Pharmacology Flashcards
APAP Pregnancy Category
Category B
Kappa receptor activation produces
Analgesia, hallucinations, dysphoria
Delta receptor activation produces
Analgesia, and some can cause seizures at high doses
Carbamazepine MOA
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
Least chondrotoxic LA
Ropivicaine
Tertiary amine TCA with less anticholinergic s/e
desipramine, nortriptyline
TCA used for pain secondary to…
- 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
Baclofen MOA
GABA-B receptor agonist
Propionic derivatives
- Ibuprofen
- Naproxen
- Ketoprofen
- Oxaprozin
Soma derivative
Meprobamate -> dependence and abuse potential
HIGHEST MME
Hm> oxycodone>morphine =hydrocodone
Long term use of NSAIDs causes
Mildly prolonged bleeding time
Opioids causes ventilatory changes such as
rightward shift and decrease slope of CO2 response curve
What is the half life of oxaprozin?
40-60 hours
Acetic acid derivative
Ketorlac, etodolac, diclofenac, indomethacin
Ketorlac inhibits…
Both COX1 and COX 2
Clonidine causes
decrease postop O2 consumption
Converting morphine to methadone
<90mg morphine 4:1
90-300mg morphine 8:1
>300mg morphine 12:1
Carbamazepine metabolite is …
equipotent anticonvulsant activity
Ziconotide side effects include
- Hallucinations
- Blurred vision
- VertigO, dizziness
- Hypotension
- Ataxia
- CPK elevations
- Headache, somnolence, confusion
N-type voltage gated calcium channel blocker
St Johns Worts can…
Elevate serotonin levels
Butalbital tapering requires phenobarbital bridging
Withdrawal is life threatening
Opioid antagonist
- 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
Acetaminophen MOA
Reducing heme at peroxidase site and preventing COX activation
Corticosteroids MOA for analgesia
Inhibition of phospholipase A2 activation
2mg morphine/24h =
1mcg/h transdermal fentanyl
Which has the most tolerated S/e profile of TCAs
desipramine and nortriptyline
Nalbuphine MAO
Kappa agonist, Mu antagonist
Naltrexone MAO
mu and kappa antagonist
Naloxone infusion used for
opioid induced N/V in peds
Corticosteroid MOA
Switch of genes that encode inflammatory molecule
TCA MOA
creates sympatholytic through antagonism of alpha-1 adrenoreceptors leading to orthostatic hypotension in addition to sedation
Acetaminophen
- peak plasma 30-60 minutes
- rectal bioavailability is half the oral dose
- primary metabolic pathway through conjugation with glucuronic acid
TCA
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.
Pregabalin
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
ASA MOA
COX1 - irreversible acetylation of COX1
COX2- modifies enzymatic activity
Propoxyphene
weak opioid agonist, high risk of cardiac arrythmias so taken off market in 2010
Superior hypogastric plexus block
pain associated with cervical, bladder, rectal and prostate cancer
