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Non opioids Flashcards

1
Q

Epidural and intrat used for pain management for cancer and non cancer pain and post op

A

Clonidine

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2
Q

Used as IV sedation short period for intubates/mechanically ventilated patients (less than 24 hrs)

A

Dexmedetomidine does not depress respiratory

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3
Q

If discontinued cause withdrawal effect

A

Clonidine and dexmedetomidine

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4
Q

Used as adjunct in labor anesthesia

A

Clonidine

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5
Q

Enhances and prolongs sensory block and motor blockage, anesthetic action and analgesia action of LA epidural
Synergism effect on LA epidural, prolongs duration

A

Clonidine

Dexmedetomidine

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6
Q

Reduce dosage liver AND kidney impairment

A

Dexmedetomidine

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7
Q

Side effects: Bradycardia, heart block, hypotension, nausea

A

Dexmedetomidine

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8
Q

Withdrawal causes rebound hypertension, agitation and sympathetic overactivity

A

Clonidine

Dexmedetomidine also causes withdrawal

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9
Q

Increases Nausea and vomiting

A

Neostigmine, Baclofen & Dexmedetomidine

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10
Q

Intrathecal Increases effects of LA, Opioids and other alfa 2 agonists drugs like clonidine

A

Neostigmine

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11
Q

Epidural does not affect motor blockage

A

Nesotigmine

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12
Q

Does not cause respiratory depression or pruritus alone or with opioids

A

Neostigmine

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13
Q

Alfa 2 receptors need to be inhibited or activated by agonist

A

Activated to cause inhibitory effect

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14
Q

Spinal used in pediatric lower abdominal & urological cases

A

Neostigmine

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15
Q

Nociceptive stimulation release which excitatory NT

A

Glutamate, asparate & neuropeptides

Substance P

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16
Q

Epidural administration must be administered preservative free

A

Ketamine, preservative causes neurotoxicity

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17
Q

May be used as a sole agent or with opioids in post op pain

A

Ketamine

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18
Q

Prolongs onset and duration of LA

A

Ketamine

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19
Q

Intrathecal reduces N/V

A

Versed

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20
Q

MOA of versed

A

Binds to GABA A receptor, increases GABA A ,allowing Cl influx
Also binds to d opioid receptors

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21
Q

2 meds risk of neurotoxicity

A

Ketamine & Versed

ketamine due to metabolite

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22
Q

Epidural & intrathecal antiemetic

A

Droperidol

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23
Q

Increases suicidal instincts

A

Ziconotide

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24
Q

Only nonopioid approved for FDA for neuropathic pain

A

Zicotidine Spinal

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25
Q

Reduces pruritus and post op N/V

A

Dropiderol

26
Q

N type Calcium channel receptors

A

Zicotidine, decreases NE

27
Q

Gabapentin and preabalin uses (3)

A

neuropathic pain, anticonvulsant (oral), fibromyalgia

28
Q

Baclofen unique MOA

A

Activates GABA B receptors, increases K, causes hyperpolarization, also presynaptically inhibits Glutamate and Substance P

29
Q

Uses for Baclofen

A

MS, Cerebral Palsy, spasticity, dystonia, low pain pain with root compression

30
Q

Side effects of Baclofen

A

sedation, drowsiness, headache, nausea, weakness rhabdomyolysis and multiple organ faillure

31
Q

One of the side effects is rhabdomyolyisis and multiple organ failure

32
Q

COX Pathway leads to the production of what mediators?

A

Prostaglandyns, Prostacyclins and thromboxanes

33
Q

What 2 reactions catalyzed COX

A

1: Cyclization of AA acid to PGG2 2: PGG2 reduction to PGH2

34
Q

Meds contraindication for Ketotolac

A

Decreases protein binding, increases drug

35
Q

Highly bound to plasma albumin

A

COX inhibitors, (Aspirin reduces plasma binding od Ketorolac and increases drug)

36
Q

Does not have antiinflammatory effects

A

Acetaminophen

37
Q

NSAIDS recommended for cardiovascular complications

38
Q

Result on ductus arteriousus

A

Closes ductus arteriosus in neonates, Prostaglandins maintain open

39
Q

Which COX inhibitors cause GI bleeding & GI bleeding?

A

COX 1 also Ibuprofen and

40
Q

Respiratory effects

A

Risk of anaphylaxis: Nasal polyps, sllergic rhinitis & asthma

41
Q

IV NSAID

42
Q

NSAID does not cross BBB

43
Q

Coxibs do not affect

A

Platelet inhibition

44
Q

Responsible for pain COX 1, 2

45
Q

NSAID limited for 5 days due to renal toxicity (papillary necrosis) and GI ulceration

46
Q

Aspirin OD

A

acid/base imbalaces & RESPIRATION

47
Q

Acetaminophen Overuse

A

Fulminant Renal Failure

48
Q

Adverse effects of COX 1 inhibitors (graph)

A

Platelet dysfunction, Hypersensitivity & GI ulceration

49
Q

Selective COX 2

A

Acetaminophen and Coxib

50
Q

MOA of TCA

A

Block Na channels and increase antinociceptive noradrenergic an serotonergic projections descending from the brain to the spinal cord

51
Q

Beneficial for post op resp depression or emesis

52
Q

Short management of pain (Less than 5 days ) causes renal toxicity and GI ulceration (increases Aspirin effects)

53
Q

Cox 2 selective inhibitor with little anti inflammatory effects

A

Acetaminophen

54
Q

Has low therapeutic index, overdose can result in liver failure

A

Acetaminophen

55
Q

COX 2 Selective Inhibitors that are antiinflammatories, analgesica and antipyretic actions as conventional NSAIDS but without antiplatelet action.

A

COXIBS, Celecoxib

56
Q

DIffernece between COX 1 AND 2 Inhibitors

A

COX 1 GI upset and bleeeding more than CO@
COX 2 no antiplatelet action
COX 1 Hypersensitivity

57
Q

Drug used primarily to treat trigeminal neuralgia

A

Antiarrthymic Drugs, treats chronic pain

58
Q

MOA of Carbamazepine (antiarrthmic drug)

A

Blocks Na channels

59
Q

Antidepressants are also used for

A

Chronic pain

60
Q

MOA for antidepressants TCA manage of chronic pain

A

Blocks sodium channels

61
Q

MOA for Venlafaxine and Duloxetine for management of chronic pain

A

Block NE and serotonin reuptake (Reuptake inhibitors)

Non opioids (1 decks)

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