MSK Pharmacology

Question 1

What is acetaminophen used for?

Answer 1

Mild to moderate pain

Question 2

What effects does acetaminophen have?

Answer 2

Analgesic and anti-pyretic (no anti inflammatory)

Question 3

What can acetaminophen be toxic to at high doses?

Answer 3

Liver

Question 4

What type of effects does ibuprofen have?

Answer 4

Analgesic, anti-pyretic, and anti-inflammatory

Question 5

What is a characteristic of ibuprofen?

Answer 5

Non selective cox inhibitor

Question 6

What are the effects of aspirin?

Answer 6

Analgesic, anti-pyretic, anti-inflammatory, and anti-coagulant (increased risk of bleeding)

Question 7

What do NSAIDs block?

Answer 7

Action of cyclooxygenase

Question 8

What do NSAIDs decrease?

Answer 8

Prostaglandins

Question 9

What does tissue injury lead to the release of?

Answer 9

Membrane phospholipids (converted to AA, then cyclooxygenases, then prostaglandins)

Question 10

What do prostaglandins cause?

Answer 10

Inflammation

Question 11

What enzymes do NSAIDs block?

Answer 11

Both cox ones

Question 12

What does cox 1 do?

Answer 12

Produces protective physiological actions (promotes protection of gastric mucosa)

Question 13

What does cox 2 produce?

Answer 13

Pro-inflammatory prostaglandins and prostacyclin

Question 14

What do prostacyclin cause?

Answer 14

Vasodilation

Question 15

What can NSAIDs result in?

Answer 15

Gastric irritation, GI hemorrhage, and increased cardiac risks

Question 16

What do prostaglandins protect?

Answer 16

GI lining

Question 17

What do prostaglandins promote?

Answer 17

Clotting, inflammation, pain, and fever

Question 18

What is the goal with NSAIDs?

Answer 18

To block only cox 2 and not cox 1 (because cox 1 protects the stomach while cox 2 causes pain)

Question 19

What do cox 2 selective decrease?

Answer 19

GI side effects but increased CV side effects

Question 20

Is it safe to take acetaminophen and ibuprofen at the same time?

Answer 20

Yes

Question 21

What is Elavil used for?

Answer 21

Tricyclic antidepressant

Question 22

What is Cymbalta used for?

Answer 22

Antidepressant (SNRI)

Question 23

What is Savella used for?

Answer 23

Antidepressant (SNRI)

Question 24

What is Flexeril used for?

Answer 24

Muscle relaxant

Question 25

What is Gabapentin used for?

Answer 25

Antiepileptic

Question 26

What is Pregabalin used for?

Answer 26

Antiepileptic

Question 27

What is Carbamazepine used for?

Answer 27

Antiepileptic

Question 28

What are the three types of opioid receptors?

Answer 28

Mu, kappa, and delta

Question 29

What are partial agonist opioids?

Answer 29

Tramadol and buprenophine

Question 30

What are antagonist opioids?

Answer 30

Narcan and naltrexone

Question 31

What are morphine and most oral narcotics derived from?

Answer 31

Opium poppy

Question 32

What is the top prescribed and abused opioid drug?

Answer 32

Hydrocodone

Question 33

What are the potency strengths of opioid drugs from lowest to highest?

Answer 33

Codeine, hydrocodone, oxycodone, hydromorphone

Question 34

When are you at increased odds for being on opioids for more than a year?

Answer 34

After using it for 5 days

Question 35

What is tolerance?

Answer 35

Need more medication for same effect

Question 36

What is physical dependence?

Answer 36

Physical symptoms of withdrawal when drug is removed

Question 37

What is misuse/psychological dependence?

Answer 37

Behaviors described as loss of control and preoccupation with the substance being abused

Question 38

What is positive reinforcement with opioids?

Answer 38

Linked to feelings of reward

Question 39

What is negative reinforcement with opioids?

Answer 39

Pain reduction

Question 40

How can buprenorphine and naloxone treat opioid dependence?

Answer 40

Agonizes mu and kappa receptors and prevents withdrawal symptoms

Question 41

How does naltrexone treat opioid dependence?

Answer 41

Blocks euphoric feelings

Question 42

What is rheumatoid arthritis?

Answer 42

Chronic inflammation and proliferation of synovial tissue lining the joint space (autoimmune)

Question 43

What is a common characteristic of rheumatoid arthritis?

Answer 43

Morning stiffness, symmetrical joint pain

Question 44

Where is rheumatoid arthritis most common?

Answer 44

Hands and wrist

Question 45

What are the primary goals of meds used for rheumatoid arthritis?

Answer 45

Reduce inflammation and prevent progression

Question 46

What are meds used for rheumatoid arthritis?

Answer 46

NSAIDs Steroids DMARDs

Question 47

When should DMARDs begin?

Answer 47

Within 3 months of diagnosis

Question 48

What are DMARDs working specifically to do?

Answer 48

Stop effects of synovial overproliferation and auto immune response

Question 49

What are DMARDs used to treat?

Answer 49

Rheumatoid arthritis

Question 50

What is osteoarthritis?

Answer 50

Cartilage damage by forces or overuse

Question 51

What age group usually has osteoarthritis?

Answer 51

> 40 y/o

Question 52

How do patients with osteoarthritis present?

Answer 52

Asymmetric joint pain and stiffness

Question 53

What are the common joints with osteoarthritis?

Answer 53

Fingers, knees, hip, and spine

Question 54

What meds are used to treat rheumatoid arthritis?

Answer 54

NSAIDs, glucocorticoids, and DMARDs

Question 55

What population is most common for rheumatoid arthritis?

Answer 55

Women age 15-45

Question 56

Nodules

Answer 56

Asymptomatic bumpy scar tissue regions (elbows, forearms, and hands)

Question 57

Pulmonary

Answer 57

Nodules in lung tissue

Question 58

Ocular

Answer 58

Inflammation of sclera, cornea, and lacrimal glands (reduced tear production)

Question 59

Cardiac

Answer 59

Pericarditis

Question 60

What will NSAIDs do for rheumatoid arthritis?

Answer 60

Does not prevent progression but will help with symptoms

Question 61

How long do DMARDs take to work?

Answer 61

Months

Question 62

What type of DMARDs work faster?

Answer 62

Biological (produced by living systems)