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Pain Medicine Board Lis and Maggie > Pharmacology > Flashcards

Pharmacology Flashcards

1
Q

APAP Pregnancy Category

A

Category B

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2
Q

Kappa receptor activation produces

A

Analgesia, hallucinations, dysphoria

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3
Q

Delta receptor activation produces

A

Analgesia, and some can cause seizures at high doses

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4
Q

Carbamazepine MOA

A 
Blocks voltage dependent Na channel
Acts centrally and peripherally
Suppresses firing of C and A-delta fibers
Chemically related to TCAs
Has some anti inflammatory effects
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5
Q

Least chondrotoxic LA

A

Ropivicaine

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6
Q

Tertiary amine TCA with less anticholinergic s/e

A

desipramine, nortriptyline

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7
Q

TCA used for pain secondary to…

A
  • Post stroke pain
  • Post herpetic neuralgia
  • DM neuropathy
  • Non diabetic polyneuropathy
  • Post-mastectomy pain syndrome

NOT from HIV neuropathy, phantom limb pain, pain due to SCI

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8
Q

Baclofen MOA

A

GABA-B receptor agonist

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9
Q

Propionic derivatives

A
  • Ibuprofen
  • Naproxen
  • Ketoprofen
  • Oxaprozin
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10
Q

Soma derivative

A

Meprobamate -> dependence and abuse potential

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11
Q

HIGHEST MME

A

Hm> oxycodone>morphine =hydrocodone

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12
Q

Long term use of NSAIDs causes

A

Mildly prolonged bleeding time

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13
Q

Opioids causes ventilatory changes such as

A

rightward shift and decrease slope of CO2 response curve

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14
Q

What is the half life of oxaprozin?

A

40-60 hours

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15
Q

Acetic acid derivative

A

Ketorlac, etodolac, diclofenac, indomethacin

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16
Q

Ketorlac inhibits…

A

Both COX1 and COX 2

17
Q

Clonidine causes

A

decrease postop O2 consumption

18
Q

Converting morphine to methadone

A

<90mg morphine 4:1
90-300mg morphine 8:1
>300mg morphine 12:1

19
Q

Carbamazepine metabolite is …

A

equipotent anticonvulsant activity

20
Q

Ziconotide side effects include

A
  • Hallucinations
  • Blurred vision
  • VertigO, dizziness
  • Hypotension
  • Ataxia
  • CPK elevations
  • Headache, somnolence, confusion

N-type voltage gated calcium channel blocker

21
Q

St Johns Worts can…

A

Elevate serotonin levels

22
Q

Butalbital tapering requires phenobarbital bridging

A

Withdrawal is life threatening

23
Q

Opioid antagonist

A
  • Methylnaltraxone (subcutaneous injecion) for opioid induced constipation, Mu antagonist
  • Naltrexone
  • Naloxegol (oral route)
  • Naldemedine

-Lubiprostone treats opioid induced constipation, PGE analogue, not an opioid antagonist

24
Q

Acetaminophen MOA

A

Reducing heme at peroxidase site and preventing COX activation

25
Q

Corticosteroids MOA for analgesia

A

Inhibition of phospholipase A2 activation

26
Q

2mg morphine/24h =

A

1mcg/h transdermal fentanyl

27
Q

Which has the most tolerated S/e profile of TCAs

A

desipramine and nortriptyline

28
Q

Nalbuphine MAO

A

Kappa agonist, Mu antagonist

29
Q

Naltrexone MAO

A

mu and kappa antagonist

30
Q

Naloxone infusion used for

A

opioid induced N/V in peds

31
Q

Corticosteroid MOA

A

Switch of genes that encode inflammatory molecule

32
Q

TCA MOA

A

creates sympatholytic through antagonism of alpha-1 adrenoreceptors leading to orthostatic hypotension in addition to sedation

33
Q

Acetaminophen

A
  • peak plasma 30-60 minutes
  • rectal bioavailability is half the oral dose
  • primary metabolic pathway through conjugation with glucuronic acid
34
Q

TCA

A

Older class of antidepressants, by inhibiting serotonin and norepinephrine. Aids depression and chronic pain states the onset of analgesia and proceeds onset of antidepressant effects.

35
Q

Pregabalin

A

approved for neuropathic pain, DPN, PHN for partial onset seizures or fibromyalgia binds to the alpha-2-delta subunit of the voltage dependent calcium channel in the CNS

36
Q

ASA MOA

A

COX1 - irreversible acetylation of COX1

COX2- modifies enzymatic activity

37
Q

Propoxyphene

A

weak opioid agonist, high risk of cardiac arrythmias so taken off market in 2010

38
Q

Superior hypogastric plexus block

A

pain associated with cervical, bladder, rectal and prostate cancer

Pain Medicine Board Lis and Maggie (7 decks)

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