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Drugs > Pain Medications > Flashcards

Pain Medications Flashcards

1
Q

What do NSAIDs work on?

A

1) NSAIDs inhibit cycloxygenase enzyme

2) Results in the inhibition of prostaglandin synthesis

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2
Q

Define analgesic

A

Pain relief medication

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3
Q

Define Antipyretic

A

Anti-fever

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4
Q

Drug that is selective for COX-2 enzyme; no effect on bleeding time/platelets

A

Celecoxib (celebrex)

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5
Q

Drug that irreversibly inhibits COX enzyme

A

Aspirin

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6
Q

Where is Thromboxane A2 produced and what is its functions?

A

1) Platelets
2) Vasoconstrictor
3) Activator of platelet aggregation

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7
Q

How long does it take for platelet aggregation to recover in a patient who has taken aspirin?

A

1) Aspirin irreversibly inhibits COX enzyme resulting in decreased production of Thromboxane A2
2) 8-11 days

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8
Q

What prostaglandin is involved with sensitization of pain nerve endings, causes vasodilation, inhibits gastric acid secretion, and Promotes mucosal blood flow

A

Prostaglandin E2

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9
Q

When should NSAIDs and COX-2 inhibitors be used with caution?

A

Pt. has:

1) Reduced renal function
2) Heart failure
3) Liver dysfunction
4) Pt. on ACEi or diruetics

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10
Q

Why should NSAIDs and COX-2 inhibitors be used with caution in states of high levels of vasoconstrictors?

A

1) NSAIDs and COX-2 inhibit prostaglandin synthesis

2) Prostaglandins cause vasodilation of the afferent arteriole

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11
Q

What is contraindicated to children with chicken pox or influenza?

A

1) Salicylates

2) Can cause Reye’s syndrome

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12
Q

What prostaglandin keeps a patent ductus areteriosus open? What drug is used to close it? What is this drug also used for?

A

1) PGE2
2) Indomethacin
3) Suppression of uterine contraction

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13
Q

What are the two main contraindications for NSAIDs/aspirin?

A

1) Aspirin allergy

2) Third trimester of pregnancy

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14
Q

What are the uses for indomethacin?

A

1) Closure of a patent ductus arteriosus
2) Decrease uterine contractions
3) Can only be used episodically because stronger than aspirin

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15
Q

Most efficacious NSAID analgesic, weak anti-inflammatory effect; used for post op pain

A

Ketorolac

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16
Q

Non-narcotic analgesic and antipyretic with weak anti-inflammatory acitivty

A

Acetaminophen (tylenol)

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17
Q

What is used to treat an overdose of acetaminophen?

A

1) N-acetylcysteine

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18
Q

Drugs that bind to opioid receptors

A

Opioids

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19
Q

Natural products and derivatives obtained from the opium poppy

A

Opiates

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20
Q

What are the types of opioid receptors

A

1) Mu
2) Kappa
3) Delta

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21
Q

What opioid receptor binds to endorphins?

A

1) Mu

2) Stronger than enkephalin

22
Q

What opioid receptor binds to enkephalins?

A

1) Mu

2) Delta

23
Q

What opioid receptor binds to dynorphins?

A

1) Kappa

24
Q

What are endorphins derived from?

A

POMC

25
Q

What are enkephalins derived from?

A

1) POMC (met-enkephalin)

2) Preproenkephalin (6-met and 1-leu)

26
Q

What are dynorphins derived from?

A

Prodynorphins

27
Q

What are the classic effects of opioids? (6 total)

A

1) Analgesia
2) Euphoria
3) Miosis
4) Respiratory distress
5) Physiological dependence
6) Reduced GI motility

28
Q

Why is Meperidine only used for short periods of time?

A

1) Because its metabolite causes seizures

29
Q

What are the high efficacy mu opioids?

A

1) Morphine
2) Meperidine
3) Methadone
4) Fentanyl
5) Heroin

30
Q

Opioid that has a long half life, blocks NMDA receptors and monoamine reuptake pumps, used in rehab for opioid abuse

A

Methadone

31
Q

Most lipid soluble mu opioid; highest potency; effective with a transdermal patch

A

Fentanyl

32
Q

What are the high efficacy kappa opioids?

A

1) Butorphanol

2) Nalbuphine

33
Q

What are two of the main effects on the kappa opioid receptor?

A

1) Dysphoria

2) Psychotomimetic response

34
Q

What drug is a kappa agonist and a Mu antagonist? Used post op for pt. with respiratory depression.

A

1) Nalbuphine

35
Q

What are opioids with intermediate efficacy?

A

1) Hydrocodone
2) Oxycodone
3) Pentazocine

36
Q

What is more efficacious with oral intake? Morphine or Oxycodone?

A

1) Oxycodone

2) Morphine has a low oral:parenteral potency

37
Q

Characterized by signs and symptoms when drug use is stopped; not an addiction

A

Dependence

38
Q

Using a drug for its euphoric effect, observed as escalation in drug dose unrelated to pain level

A

Abuse

39
Q

Moderate Kappa agonist; partial Mu agonist/pure Mu antagonist

A

Pentazocine

40
Q

Opioids with low efficacy

A

1) Buprenorphine

2) Codeine

41
Q

Low efficacy opioid; long duration of action, slow to dissociate from Mu receptors; not readily reversed

A

Buprenorphine

42
Q

Enzyme that is involved with converting codeine to morphine

A

1) CYP2D6

2) Responsible for demethylation

43
Q

What is the MOA for Tramadol?

A

1) Weak Mu agonist
2) CNS serotonin releaser
3) Norepinephrine re-uptake inhibitor

44
Q

What given with serotonin selective reuptake inhibitors can cause a serotonin syndrome?

A

1) Tramodol

45
Q

How do weak partial agonists act when given with a full agonist?

A

Weak partial agonist become antagonists

46
Q

What are three opioid antagonists?

A

1) Naloxone (injection only)
2) Naltrexone (oral only)
3) Nalmefene

47
Q

What is the triad of primary findings observed in opioid overdose?

A

1) Lethargy/coma
2) Miosis
3) Depressed respiration

48
Q

What is the drug of choice for opioid overdose?

A

Naloxone

49
Q

What opioids are used for treatment of Diarrhea?

A

1) Ioperamide
2) Diphenoxylate
3) Difenoxin

50
Q

What drug is used to treat the reactive (affective) portion of pain?

A

Amitriptyline

51
Q

What are the adverse effects of salicylism?

A

1) Nausea
2) Vomiting
3) Tinnitus
4) Hyperventilation

Drugs (13 decks)

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