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Pharmacology > Pain and Anti Inflammatory Agents > Flashcards

Pain and Anti Inflammatory Agents Flashcards

1
Q

Explain how chemical mediators get released

A

1.)Tissue Injury Happens

2.) Vasoconstriction

3.) Then Chemical Mediators get released (HISTAMINE, KININS AND PROSTAGLANDIN)

4.) These chemical mediators trigger Vasodilation which then results into Redness and Erythma

5.) Increased Capillary permeability happens which results into Swelling Edema

6.) Pain receptors

7.) Fever happens which is also associated with Heat

8.) Everything results into Loss of Function

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1
Q

a class of medications designed specifically to relieve pain

A

Analgesics

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2
Q

Inflammation can cause

A

~Trauma
~Surgical Interventions
~Extreme Hot and Cold and Caustic chemical Agents

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2
Q
  • Response to tissue injury and
    infection
  • Protective mechanism
A

Inflammation

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3
Q

Enzyme responsible for conversion of arachidonic acid into prostaglandins

A

Cyclooxygenase (Cox)

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4
Q
  • Protects stomach lining
  • Regulates blood platelets
A

COX-1

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5
Q
  • Triggers inflammation and pain
A

COX-2

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6
Q

~Prostaglandin inhibitors

  • Relieve pain (analgesic)
  • Reduce elevated body
    temperature (antipyretic)
  • Inhibit platelet aggregation
    (anticoagulant)

~NSAIDs

A

Anti inflammatory Agents

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7
Q
  • Aspirin, also known as acetylsalicylic acid (ASA)
A

Salicylates

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7
Q

Seven Groups of NSAIDs

A

~Salicylates
~Para-Chlorobenzoic Acid derivatives or indoles
~Phenylacetic Acids
~Propionic Acid derivatives
~Fenamates
~Oxicams
~Selective Cox-2 inhibitors

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8
Q

Salicylates Functions

A
  • Anti-inflammatory
  • antiplatelet
  • antipyretic effects
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9
Q

1.) Therapeutic serum salicylate level:

2.) Toxic serum salicylate level:

A

1.) 10-30 mg / dl

2.) >40-50 mg/dl

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9
Q

Salicylates Drug Interactions:

A
  • anticoagulants
  • glucocorticoids
  • oral hypoglycemic
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10
Q

Salicylates WOF:

A

~Should be taken with MILK, WATER OR FOOD = GI UPSET

~Not be taken by children with flu symptoms = REYE SYNDROME

~C/I: PREGNANCY

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10
Q

It is an extremely serious pathological condition associated with swelling of liver and brain

A

Reye Syndrome

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10
Q

*Hypersensitivity to salicylate products

A

~Tinnitus
~Vertigo
~Bronchospasm

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11
Q

Para-chlorobenzoic acid Indications

A
  • Rheumatoid arthritis
  • Gouty arthritis
  • Osteoarthritis

May cause Increased BP and sodium & water retention

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12
Q

Para-chlorobenzoic acid Classifications

A

~Indomethacin (Indocin)
~Sulindac (Clinoril)

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13
Q

PHENYLACETIC ACID DERIVATIVES Indications

A
  • Rheumatoid Arthritis
  • Osteoarthritis
  • Ankylosing spondylitis
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14
Q

PHENYLACETIC ACID DERIVATIVES Type

A

Diclofenac Na (Voltaren)

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15
Q

PHENYLACETIC ACID DERIVATIVES:

  • short term management of pain
  • 1st injectable NSAIDs
  • Greater analgesic effect
A

Ketorolac

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16
Q

Propionic Acid Derivatives Type

A

Ibuprofens
(Alaxan, Advil and Medicol)

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17
Q

Propionic Acid Derivatives Type Drug Interactions:

A

~ Increase Effects of warfarin
~ Sulfonamides
~ Certain Cephalosporins
~ Phenytoin
~ Insulin
~ Oral Hypoglycemic

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18
Q

Propionic Acid Derivatives Side Effects

A

~ Gastric Upset (To be taken with food)

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19
Q

Fenamates Indications

A

~ Acute and Chronic Arthritis Conditions

20
Q

Fenamates Side Effects:

A

Gastric Irritation

21
Q

Fenamates Contraindication:

A

~ Patient with Peptic Ulcer
~ Mefenamic Acid (Ponstel) (Ponstan)
~ Meclofenamate Na Monohydrate (Meclomen)

22
Q

Oxicams Types

A

~ Piroxicam (Feldene Flash)
~ Meloxicam

23
Q

Oxicams Indication and Side Effects

A

1.) Long Term Arthritic Conditions

2.) Lower Incidence of Gastric problems
~ Ulceration
~ Epigastric Distress

24
Q

Oxicams should not be taken with 1.) _______ and other 2.)______

A

1.) Aspirin

2.) NSAIDS

25
Q

COX-2 Inhibitor Drug Agents

A
  • Celecoxib (Celebrex)
  • Rofecoxib (Vioxx)
  • Nabumetone (Relafen)
26
Q

Caution: not to be taken during third
trimester of pregnancy

  • NSAIDs in the elderly
  • Assessment of renal function
  • Prescribed NSAID dose may need to be decreased
A

COX-2 Inhibitors

27
Q
  • Suppressing and preventing many of
    the components of the inflammatory
    process at the injured site.
  • Dexamethasone
  • Prednisone
  • Prednisolone
A

Corticosteroids

28
Q
  • Inflammation of the joints
  • Uric Acid
A

Gout

29
Q

ANTIGOUT DRUGS
* Inhibit leukocytes on the inflamed site

A

Colchicine

30
Q

COLCHICINE SIDE EFFECTS

A
  • Gastric irritation
  • NV
  • Diarrhea
  • Abdominal pain
31
Q

Antigout Drugs:

  • Inhibit final steps of
    uric acid synthesis
  • No caffeine and alcohol
  • Indicated gout patients with renal impairment
A

Uric Acid inhibitor:
Allopurinol

32
Q

ANTIGOUT DRUGS
* Increase level of uric acid

A

Thiazide diuretics

33
Q
  • Alleviating chronic gout
  • Probenecid
A

Uricosurics

34
Q
  • Increase rate of uric acid excretions in the kidneys.
A

Probenecid

35
Q

NONOPIOIDS ACTS ON 1.) ________

OPIOIDS ACTS ON 2.)___________

A

1.) PNS

2.) CNS

35
Q

Probenecid Side Effects

A

~ Sore Gums
~ Headache
~ Flushed Skin

36
Q

NONOPIOID ANALGESICS:

safe, effective analgesic and
antipyretic drug used for
muscular aches, pains and
fever caused by viral infections

  • hepatotoxic; little to no GI
    distress
A

ACETAMINOPHEN

37
Q

1.) Unpleasant sensory and emotional experience related to
tissue injury

2.) Relief of pain

A

1.) Pain

2.) Analgesic

38
Q

1.) ACETAMINOPHEN therapeutic serum range:

2.) ACETAMINOPHEN Antidote:

A

1.) 5-20 MCG/ML

2.) ACETYLCYSTEINE (MUCOMYST)

39
Q

~ Opioid agonists
~ Can cause addiction
~ Analgesia, respiratory depression, euphoria, and sedation
~ Cough suppression
~ Antidiarrheal effect

A

OPIOID ANALGESICS

40
Q

OPIOID ANALGESICS SIDE EFFECTS

A

~ Nausea and Vomiting
~ Constipation
~ Decrease in BP
~ Urinary Retention
~ Antitussive Effects

41
Q

Pain medicine similar to an opioid. It acts in the
central nervous system (CNS) to relieve pain.

Seizures have been reported in patients taking it

( TDL HCL) 50 mg/cap

Tramadol HCL 37.5 mg, Paracetamol 325 mg
( DOLCET)

A

Tramadol

42
Q

Tramadol Max dose

A

400mg Per day

43
Q

As pre op medication- relieve anxiety
~ Route: Oral, IV, IM, SUBQ

A

Morphine

44
Q

1.) Morphine Antidote:

2.) Morphine NR:

A

1.) NALOXONE (NARCAN)

2.)
* Monitor RR, BP, UO, BS
* Antidote at bedside
* No alcohol/ CNS depressants
* Safety

45
Q

~ Shorter duration of action than Morphine
~ Route: Oral, IM and IV
~ No antitussive property
~ Neurotoxic
~ Can decrease BP

A

Meperidine (Demerol)

46
Q
  • More potent than morphine
  • Faster onset, shorter duration of action than Morphine
  • Oral, rectal, subcutaneous, IM, IV
  • SIVP
A

Hydromorphone

47
Q

HEADACHE PREVENTATIVE TREATMENT

A

~ Beta-adrenergic blockers (Propranolol & Atenolol)
~ Anticonvulsant (Valproic Acid & Gabapentin)
~ TCA (amitriptyline & imipramine)

47
Q

HYDROMORPHINE:
~ irritability, diaphoresis, muscle twitching, increase
in PR and BP

A

WITHDRAWAL SYNDROME

48
Q

HEADACHE TREATMENT / CESSATION OF ATTACK

A

~ OPIOID ANALGESICS
~ ERGOT ALKALOIDS
~ SELECTIVE SEROTONIN

49
Q

1.) long acting opioid analgesic medications for round the clock for acute and chronic pain.

2.) immediate acting opioid analgesic medications for breakthrough pain.

A

1.) Oxycontin

2.) Oxynorm

50
Q

~ This is for the management of moderate to severe chronic pain unresponsive to non-narcotic analgesia.

~ Treatment and /or Prophylaxis of OPIOID-Induced
constipation.

A

TARGIN- (Oxycodone + Naloxone )

51
Q

~ Oxycontin- long acting opioid analgesic medications for round the clock for acute and chronic pain.

~ Oxynorm- immediate acting opioid analgesic medications for breakthrough pain.

~ Available in oral and IV

A

Oxycodone

52
Q

~ Powerful opioid used as a pain medication and together with other medications for anesthesia.
~ 50 to 100 times more potent than Morphine
~ Available in Transdermal patch and Ampule
~

A

Fentanyl

53
Q

FENTANYL:
1.) For example of transdermal______
2.) For example of ampule________

A

1.) Durogesic D- Trans

2.) Hospira Fentanyl Citrate

Pharmacology (9 decks)

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