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BIOM2009 > Pain Meds > Flashcards

Pain Meds Flashcards

1
Q

Main function of NSAIDs

A

Inhibit prostaglandin synthesis by inhibiting cyclooxygenase (COX) 1 and 2

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2
Q

Describe the role of the prostaglandin that COX 1 catalyses

A

Protective prostaglandins.

Coat the stomach lining in mucus, cause platelet aggregation, regulate renal blood flow

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3
Q

Describe the prostaglandin that COX 2 catalyses

A

Inflammatory prostaglandins
Increases body temp by acting on hypothalamus, sensitises nociceptors and recruits inflammatory markers towards the injured area of the body

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4
Q

What effect do NSAIDs have on renal blood flow?

A

Reduced.

This increases exposure time to drugs

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5
Q

What cardiovascular effects do NSAIDs have?

A

Aspirin limits blood clotting.

All NSAIDs= increase blood pressure

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6
Q

Aspirin has a prolonged effect on platelets and clotting. Explain this.

A

Aspirin irreversibly inhibits COX 1 in platelets. The platelets do not have their own nucleus, and therefore cannot synthesise new COX 1. Therefore, have to wait for platelet to be turned over / replaced which happens weekly

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7
Q

Basic MOA of aspirin

A

Irreversibly inhibits COX 1 and 2 (slightly more selective for COX 1)

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8
Q

Compare indomethacin and ibuprofen

A

Both are competitive, reversible inhibitors of COX 1 and 2
Indomethacin = one of the most potent NSAIDs. Use is limited due to toxicity. Causes more GIT and CV risks than the others.

Ibuprofen = safe for use in children, generally well tolerated

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9
Q

Compare naproxen and diclofenac

A

Both are competitive, reversible inhibitors of COX 1 and 2

Naproxen = commonly used for period pain. Longer lasting than ibuprofen

Diclofenac = one of the most potent NSAIDs + the longest lasting.
- increased ADRs, commonly co-dosed with antacids

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10
Q

How does paracetamol compare to NSAIDs in terms of efficacy?

A

Weak anti-inflammatory, good analgesia and much better anti-pyretic

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11
Q

What is the main MOA of SAIDs

A

They increase the synthesis of annexins (lipocortin 1) which blocks prostaglandin synthesis

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12
Q

Increased BP, cholesterol and blood sugar levels are symptoms of —- name 3 more

A

Cushing syndrome.

  • weight gain
  • headaches
  • skin thinning
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13
Q

Name an ADR of codeine as a second line treatment for migraines and what can be used to prevent it.

A

Codeine exacerbates nausea. Can be co-dosed with metoclopramide to reduce nausea and vomiting

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14
Q

Compare COX 1 and 2 and their effect on clotting

A

Cox 1 = pro-coagulation. (Therefore cox1 blockers = risk of bleeding)

Cox 2 = blocking cox 2 increases risk of clots (therefore, MI and stroke risk)

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15
Q

Narcotics work in the — to suppress pain rather than locally

A

CNS

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16
Q

Endogenous narcotics =?

A

Endorphins

17
Q

Summarise the opioid mechanism of action.

Include: calcium, polarisation and neurons

A

Activates a GPCR, stopping Ca entry into cell and promoting K efflux. Therefore, hyperpolarises the cell, decreasing neurotransmitters release and neuron excitability

18
Q

Describe respiratory depression and it’s cause

A

Reduced CO2 sensitivity in the brain. Meaning increase CO2 levels in blood isn’t recognised and person doesn’t increase breathing rate. Leads to death

19
Q

Most common side effects of opioids are….

A

Constipation
Nausea
Hypotension and bradycardia

20
Q

Opioid antagonist used to reverse respiratory depression

A

Naloxone

21
Q

How does methadone work to lessen addiction

A

Much less euphoria compared to the other opioid agonists

22
Q

Why is fentanyl delivered via a patch and not IV or oral?

A

Extremely lipid soluble and easily transported into brain. Extremely potent and longer half life and therefore patch is used for slow delivery

23
Q

Which opioid, when co-dosed with other opioids, produces an antagonist effect and promotes withdrawal?

A

Buprenorphine

24
Q

Rheumatoid arthritis is an autoimmune condition where the immune system attacks the — leading to chronic —

A

Synovial fluid between joints

Chronic inflammation

25
Q

RA is treated with —

A

DMARDs

26
Q

Methotrexate, sulfasalazine and hydroxychloroquine are examples of ….

A

DMARDs

27
Q

Methotrexate works by …

A

Antagonising folic acid metabolism, which reduces DNA synthesis. This decreases the proliferation of macrophages (cells involved in RA)

28
Q

Describe GOUT

A

Caused by a build up of uric acid

29
Q

Main treatment of GOUT is — and —

A

Colchicine and allopurinol

BIOM2009 (13 decks)

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