; impaired gastric function
dysphoria
mood of general dissatisfaction, restlessness, anxiety, depression
eupepsia
good digestion
euphoria
feeling of well being
fentanyl
sublimaze
hydrocodone
in lorcet; Vicodin
hydromorphone
dilaudid
ibuprofen
Motrin
ketorolac
toradol
loperamide
Imodium
meperidine
Demerol
methadone
dolophine
naproxen
Naprosyn
naproxen sodium
anaprox
oxycodone
in Percocet; tylox
propoxyphene
in Darvocet-N 100
moa of aspirin may produce analgesia by inhibiting synthesis of ____ in the CNS
Prostaglandin
prolonged administration of large doses of aspirin results in
occult bleeding, anemia, or massive GI hemorrhage
ibuprofen is an NSAID that possesses ____&___ activities
analgesic, anti-inflammatory and antipyretic
indomethacin should be used cautiously in pt w/ ____,____, and ___or___ dz
epilepsy
parkinsonism
hepatic
renal
reye’s syndrome may develop in children when ____ is used to tx fever from ____ infections
aspirin
viral
chemical agent may be released in tissue injury during th process of inflammation
prostaglandin
prevent formation of the platelet-aggregating substance
aspirin
indicated for tx of pt w/ ductus arteriosus
indomethacin
salicylates s/b used w/ caution in pts on which med
anticoagulant
ibuprofen may be given to pts in all disorder/conditions except
dysmenorrhea
fever
rheumatoid arthritis
NOT peptic ulcer
the isoenzyme cox-2 is primarily assoc w/
inflammation
acetaminophen lacks
anti-inflammatory
like traditional NSAIDS, the cox-2 inhibitors cause all except
diarrhea
dyspepsia
abdominal pain
NOT osteoarthritis
adverse effects of acetaminophen are
rare
FDA labeled celecoxib for tx of
rheumatoid arthritis
acetaminophen
Tylenol
meloxicam
movera
celecoxib
Celebrex
pentazocine/naloxone
talwin
nalmefene HCI
revex
semisynthetic narcotics include
oxycodone
adverse effects of morphine include all except
dry mouth
constipation
biliary tract spasms
NOT hypertension
opioids or opiates can interact w/ alcohol and cause
respiratory depression
hydrocodone is classified as
schedule III
oxycodone is classified as schedule
II
opioids may be natural, synthetic or ____ morphine related substances
semisynthetic
the unripe capsules of Papaver somniferum contain approx. 9.5%
morphine
safety of naloxone during pregnancy or lactation is
not established
____ contraindicated in pt receiving opioid analgesics or in acute opioid withdrawal
naltrexone
phenothiazine’s may interact w/ naltrexone and cause increased ___ and ____
somnolence
lethargy
naloxone and naltrexone are
synthetic opioid antagonist
often used w/ aspirin or acetaminophen
oxycodone
often used during open-heart surgery
fentanyl
used for detoxification of opioid addiction
methadone
fewer undesirable effects than morphine
synthetic opioid analgesics
more addicting than codeine
hydrocodone
has caused fatal reactions within 14 days
meperidine
the principal moa for fentanyl are ___ and ___ but its action is more prompt and less than morphine
analgesia
sedation
