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NMSP Week 1 > Pharmacological Approaches to Pain (Wolff) > Flashcards

Pharmacological Approaches to Pain (Wolff) Flashcards

1
Q

What does aspirin irreversibly inhibit?

Via what mechanism?

What effect does aspirin have?

A

1) Cyclooxygenase-1 and 2 (COX-1 and 2) enzymes
2) Acetylation
3) Decreases prostaglandin and thromboxane A2

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2
Q

What are potential toxicities of aspirin?

A

1) Ulcer

2) Increased risk of bleeding

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3
Q

What does ibuprofen reversibly inhibit?

What effect does ibuprofen have?

A

1) COX-1 and 2 enzymes

2) Inhibits prostaglandin synthesis

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4
Q

What black box warning do NSAIDs have with pregnancy?

A

May cause fetal renal dysfunction leading to oligohydramnios

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5
Q

What other black box warnings do NSAIDs have?

A

1) Increased risk of MI and stroke

2) Increased risk of GI bleed

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6
Q

What does celecoxib inhibit?

What effect does it have?

A

1) COX-2

2) Inhibits prostaglandin synthesis

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7
Q

Why should aspirin not be used by children with chicken pox or influenza?

A

Increases risk of Reye syndrome

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8
Q

Why does celecoxib not pose a risk of bleeding?

A

Because it doesn’t inhibit platelet aggregation

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9
Q

When NSAID therapy is required for patients at risk of cardiovascular complications, what is recommended as the NSAID of choice?

A

naproxen

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10
Q

How does acetaminophen differ from NSAIDs in terms of effect?

A

Acetaminophen does not suppress inflammation

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11
Q

Because of risk of medication errors and overdosage, what black box warning does acetaminophen have?

A

Hepatotoxicity with acute liver failure

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12
Q

Overdosage of acetaminophen is treated with?

A

Acetylcysteine

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13
Q

What does morphine bind to in the CNS?

A

Opioid receptors

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14
Q

Morphine has multiple black box warnings related to?

A

Respiratory depression

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15
Q

Amitriptyline is a tricyclic antidepressant with analgesic effects that inhibits the reuptake of?

A

NE and Serotonin

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16
Q

What blackbox warning does amitriptyline have in children, adolescents, and young adults?

A

Increased risk of suicidal thinking and behavior

17
Q

Duloxetine is an antidepressant with analgesic effects that inhibits the reuptake of?

A

NE and Serotonin

18
Q

What blackbox warning does duloxetine have?

A

Increased risk of suicidal thinking and behavior

19
Q

Pregabalin and gabapentin which are GABA analogs, does not bind to GABA receptors but instead exerts its effects by binding to?

A

Alpha2-delta subunit of voltage-gated calcium channels

20
Q

What are the clinical applications for pregabalin?

A

1) Neuropathic pain associated with diabetic neuropathy

2) Seizures

21
Q

Tramadol is an agonist for?

What does it block the reuptake of?

A

1) μ-opiate

2) NE and serotonin

22
Q

What black box warning is associated with tramadol due to medication errors/overdose?

A

Respiratory depression

23
Q

Ketamine is a noncompetitive antagonist for?

What does it block?

A

1) NMDA receptor

2) Glutamate

24
Q

What is the clinical application for ketamine?

A

Sub-anesthetic doses for analgesia, acute and chronic pain

25
Q

Dexmedetomidine is a selective agonist for?

What effect does it have?

A

1) Alpha2-adrenoceptor receptor

2) Inhibits NE release

26
Q

Clonidine is an agonist for?

A

Alpha2-adrenergic receptor

27
Q

Ziconotide selectively binds to?

Located where?

A

1) N-type voltage sensitive calcium channels

2) Nociceptive afferent nerves of the dorsal horn

28
Q

Sumatriptan is a selective agonist for?

A

Serotonin 1B and 1D receptors

29
Q

What is the clinical application for sumatriptan?

A

Migraine of moderate to severe intensity

30
Q

Lasmiditan is a selective agonist for?

A

Serotonin 1F receptor

31
Q

What is the clinical application of lasmiditan?

A

Migraines without causing vasoconstriction

32
Q

Ubrogepant which is used for the treatment of migraines, is an antagonist for?

A

Calcitonin gene-related peptide receptor

33
Q

Dihydroergotamine is an alkaloid used to treat migraines that binds to?

A

Multiple serotonin receptors

NMSP Week 1 (13 decks)

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