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Pharmacology > Pain & Analgesic Drugs > Flashcards

Pain & Analgesic Drugs Flashcards

1
Q

Neuropathic pain

A

Pain induced by injury to or disease of the somatosesnory system
-nerve injury or nervous infection

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2
Q

Analgesic

A

Affects only pain without blocking other symptoms or loss of consciousness

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3
Q

Two types of anesthetic

A

Local or general

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4
Q

Local anaesthetic

A

Blocks nerve conduction and all local sensations
-no touch or temperature

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5
Q

General anaesthetic

A

Loss of sensations and unconsciousness

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6
Q

Anesthetic

A

Group used for pain
-dulls all sensations as well as pain `

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7
Q

What is important to remember when giving analgesia?

A

Need to remember what is actually causing the pain
-as the analgesia helps to relieve it
-but isn’t healing the cause

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8
Q

Where do opioids work?

A

The brain and the spinal cord

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9
Q

Opioids affect what two processes in the brain nad spinal cord

A

Perception and modulation

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10
Q

In higher centres such as the brain, what do opioids do?

A

Pain can still be felt but produce less suffering
-perception

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11
Q

In the spinal cord, what do opioids do?

A

Reduce neurotransmitter release from terminal pain fibres in dorsal horn of spinal cord
-modulation

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12
Q

Opioids bind to

A

Opioids receptors

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13
Q

Opioids covers any

A

Drug binding to opioid receptors and can be natural or synthetic

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14
Q

Opiate

A

Any drug derived from opium
-morphine or codeine

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15
Q

Opium

A

Juice of the poppy
-palaver somniferum

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16
Q

What two forms of opioids are very similar

A

Morphine and codeine

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17
Q

What is the difference between morphine and codeine

A

Codeine has a portion needed to be metabolized before it is the same particle as morphine and can be an analgesic

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18
Q

What’s a better analgesic, morphine or codeine?

A

Morphine

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19
Q

Properties of different opioids drugs are due to

A

-affinity and activation for different opooids receptors
-pharmacokinetic differences

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20
Q

All opioids analgesics are ___ ____ or ____ ____ at U and K receptors

A

Full agonists, partial agonists

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21
Q

Morphine receptors U, Kappa, delta are all

A

Agonists

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22
Q

U (mu) receptors

A

Analgesia
-cover a wider variety of brain areas
-can limit the emotional response

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23
Q

K or Kappa receptors

A

Analgesia
-brain and spinal cord
-can cause dysphoria and hallucinations

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24
Q

Analgesia is in what two receptors

A

U and K

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25
Q

Opooids can cause sedations and ….

A

Mental clouding

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26
Q

Delta and mu receptors involve central dopaminergic pathways potentially causing

A

Euphoria and tranquility

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27
Q

Properties of opoids: antitussive

A

Depressing cough reflex by acting on a cough centre in medulla

-can be good for a continuous cough
-can be bad if needing to clear lungs

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28
Q

Most dangerous properties of opoids

A

Depression fo respiratory center
-mu receptors

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29
Q

Opoids can stimulate chemoreceptor and trigger zone of the medulla causing…

A

Nausea and vomiting

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30
Q

Opioids properties: miosis

A

Pin point pupil
-excitatory action of parasympathetic nerve inner at in pupil

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31
Q

Risk of continous or first experience on opoids

A

Tolerance and serious dependence

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32
Q

A very common property of opoids

A

Constipation
-increase GI muscle tone to point of spasm, increasing tone of anal sphincter

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33
Q

Opioid properties: postural hypotension

A

Inhibition of barorceptor reflex

34
Q

Properties of opoids: warm skin

A

Dilation of cutaneous blood vessels
-may involve histamine, sweating and itching

35
Q

Property of opoids: urination

A

Urgency to urinate, but difficulty
-inhibits urinary voiding reflex

36
Q

Methadone

A

Has a longer action than morphine, so used to help people with additions
-Cant get as high off these as morphine

37
Q

Fentanyl

A

Non naive patients
-used in patients who have morphine experience before but need pain killers

38
Q

Fentanyl was created

A

In a lab a different chemical than morphine, was made to hopefully not have respiratory depression (didn’t work)

39
Q

Indications of opoids

A

Alleviate mild to moderate to severe pain

40
Q

Opoids are often given with

A

Adjuvant analgesic agents to assist with pain relief
-Tylenol

41
Q

Opoids are also used for (aside from pain)

A

-cough centre suppression
-treatment of diarrhea
-balanced anaesthesia

42
Q

Cough centre suppression

A

Codeine

43
Q

Treatment of diarrhea

A

Loperamide

44
Q

Balanced anaesthesia

A

Fentanyl

45
Q

What is considered the standard opoids

A

Morphine
-most other opoids are compared in dosing

Morphine: 10mg
Fentanyl: 0.1 to get same degree of morphine
Codeine: 200mg to get same degree of morphine

46
Q

Morphine

A

Primarily MU opoids receptors
-acts in brain and spinal cord

47
Q

Morphine can be given

A

IV, IM, SC, PO, intrathecal
Po: extended use, takes along time to kick in

48
Q

Half life of morphine

A

2 to 4 hours

49
Q

Morphine liver metabolism

A

Extensive liver metabolism (which inactivates the molecule)
-first pass metabolism

50
Q

First pass metabolism comparison of morphine

A

IM 10 mg = 30mg PO

51
Q

Pregnancy and breast feeling, morphine

A

Risk for physical dependence
-crosses placenta and enters breast milk

52
Q

Chronic pain requires

A

Around the clock treatment of analgesics

53
Q

Breakthrough pain

A

Transient episodes of pain while chronic pain is controlled

54
Q

Cancer pain needs

A

Around the block morpheine
-sustained release

55
Q

Three stages of WHO pain management ladder

A

Stage 1: pain persisting or increasing (non opoid option)

Stage 2: pain persisting or increasing (opoid for mild to moderate pain)

Stage 3: freedom from cancer pain (opoid for moderate to severe pain)

56
Q

NSAIDS

A

The most common non narcotic analgesic
-ibuprofin

57
Q

Adjuvants

A

-antidepressants
-antiseizure drugs
-glucocorticoids

58
Q

Morphine contraindications and cautions

A

-Respiratory depression
-hepatic dysfunction
-elevated intracranial pressure
-pregnancy

59
Q

Opoids adverse effects

A

-respiratory depression
-CNS depression
-nausea and vomiting (worse on first dose)
-constipation

60
Q

Interactions of opioids

A

CNS depressants
-ethanol
-antipsychotics, antihistamines, sedatives

61
Q

Moderate opioid analgesics

A

-codeine
-oxycodone
-buprenorphine

62
Q

Codeine

A

Less analgesia and respiratory depression
-antitutissive

63
Q

Codeine is often

A

Combined with acetaminophen, Tylenol

64
Q

Oxycodone

A

Deals with pain but has less AE
-abuse potential

65
Q

Oxycodone is often used with

A

Acetaminophen

66
Q

Oxycodone- what is required for activation?

A

Metabolism

67
Q

Naloxone

A

Used for complete or partial reversal of opoid induced respiratory depression

68
Q

Naloxone is a ____ morphine is a ____

A

Antagonist, agonist

69
Q

Naloxone has a shorter

A

Half life than morphine and other opoids

70
Q

Treating opoid addiction

A

Methadone program or sub ozone (buprenorphine and naloxone)

71
Q

What is a common physiological result of chronic opioi treatment

A

Opioid tolerance

72
Q

Physical dependence

A

Drug needs to be administered to maintain normal function
-abstinence syndrome will occur with abrupt withdrawal

73
Q

Narcotic withdrawal

A

Opoid abstinence syndrome
-very unpleasement but not dangerous

74
Q

Withdrawal symptoms

A

Anxiety, irritability, chills, hot flashes, joint pain, sneezing, diaphoresis, vomiting, nausea, cramps, diarrhea

75
Q

Physical dependence is NOT the same as

A

Addiction or substance dependence syndrome

76
Q

Tolerance and physical dependence are both part of the body’s

A

Response to the presence of drug

77
Q

Oral forms of opioids should be

A

Taken with food to minimize gastric upset

78
Q

What should someone do if after taking opioids they decline in condition or VS are abnormal

A

Withhold the dose

79
Q

What is it especially important to monitor before giving dose of opiods

A

Respiratory rate
-if it is less than 12 breaths a minute

80
Q

Respiratory depression may be manifested by

A

-less than 12 breaths per minute
-dyspnea
-diminished breath sounds
-shallow breathing

81
Q

How to treat consitpation

A

Take opoiiods with adequate fluid and fibre intake
-stool softener or stimulant

Pharmacology (37 decks)

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