Exam III pt. 1

Question 1

What are 3 non-opioid analgesics?

Answer 1

NSAID non selectives, NSAID selectives, Acetominophen

Question 2

What are NSAID non-selectives?

Answer 2

Salicylates, ibuprofen, naproxen

Question 3

What is a noteable side effect of Aspirin?

Answer 3

Reye’s syndrome

Question 4

What are some noteable side effects of Ibuprofen, Naproxen?

Answer 4

Electrolyte imbalances, hemorrhages

Question 5

What condition is overall a risk factor for NSAIDs?

Answer 5

Severe stomach bleeding

Question 6

What is a common name for NSAID, selective Cox-2 inhibitor?

Answer 6

Celecoxib (Celebrex)

Question 7

What is the comparable GI toxicity between Celebrex (celecoxib) and other NSAIDs?

Answer 7

Does not block COX-1, so less GI toxicity

Question 8

What is the common use for Celebrex (celecoxib)?

Answer 8

Mild pain such as arthritis

Question 9

What are some noteable side effects of Celebrex?

Answer 9

GI perforation and bleeding, thrombosis, Stevens-Johnson syndrome, liver and renal failure

Question 10

What nutrient interactions are noted with NSAIDs?

Answer 10

Depletes vitamin C, folate, iron, zinc.

Question 11

What kind of supplements should you avoid if you’re taking NSAIDS?

Answer 11

Anticoagulant supplements (e.g. garlic, ginger, ginko, ginseng, fish oil, vitamin E, etc, etc, etc)

Question 12

Does acetaminophen work DIRECTLY to inhibit a COX pathway in protaglandin synthesis?

Answer 12

No, it acts directly on the hypothalamus, which then inhibits prostaglandin synthesis

Question 13

T/F

Acetaminophen is known for it’s analgesic, antipyretic, and anti-inflammatory properties

Answer 13

False,

Acetaminophen has no anti-inflammatory activity, regardless of it’s usage by the general populus.

Question 14

What side effects are reported with excessive dosing of acetaminophen? What doses are considered excessive?

Answer 14

Hepatotoxicity. >4g/day (adults) or large doses (6g in adults).

Question 15

What are some examples of opioid analgesics?

Answer 15

Morphine, oxycodone, several combination drugs, etc.

Question 16

What are it’s common uses and draw backs?

Answer 16

Relieves virtually any type of pain. High risk for tolerance, dependence and abuse

Question 17

What are side effects associated with opioid analgesics?

Answer 17

Sedation, constipation. Respiratory and CNS depression/death

Question 18

What drugs are a combination of hydrocodone + acetaminophen?

Answer 18

Vicodin, Narco

Question 19

What combination drug comes from oxycodone + acetaminophen

Answer 19

Percocet

Question 20

What combination drug comes from propoxyphene + acetaminophen?

Answer 20

Darvocet

Question 21

What combination drug comes from codeine + acetaminophen?

Answer 21

Tylenol 2,3,4

Question 22

What are 4 natural supplements with strong evidence of analgesic activity?

Answer 22

Capsicum, clove, comfrey, willow bark.

Question 23

Migraines come from what kind of activity in the brain?

Answer 23

Arise from neurovascular disturbance in the brain (cortical spreading depression elicits a trigeminovascular reflex).

Question 24

What NTs may cause inflammation/pain in migraine headaches?

Answer 24

Dopamine and serotonin release

Question 25

What are Triptans?

Answer 25

Serotonin 5-HT1 receptor agonists

Question 26

What are some natural migraine prophylactics that are supported by strong evidence?

Answer 26

Feverfew, butterbur, peppermint (topical). CHIROPRACTIC!!!

Question 27

What is an example of an immediate immunologic reaction triggered by antibiotics?

Answer 27

Anaphylaxis or hives

Question 28

What is an exmaple of a delayed immunologic reaciton triggered by antibiotics?

Answer 28

Rahes, serum sickness, drug fever

Question 29

What antibiotic drugs are most notorious for triggering immunologic reactions?

Answer 29

Beta-lactam drugs (penicillins, cephalosporins

Question 30

What are the 4 antiobiotic mechanisms of action?

Answer 30

Inhibition of cell wall synthesis Inhibition of protein synthesis Inhibition of general metabolic pathways Inhibition of RNA/DNA synthesis

Question 31

What is the main mechanism of action of penicillins?

Answer 31

Beta lactam ring binds to and inhibits cell wall synthesis, eventual bacterial death.

Question 32

What are the noted side effects of penicillins?

Answer 32

``` N/V diarrhea Hypersensitivity reactions (Rashes -> anaphylaxis) ```

Question 33

What kind of penicillins have a broad spectrum use?

Answer 33

2nd generation. Amoxicillin, ampicillin, augmentin.

Question 34

T/F Cephalosporins are one of the smallest classes of antibiotics

Answer 34

False, One of the largest

Question 35

When would a patient want to use particular caution when taking cephalosporins?

Answer 35

If patient is allergic to a penicillin.

Question 36

What is the mechanism of action for cephalosporins?

Answer 36

Same mechanism as penicillins except broader spectrum

Question 37

What is the mechanism of action of aminoglycosides?

Answer 37

Inhibits protein synthesis

Question 38

What are the common uses of aminoglycosides?

Answer 38

For life threatening infections

Question 39

What is the mechanism of action of tetracyclines?

Answer 39

Reversibly bind to ribosomes, inhibiting protein synthesis

Question 40

What are the common uses of tetracyclines?

Answer 40

Broad spectrum

Question 41

What are some noteable side effeccts of tetracyclines?

Answer 41

Photosensitivity, dizziness, tooth discoloration

Question 42

What is the mechanism of action for sulfonamides?

Answer 42

compete with pathogenic bacteria for PABA (needed to synthesize folate)

Question 43

What is important to do when taking sulfonamides to prevent interactions?

Answer 43

Drink at least 3 quarts of water

Question 44

What is the mechanism of action for macrolides?

Answer 44

Inhibits bacterial protein synthesis

Question 45

What kind of side effects are noted with macrolides?

Answer 45

Allergic reactions

Question 46

What are the uses of fluoroquinolones?

Answer 46

Broad spectrum

Question 47

What are some noted side effects of fluoroquinolones?

Answer 47

Crystalluria; possible cartilage or tendon damage

Question 48

What is an important factor in preventing interactions with fluoroquinolones?

Answer 48

Drink plenty of water

Question 49

What is the mechanism of action of antimycobacterial agents?

Answer 49

Inhibits RNA synthesis

Question 50

What are side effects noted with antimycobacterial agents?

Answer 50

N/V, cramps, rash, fever, drowsiness, RED-ORGANGE BODY FLUIDS, elevated liver function tests. Hyper sensitivity, hyperbilirubinemia, thrombocytopenia

Question 51

What is another mechanism of action of antimycobacterial agents?

Answer 51

Inhibits the synthesis of mycolic acids, an essential component of the mycobacterial cell wall

Question 52

What are some other noteable side effects of antimycobacterial agents?

Answer 52

PERIPHERAL NEUROPATHY, anorexia, N/V, abdominal pain. SLE, hepatitis, anemia.

Question 53

What would you supplement with antimycobacterial agents to prevent PN?

Answer 53

Vitamin B6

Question 54

What is the mechanism of action for vancomycin?

Answer 54

Inhibits cell wall synthesis.

Question 55

What is one of the most commonly used antibiotics in hospitals?

Answer 55

Vancomycin. Due to MRSA. As a results we are seeing strains known as VRSA

Question 56

What are some noted side effects of vancomycin?

Answer 56

Red man syndrome (rash, flushing, tachycardia, hypotension). Ototoxicity, nephrotoxicity, anaphylaxis

Question 57

What are some noted antibacterial natural supplements with high evidence of efficacy?

Answer 57

Iodine, probiotics, colloidal silver