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Pharmacology > L15 Analgesics > Flashcards

L15 Analgesics Flashcards

1
Q

What are analgesics ?

A

drugs that act centrally or peripherally , reliving pain while not affecting consciousness

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2
Q

what are some examples of non-selective COX inhibitors ?

A

aspirin

ibuprophen

ketorolac

naproxen

indomethacin

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3
Q

what are some examples of preferential COX-2 inhibitors ?

A

diclofenac , acelofenac , nimesulide

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4
Q

analgesic / antipyretic with weak anti inflammatory activity ?

A

acetaminophen

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5
Q

describe the mechanism of action of NSAIDs.

A

block COX enzyme from activating COX pathway which produces prostaglandins and other mediators of inflammation , pain , and fever

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6
Q

which COZ enzyme is responsible for protection of stomach and renal function ?

A

COX-1

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7
Q

which COX enzyme is present in the kidney and brain and mediates inflamation , pain and fever ?

A

COX II

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8
Q

Which COX enzyme exclusively has pain pathways only?

A

COX III

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9
Q

which COX enzyme is blocked by acetaminophen ?

A

COX III

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10
Q

Binding of asprin to COX is ____

A

irreversible

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11
Q

aspirin is used in :

A

post operative dental pain and inflammation

to treat arthritis , gout , headache , myalgia

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12
Q

how is dose affected when an opioid is paired with an NSAID ?

A

dose of opioid is decreased

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13
Q

what NSAID causes gastric bleeding and ulceration most commonly ?

A

Aspirin

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14
Q

which NSAID can cause acute reversible renal insufficiency in hepatic cirrhosis patients ?>

A

Aspirin

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15
Q

which NSAID can cause Reye’s syndrome in children ?

A

Aspirin

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16
Q

what is Reye’s disease and who does it affect “?

A

liver damage and encephalopathy

is most common in children with viral infection

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17
Q

what NSAID should be given to children under the age of 12?

A

acetaminophen

18
Q

what’s the adult fatal dose of aspirin ?

A

15-30g

19
Q

treatment for acute salicylate poisoning is ____

A

symptomatic and supportive

20
Q

coma and death from acute salicylate poisoning is because of ?

A

respiratory failure and cardiovascular collapse

21
Q

ibuprophen is an analgesic , antipyretic , and anti-inflammatory agent

A

:D

22
Q

What is the drug of choice for dental pain when NSAID is indicated ?

A

ibuprophen

23
Q

NSAIDs ( non selective ) should generally not be given to peptic ulcer patients

A

:D

24
Q

Which NSAID should be used for short duration ( around 5 days ) only ?

A

ketorolac

25
Q

describe the properties of ketorolac.

A

potent analgesic with moderate anti-inflammatory effects .

adverse effects : gastric ulcer and renal toxicity

26
Q

indomethacin:

A

10-40x more potent

non-selective cox inhibitor

reserve drug only used if patient is not responding to other NSAIDs

high incidence of GI and CNS side effects

27
Q

diclofenac is which type of COX inhibitor ?

A

preferential COX-II inhibitor

28
Q

when is diclofenac used?

A

to treat arthritis , toothage , and spndylitits

29
Q

what special property makes diclofenac effective in treatment of arthritis ?

A

it stays in synovial fluid 3X as long as it does in plasma

30
Q

whats the usual adult dosing of acetaminophen ?

A

325-650mg every 4-6 hours

31
Q

what’s the recommended limit of paracetamol intake in 24 hours ?

A

not to exceed 4G

32
Q

what dose of paracetamol can result in hepatic necrosis ?

A

20-25 G

33
Q

what side effects can be seen in long term acetaminophen use?

A

nephrotoxicity and rashes

34
Q

> 250g/kg paracetamol = fatal

A
35
Q

describe the mechanism of toxicity of acetaminophen .

A

it produces a toxic metabolie NAPIQ which is detoxified when conjugated by liver synthesized glucoronide

36
Q

what specific antidote can reverse acute paracetamol poisoning ?

A

N- acelylccysine : replenishes glucuronide in liver

37
Q

what receptors do opioids bind to?

A

Mu , Kappa , and delta

38
Q

dihyfrocodine is an example of ___

A

semisynthetic opioids

39
Q

opioid agonist/ antagonist :

A

pentazocine

40
Q

opioid antagonist

A

naloxone

41
Q

when should NSAID be given to pregnant women ?

A

1st trimester : minimal use only

3rd trimester : completly avoided

2nd trimester : optimal

Pharmacology (10 decks)

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