Pain/MSK drugs

Question 1

How does diclofenac work?

Answer 1

Its an NSAID. Potent inhibitor of prostaglandin biosynthesis

Question 2

Indications for diclofenac?

Answer 2

Pain and inflammation in rheumatic disease and other MSK disorders, acute gout, post op pain

Question 3

Contraindications for diclofenac?

Answer 3

Severe heart failure, IHD, cerebrovascular disease, peripheral arterial disease

Question 4

Diclofenac is a non-selective NSAID, what is there an increased risk of in COX-2 selective types?

Answer 4

Thrombotic events

Question 5

To what drug class do codeine and morphine belong?

Answer 5

Opiates

Question 6

How do codeine and morphine work?

Answer 6

Codeine gets converted to morphine. Bind opioid mew receptors, reduces painful stimuli. Morphine also directly suppresses the cough centre in the medulla

Question 7

Indications for codeine and morphine?

Answer 7

Codeine: mild to moderate pain
Morphine: Severe pain
Cough suppression

Question 8

To which drug do codeine and morphine have an antagonistic effect?

Answer 8

Metaclopromide

Question 9

What drug can be used to reverse the effects of morphine?

Answer 9

Naloxone

Question 10

How long does it take before tolerance to morphine sets in?

Answer 10

2 weeks of continuous treatment, after which point dose should be increased