Parmacology

Question 0

Dipyrone

Answer 0

May be similar w/ Tylenol on mechanism

Question 1

Paracetamol

Answer 1

acetaminophen

Question 2

Nefopam

Answer 2

1. Not anti-inflammatory

2. Not antipyretic

Question 3

Tapentadol

Answer 3

1. Nucynta
2. Mu + norepinephrine reuptake inhibitor
3. 100mg = 15 mg oxycodone
4. Q4-6 hrs

Question 4

Peripherally acting mu-opioid antagonists

Answer 4

1. Methylnaltrexone

2. Albino pan: increase MI in one study

Question 5

Fentanyl patch

Answer 5

1. transdermal: equivalent to parenteral fentanyl

2. upon patch removal—>serum contration reduce by 50% per 17 hrs.

Question 6

Incomplete cross tolerance

Answer 6

reduction in anticipated dose following opioid rotation and conversion. Typically this involves an initial dose 25-50% lower than calculated.

Question 7

histamine release

Answer 7

Morphine, meperidine and codeine are three opioids whose administration can result in histamine release

Question 8

Tertiary amine agents vs secondary amines

Answer 8

3rd: amitriptyline, imipramine—>=inhibiting norepinephrine and serotonin
2ed: nortriptyline, desiprine—> favor epi

Question 9

Celecoxib

Answer 9

1. clinically most cox-2 selective NSAID

2. increase adverse cardiac events: MI, stroke

Question 10

Naproxen

Answer 10

1. opposite celecoxib
2. likely most cox-1 selective
3. lowest cardiovascular risk of available NSAIDS
4. Increase peptic ulceration & GIB–>Px: PPI, H2-blocker

Question 11

acetaminophen

Answer 11

1. mechanism poorly defined
2. COX-2 inhibitor in vitro
3. COX-3 (splice variant of COX-1) inhibitor in CNS
4. NNT: 4-5
5. IV: start 5min, peak 1hrs, last 4-5 hrs.
6. NAPQI–>hepatic toxicity

Question 12

clonidine vs dexmedetomidine

Answer 12

1. dex: 7 fold greater affinity

2. clonidine: more hemodynamic instability

Question 13

NMDA antagonists

Answer 13

1. ketamine: strong

2. methedone: weak

Question 14

sub-anesthetic dose of ketamine

Answer 14

1. perioperative analgesia
2. reducing opioid
3. rescue analgesics
   $$: hallucination, dizziness, sedation, out-of-body sensation, nightmare

Question 15

Naprosyn = naproxen

Answer 15

1. noselective NSAID

2. relatively risk-neural cardiovascular profile