Neuro Unit 2 Drugs

Question 1

Cocaine

Answer 1

Local anesthetic= block sodium channel function

Ester

Question 2

Lidocaine

Answer 2

Amide

Question 3

Bupivacaine

Answer 3

Amide

Question 4

Mepivicaine

Answer 4

Amide

Question 5

Morphine

Answer 5

Mu agonist
Less lipid soluble than heroin
Sustained release (MS contin) 8-24 hrs

Question 6

Hydrocodone

Answer 6

Mu Agonist
With Ibuprofen= Vicoprofen
With acetominophen= Vicodin

Question 7

Oxycodone

Answer 7

Mu agonist
Combined with acetominophen= Percocet
Sustained release (Oxcontin)= up to 12 rs

Question 8

Codeine

Answer 8

Anti-tussive mu agonist
Combined with acetominophen= Tylenol #3
with aspirin = “Empirin compound”

Question 9

Tramadol

Answer 9

Mu agonist

Question 10

Fentanyl

Answer 10

Mu Agonist-quite lipid soluble
Works 0.5-1 hrs
** transdermal patch- 48-72 hrs***

Question 11

Loperamide

Answer 11

Mu Agonist used as antidiarrheal (Imodium)

Question 12

Dextromethorphan

Answer 12

Anti-Tussive (DX in robitussin DX)

Question 13

Prostaglandin effect on pain

Answer 13

Sensitizing agents - produce bradykinin that make the pain pathway work better

Question 14

Buprenorphine

Answer 14

Partial Mu agonist

Question 15

Naloxone

Answer 15

Mu antagonist

Acute treatment of opioid overdose

Question 16

Ibuprofen

Answer 16

Cox 1/2 antagonist, do not affect subjective reaction to pain, no abuse potential

Question 17

Naproxen

Answer 17

Cox 1/2 antagonist, does not affect subjective rxn–> no abuse potential

Question 18

Receptor targets for pain modulation

Answer 18

M/K opioid receptors 
a2 adrenergic 
NMDA-Glu
5-HT3
5-HT1d

Question 19

Ketorolac

Answer 19

Cox 1/2 antagonist

Question 20

Celecoxib

Answer 20

Cox 2 selective

Question 21

Acetominophen

Answer 21

CNS cox-2 inhibitor

Question 22

Ketamine

Answer 22

NMDA antagonist

Question 23

Adjuvant antidepressives

Answer 23

Tricyclic antidepressants, SNRI’s*

Do not start working quickly

Question 24

Adjuvant anticonvulsant

Answer 24

Gabapentin

Question 25

Adjuvant pain therapy: Local anesthetic

Answer 25

Lidocaine (patch!)

Question 26

Migraine Abortive therapy: NSAIDS

Answer 26

NSAIDS: ibuprofen, naproxen, acetominophen

Question 27

Migraine Abortive Therapy (DA antagonist)

Answer 27

Tx for nausea and vomiting!

Metoclopramide

Question 28

Opioid Monotherapy

Answer 28

Mainstay for postoperative pain

Question 29

Multimodal analgesia

Answer 29

Most drugs within a class have comparable analgesic efficacy, pharmacokinetics is the important factor in considerations

Question 30

Migraine abortive therapy (Seratonin agonist)

Answer 30

1D agonists: Sumatriptan (imatrex)

Question 31

Migraine abortive therapy: Ergot compounds

Answer 31

Dihydroergotamine

Question 32

Migraine Prophylactic Therapy

Answer 32

Blood pressure meds: Beta blockers, CCB’s, ACE inhibitors
Anticonvulsants
Antidepressants

Question 33

Alzheimer’s drugs

Answer 33

Cholinesterase inhibitor: Donezipil/Aricept

NMDA/Glutamate Antagonist: Memantine

Question 34

Wernicke’s Encephalopathy

Answer 34

Thiamine

Question 35

Acetaminophen (Tylenol)

Answer 35

• Little- no effects on peripheral Cox1 or 2 (CNS only)
• Hepatotoxicity is a major concern.
• Ceiling effect ~650 mg
• 1000 mg - not more analgesia, more risk to liver
• No large effects on musculoskeletal pain