Pain medication

Question 1

NSAIDs
1) NSAIDs inhibit the COX-1 and COX-2 enzymes to reduce the production of what 2 things?
2) Name a non-selective NSAID
3) Name a COX-2 selective NSAID
4) Selective COX-2 NSAIDs decrease the incidence of what?
5) Name 2 side effects of NSAIDs

Answer 1

1) Thromboxane A2 and prostaglandin A2
2) Ibuprofen, naproxen, diclofenac
3) Celecoxib, etoricoxib
4) GI upset/adverse effects
5) GI bleeding and ulceration, renal insufficiency, bronchospasm, headaches, drowsiness, dizziness

Question 2

Drugs for neuropathic pain
1) How are gabapentin and pregabalin theorised to work?
2) Name a side effect of gabapentin
3) Name a side effect of pregabalin

Answer 2

1) Decrease cell expression of Ca2+ channels which are upregulated in neuropathic pain
2) Abnormal eye movements that are continuous, uncontrolled, back-and-forth, or rolling, clumsiness or unsteadiness, nausea and
vomiting, dry mouth
3) Dizziness, sleepiness, trouble concentrating, blurry vision, dry mouth, weight gain

Question 3

Opioids
1) Name a weak opioid
2) Name a strong opioid
3) Name a very strong opioid
4) What opioid is used as a treatment for physical dependency in heroin addicts?
5) What drug is used in the case of an opioid overdose?
6) Which opioid is given to people with renal impairment as it is nephroprotective?
7) Name 4 side effects of opioids
8) Name 2 symptoms of opioid withdrawal
9) Which opioid is preferred in palliative care in patients with renal dysfunction?

Answer 3

1) Codeine, tramadol
2) Morphine, oxycodone, methadone
3) Fentanyl, dihydrocodeine
4) Methadone
5) Naloxone
6) Buprenorphine
7) Constipation, skin itching, nausea, altered mental state (sedation, cognitive impairment or confusion), respiratory depression, addiction, postural hypotension
8) Dilated pupils, diarrhea, piloerection, increased anxiety, sweating and confusion, muscle pain
9) Oxycodone