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Pharmocology > Pain Part 2 (Non-Opioids).pptx > Flashcards

Pain Part 2 (Non-Opioids).pptx Flashcards

1
Q

Injuries can release an ?

a. neuropathic pain
b. inflammatory soup

A

inflammatory soup

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2
Q

Inflammatory Soup includes ?

a. oxytocin
b. prostaglandins

A

b. prostaglandins

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3
Q

Which causes pain and inflammation?

a. oxytocin
b. prostaglandins

A

b. prostaglandins

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4
Q

Which help with inflammation.?
a. NSAIDS (ibuprofen)
B. OPIODS (morphine)

A

a. NSAIDS (ibuprofen)

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5
Q

Which treat MODERATE TO SEVERE pain
a. NSAIDS (ibuprofen)
B. OPIODS (morphine)

A

B. OPIODS (morphine)

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6
Q

Inflamation is considered

a. Mild
b. Moderate
c. Severe

A

a. Mild

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7
Q

protective prostaglandins in stomach

a. Cox 1 pathway
b. Cox 2 pathway

A

a. Cox 1 pathway

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8
Q

Inflammatory prostaglandins ;hyperalgesia

a. Cox 1 pathway
b. Cox 2 pathway

A

b. Cox 2 pathway

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9
Q

? are a group of lipids made at sites of tissue damage or infection that are involved in dealing with injury and illness.

a. hyperalgesia
b. prostaglandins
c. PGI2- Prostacyclin)
d. PGI1- Prostacyclin)

A

b. prostaglandins

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10
Q

Which is abnormally heightened sensitivity to pain?

a. hyperalgesia
b. prostaglandins

A

a. hyperalgesia

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11
Q

Vasodilation (blood vessels, kidneys)

a. hyperalgesia
b. prostaglandins
c. PGI2- Prostacyclin)
d. PGI1- Prostacyclin)

A

b. prostaglandins

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12
Q

Inflammation and pain

a. hyperalgesia
b. prostaglandins
c. PGI2- Prostacyclin)
d. PGI1- Prostacyclin)

A

b. prostaglandins

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13
Q

Stop platelet aggregation

a. hyperalgesia
b. prostaglandins
c. PGI2- Prostacyclin)
d. PGI1- Prostacyclin)

A

b. prostaglandins

c. PGI2- Prostacyclin)

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14
Q

Protect gastric mucosaa. hyperalgesia

a. hyperalgesia
b. prostaglandins
c. PGI2- Prostacyclin)
d. PGI1- Prostacyclin)

A

b. prostaglandins

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15
Q

Cyclooxygenase (COX-I, COX-II)

  1. Tissue Injury- ?- promote inflammation and sensitize receptors to pain
  2. Stomach- ?- help protect gastric mucosa
  3. Platelets-?- stimulates platelet aggregation
  4. Blood vessels- ? causes vasodilation, inhibits platelet aggregation
  5. Kidney-?- causes vasodilation- maintains renal blood flow
  6. Brain- ?- Fever and perception of pain
  7. Uterus- ?- Promote contractions at term
    a. PG- prostaglandins
    b. TXA2 thromboxane
A
  1. a. PG- prostaglandins
  2. a. PG- prostaglandins
  3. b. TXA2 thromboxane
  4. a. PG- prostaglandins
  5. a. PG- prostaglandins
  6. a. PG- prostaglandins
  7. a. PG- prostaglandins
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16
Q 
Location- Effect of COX INHIBITION (NSAID use)
Stomach- Gastric ulceration
a. Cox 1
b. Cox 2
c. Both
A

a. Cox 1

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17
Q

Location- Effect of COX INHIBITION (NSAID use)
Platelets- Bleeding; protection against MI* (ASA)
a. Cox 1
b. Cox 2
c. Both

A

a. Cox 1

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18
Q

Location- Effect of COX INHIBITION (NSAID use)
Blood vessels(endothelial cells)- Blood vessels(endothelial cells)
a. Cox 1
b. Cox 2
c. Both

A

b. Cox 2

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19
Q

Location- Effect of COX INHIBITION (NSAID use)
Kidney- Renal impairment; disrupted Na+ and H2O balance
a. Cox 1
b. Cox 2
c. Both

A

c. Both

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20
Q

Location- Effect of COX INHIBITION (NSAID use)
Injured tissue- Reduced inflammation and reduced pain
a. Cox 1
b. Cox 2
c. Both

A

b. Cox 2

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21
Q 
Location- Effect of COX INHIBITION (NSAID use)
Brain- Reduced fever and reduced pain
a. Cox 1
b. Cox 2
c. Both
A

b. Cox 2

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22
Q

Good?

a. Cox 1
b. Cox 2
c. Both

A

a. Cox 1

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23
Q

Bad?

a. Cox 1
b. Cox 2
c. Both

A

b. Cox 2

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24
Q

Select all that applies to Cox 1

a. Colon – “colon cancer”
b. Gastric mucosa protection
c. Blood vessels- dilation
d. Platelet aggregation
e. stops platelet aggregation
f. Supports renal function
g. Sites of tissue injury “inflammation”
h. in brain- mediates fever and pain

A

b. Gastric mucosa protection
d. Platelet aggregation
f. Supports renal function

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25
Q

Select all that applies to Cox 2

a. Colon – “colon cancer”
b. Gastric mucosa protection
c. Blood vessels- dilation
d. Platelet aggregation
e. stops platelet aggregation
f. Supports renal function
g. Sites of tissue injury “inflammation”
h. in brain- mediates fever and pain

A

a. Colon – “colon cancer”
c. Blood vessels- dilation
e. stops platelet aggregation
g. Sites of tissue injury “inflammation”
h. in brain- mediates fever and pain

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26
Q

? stimulates platelet aggregation

a. Prostacyclin, PGI2-
b. TXA2

A

b. TXA2

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27
Q

Stop platelet aggregation

a. Prostacyclin, PGI2-
b. TXA2

A

a. Prostacyclin, PGI2-

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28
Q

Which is Prostaglandins?

a. Generally cause VASODILATION
b. PROTECT the GI Tract
c. Cause PAIN and FEVER
d. Causes platelets to form a platelet plug
e. Precursor to a blood clot

A

a. Generally cause VASODILATION
b. PROTECT the GI Tract
c. Cause PAIN and FEVER

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29
Q

Which is TXA2 (Thromboxane)

a. Generally cause VASODILATION
b. PROTECT the GI Tract
c. Cause PAIN and FEVER
d. Causes platelets to form a platelet plug
e. Precursor to a blood clot

A

d. Causes platelets to form a platelet plug

e. Precursor to a blood clot

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30
Q

Our 1. ( NSAIDS or OPIOIDS ) block prostaglandins. They reduce PAIN and FEVER, but you 2. (Lose or Keep) the protection of the GI Tract (these can cause stomach ulcers)

A
  1. NSAIDS

2. Lose

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31
Q

Salicylates=

a. Reversible
b. Irreversible

A

b. Irreversible

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32
Q

Non-Salicylates=

a. Reversible
b. Irreversible

A

a. Reversible

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33
Q

Aspirin=

a. Non-Salicylates
b. Salicylates

A

b. Salicylates

34
Q

Aspirin are ?

a. Reversible
b. Irreversible

A

b. Irreversible

35
Q

Which applies to aspirin?

a. Rheumatoid Arthritis
b. Osteoarthritis
c. Joint pain, swelling, inflammation (arthritis, tendonitis, d. bursitis, etc.)
e. Fever
f. Mild – moderate pain
g. Pain

A

a. Rheumatoid Arthritis
b. Osteoarthritis
c. Joint pain, swelling, inflammation (arthritis, tendonitis, d. bursitis, etc.)
e. Fever

36
Q

is an autoimmune disease that can cause joint pain and damage throughout your body.

a. Osteoarthritis
b. Rheumatoid Arthritis

A

b. Rheumatoid Arthritis

37
Q

A type of arthritis that occurs when flexible tissue at the ends of bones wears down.

a. Osteoarthritis
b. Rheumatoid Arthritis

A

a. Osteoarthritis

38
Q

you lose the cardio protective benefit

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

b. Aspirin

39
Q

What is the half life of aspirin and what time period you should take them?

A

20

4-6 hours

40
Q

Aspirin-WHY DO WE USE FOR STROKE/MYOCARDIAL INFARCTION PREVENTION? Select

a. Irreversibly binds to COX enzymes (2) of platelets
b. Irreversibly binds to COX enzymes (1&2) of platelets
c. Inhibits the action of COX for entire life of platelet
d. Promotes the action of COX for entire life of platelet

A

b. Irreversibly binds to COX enzymes (1&2) of platelets

c. Inhibits the action of COX for entire life of platelet

41
Q

Should aspirin be taken with food?

Yes or No

A

Yes, to avoid nausea

42
Q
  1. Should aspirin be taken with food?
  2. And does it irritate the stomach lining?
    Yes or No
A

Yes, Gastric distress, heartburn, nausea

Yes

43
Q

Since aspirin causes Gastric bleeding / ulceration which patients are more at risk?

a. smokers
b. alcohol users
c. PUD (peptic ulcer disease) patient
d. All

44
Q

Why do Reye syndrome develop in children with aspirin

a. it doesn’t
b. Viral Infection
c. Children <12 should not be taking Aspirin
d. Children <12 can be taking Aspirin

A

b. Viral Infection

c. Children <12 should not be taking Aspirin

45
Q

Do aspirin (promote or inhibit )platelets (thromboxane A2) resulting bleeding

46
Q

Which drug has Salicylism toxicity?

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

b. Aspirin

47
Q

Which is side effects of Salicylism toxicity

a. Tinnitus
b. Sweating
c. Headache
d. Dizziness
e. N/V/D
f. N/V/C
g. Respiratory Alkalosis (rapid breathing)
h. Respiratory Acidosis (decrease breathing)

A

a. Tinnitus
b. Sweating
c. Headache
d. Dizziness
e. N/V/D
g. Respiratory Alkalosis (rapid breathing)

48
Q

Aspirin can only be given to children with which iliness

a. Lupus
b. Cancer
c. Kawasaki

A

c. Kawasaki

49
Q

What increases the risk of bleeding when taken with aspirin.

a. Warfarin
b. Steroids
c. Smoking
d. Alcohol
e. Other NSAIDs
f. Heparin.

A

a. Warfarin
c. Smoking
d. Alcohol
f. Heparin.

50
Q

Which increases the risk of GI tract complications (risk for ulcer/bleed) with aspirin

a. Warfarin
b. Steroids
c. Smoking
d. Alcohol
e. Other NSAIDs
f. Heparin.

A

b. Steroids

51
Q

Which cause more adverse side effect while taken with aspirin?

a. Warfarin
b. Steroids
c. Smoking
d. Alcohol
e. Other NSAIDs
f. Heparin.

A

e. Other NSAIDs

52
Q

Which are First generation NSAIDS

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

a. ibuprofen
e. naproxen
c. Ketorolac
g. indomethacin
h. diclofenac

53
Q

What do First generation NSAIDS:ibuprofen, naproxen, ketorolac, indomethacin, diclofenac treat?

a. Rheumatoid Arthritis
b. Osteoarthritis
c. Joint pain, swelling, inflammation (arthritis, tendonitis, d. bursitis, etc.)
e. Fever
f. Mild – moderate pain
g. Pain

A

c. Joint pain, swelling, inflammation (arthritis, tendonitis, d. bursitis, etc.)
e. Fever
f. Mild – moderate pain

54
Q

Is First generation NSAIDS:ibuprofen, naproxen, ketorolac, indomethacin, diclofenac similar to aspirin?
Yes or No

55
Q

Where does this suffix go? profen

a. first generation
b. second generation
c. Herbals

A

a. first generation

56
Q

Where does this suffix go? fenac

a. first generation
b. second generation
c. Herbals

A

a. first generation

57
Q

Which reversibly inhibits Cox 1 and 2 pathways

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

first generation

a. ibuprofen
c. Ketorolac
e. naproxen
g. indomethacin
h. diclofenac

58
Q

Which stop prostaglandin in both Cox 1 and Cox 2

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

a. ibuprofen
c. Ketorolac
e. naproxen
g. indomethacin
h. diclofenac

59
Q

Which first generation NSAIDs should be used only 5 days max due to GI Bleeding

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

c. Ketorolac

60
Q

Which causes Increased blood pressure (MI/Stroke)

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

a. ibuprofen
c. Ketorolac
e. naproxen
g. indomethacin
h. diclofenac
j. celecoxib

61
Q

Which cause renal impairment (potential for AKI)

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

a. ibuprofen
c. Ketorolac
e. naproxen
g. indomethacin
h. diclofenac
j. celecoxib

62
Q

Which can Not to be used in heart failure (sodium/fluid retention)

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

a. ibuprofen
c. Ketorolac
e. naproxen
g. indomethacin
h. diclofenac
j. celecoxib

63
Q

Which reduces (MI and Strokes)

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

b. Aspirin

64
Q 
Which treats 
Joint pain, swelling, inflammation (arthritis, tendinitis, bursitis, etc.)
Fever
Mild – moderate pain
a. ibuprofen 
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen 
f. Feverfew
g. indomethacin 
h. diclofenac
i. Acetaminophen
j. celecoxib
A

a. ibuprofen
c. Ketorolac
e. naproxen
g. indomethacin
h. diclofenac
j. celecoxib

65
Q

Which Selectively inhibits COX-2 enzyme

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

j. celecoxib

66
Q

Which NSAIDS should avoid with SULFA Allergy?

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

j. celecoxib

67
Q

Which is a non Nsaids

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

i. Acetaminophen

68
Q

Which just treats Pain or Fever

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

i. Acetaminophen

69
Q

Works on hypothalamus (heat regulating center)= treats fevers

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

i. Acetaminophen

70
Q

Works on hypothalamus (heat regulating center)= treats fevers

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

i. Acetaminophen

71
Q

Which NSAIDS or NON NSAIDS do NOT help with Inflammation

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

i. Acetaminophen

72
Q

Which have NO gastric ulceration, renal impairment, bleeding!

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

i. Acetaminophen

73
Q

Which has LIVER TOXIcity

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

i. Acetaminophen

74
Q

High doses of Acetaminophen result in large levels of toxic metabolite and rapidly deplete ?

a. fluoxetine
b. glutathione

A

b. glutathione

75
Q 
Do not exceed Acetaminophen ? mg/dose
FDA says do not exceed ? mg/day
A. 2000
b. 1000
c. 4000
76
Q

If you drink more than 3 alcoholic beverages day- MAX is Acetaminophen ? mg/day
A. 2000
b. 1000
c. 4000

77
Q

Which is tylenol, paracetamol, APAP

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

i. Acetaminophen

78
Q

Which is safe for children and is weight based?

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

i. Acetaminophen

79
Q

Which of the following are signs of an over dose

a. ASYMPTOMATIC
b. Diaphoresis,
c. N/V/D
d. This damages Liver- LFTS will rise

80
Q

This an antidote for Acetylcysteine (Acetadote®)

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib
k. Acetylcysteine

A

i. Acetaminophen

81
Q 
Mucolytic is the Inhaled version to thin secretions
What os used for Acetaminophen overdose
a. ibuprofen 
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen 
f. Feverfew
g. indomethacin 
h. diclofenac
i. Acetaminophen
j. celecoxib
k. Acetylcysteine
A

k. Acetylcysteine

82
Q

Which Oral Version- Smells like rotten eggs

a. ibuprofen
b. Aspirin
c. Ketorolac
d. Glucosamine + Chondroitin
e. naproxen
f. Feverfew
g. indomethacin
h. diclofenac
i. Acetaminophen
j. celecoxib

A

i. Acetaminophen

Pharmocology (36 decks)

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