L15 Analgesics

Question 1

What are analgesics ?

Answer 1

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

Question 2

what are some examples of non-selective COX inhibitors ?

Answer 2

aspirin

ibuprophen

ketorolac

naproxen

indomethacin

Question 3

what are some examples of preferential COX-2 inhibitors ?

Answer 3

diclofenac , acelofenac , nimesulide

Question 4

analgesic / antipyretic with weak anti inflammatory activity ?

Answer 4

acetaminophen

Question 5

describe the mechanism of action of NSAIDs.

Answer 5

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

Question 6

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

Answer 6

COX-1

Question 7

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

Answer 7

COX II

Question 8

Which COX enzyme exclusively has pain pathways only?

Answer 8

COX III

Question 9

which COX enzyme is blocked by acetaminophen ?

Answer 9

COX III

Question 10

Binding of asprin to COX is ____

Answer 10

irreversible

Question 11

aspirin is used in :

Answer 11

post operative dental pain and inflammation

to treat arthritis , gout , headache , myalgia

Question 12

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

Answer 12

dose of opioid is decreased

Question 13

what NSAID causes gastric bleeding and ulceration most commonly ?

Answer 13

Aspirin

Question 14

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

Answer 14

Aspirin

Question 15

which NSAID can cause Reye’s syndrome in children ?

Answer 15

Aspirin

Question 16

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

Answer 16

liver damage and encephalopathy

is most common in children with viral infection

Question 17

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

Answer 17

acetaminophen

Question 18

what’s the adult fatal dose of aspirin ?

Answer 18

15-30g

Question 19

treatment for acute salicylate poisoning is ____

Answer 19

symptomatic and supportive

Question 20

coma and death from acute salicylate poisoning is because of ?

Answer 20

respiratory failure and cardiovascular collapse

Question 21

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

Answer 21

:D

Question 22

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

Answer 22

ibuprophen

Question 23

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

Answer 23

:D

Question 24

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

Answer 24

ketorolac

Question 25

describe the properties of ketorolac.

Answer 25

potent analgesic with moderate anti-inflammatory effects . adverse effects : gastric ulcer and renal toxicity

Question 26

indomethacin:

Answer 26

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

Question 27

diclofenac is which type of COX inhibitor ?

Answer 27

preferential COX-II inhibitor

Question 28

when is diclofenac used?

Answer 28

to treat arthritis , toothage , and spndylitits

Question 29

what special property makes diclofenac effective in treatment of arthritis ?

Answer 29

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

Question 30

whats the usual adult dosing of acetaminophen ?

Answer 30

325-650mg every 4-6 hours

Question 31

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

Answer 31

not to exceed 4G

Question 32

what dose of paracetamol can result in hepatic necrosis ?

Answer 32

20-25 G

Question 33

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

Answer 33

nephrotoxicity and rashes

Question 34

>250g/kg paracetamol = fatal

Question 35

describe the mechanism of toxicity of acetaminophen .

Answer 35

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

Question 36

what specific antidote can reverse acute paracetamol poisoning ?

Answer 36

N- acelylccysine : replenishes glucuronide in liver

Question 37

what receptors do opioids bind to?

Answer 37

Mu , Kappa , and delta

Question 38

dihyfrocodine is an example of ___

Answer 38

semisynthetic opioids

Question 39

opioid agonist/ antagonist :

Answer 39

pentazocine

Question 40

opioid antagonist

Answer 40

naloxone

Question 41

when should NSAID be given to pregnant women ?

Answer 41

1st trimester : minimal use only 3rd trimester : completly avoided 2nd trimester : optimal