Pharm 5: Clinical approach to pain

Question 1

Drug that selectively blocks COX-2 and may cause less gastric ulceration than nonselective inhibitors

Answer 1

Celecoxib

Question 2

Acetaminophen relief of symptoms

Answer 2

supresses pain and fever, NOT inflammation

Question 3

Acetaminophen benefit

Answer 3

does NOT impair renal function

Question 4

What drugs have independent analgesic effects as well as an ability to relieve the depressive symptoms associated with chronic pain?

Answer 4

TCAs (amitriptyline)

Question 5

What drug has broad spectrum anti-seizure activity but >80% of the prescriptions written for it are for post-herpetic neuralgia, diabetic neuropathy, prophylaxis for migraines, fibromyalgia, and restless leg syndrome?

Answer 5

gabapentin (neurontin)

Question 6

Describe use of tapentadol (nucynta)

Answer 6

moderate to strong opioid agonist reserved for patients who are not effectively treated with other non-opioids and opioids

Question 7

how is clonidine administered?

Answer 7

by continuous infusion through an epidural catheter

Question 8

MOA clonidine

Answer 8

alpha2- adrenergic agonist

Question 9

When is clonidine used to treat pain?

Answer 9

approved for treating severe cancer in pain in those not treated effectively by an opioid alone

Question 10

When is butorphanol contraindicated?

Answer 10

increased cardiac work, so contraindicated with MI

Question 11

Drug of choice for terminating ongoing migraine attack, but also has risk of physical dependence

Answer 11

Ergot alkaloids/ergotamine

Question 12

Drug of choice for terminating ongoing migraine attack and has no risk of physical dependence

Answer 12

Ergot alkaloids/dihydroergotamine

Question 13

5-HT agonists, first line for terminating migraine attacks

Answer 13

Sumatriptan