pharmacology

Question 1

1st stage of the WHO pain ladder (mild pain)

Answer 1

non-opioid (paracetamol) +/- adjuvant (ibuprofen)

Question 2

2nd stage of WHO pain ladder (moderate pain)

Answer 2

weak opioid (codeine, co-codamol) +/- non-opioid +/-adjuvant

Question 3

3rd stage of WHO pain ladder (severe pain)

Answer 3

strong opioid (morphine, oxycodone, fentanyl) +/- non-opioid +/-adjuvant

Question 4

What receptors do opioids act on?

Answer 4

mu receptors

Question 5

side effects of opioids

Answer 5

GI: nausea, constipation
Neuro: dependance, tolerance, sedation
Resp: bradycardia

Question 6

drugs to manage angina

Answer 6

1. Nitrates (GTN spray)
2. beta-blockers- bisprolol, atenolol, proanolol
3. CCB

• dihydropyridines (amlodepine, felodipine)- more vascular Ca2+
• nondihydropyridines (veramil)

*caution with renal/liver failure

Question 7

mechanism of nitrates

Answer 7

• converted to NO => vasodilator + venodilator
• decreases preload + afterload

Question 8

mechanism of beta-blockers

Answer 8

binds to beta (B1) adrenoreceptors

• decrease HR
• decrease contractility
• decrease afterload

Question 9

side effects of beta-blockers

Answer 9

• bradycardia (low RR)
• asthma
• hypotension
• erectile dysfunction
• constipation

Question 10

mechanism of CCBs

Answer 10

bind to L-type Ca2+ channels on vascular smooth muscle of vessels/ heart and block Ca2+ influx

• decrease HR
• decrease contractility
• decreases afterload + preload

Question 11

side effects of CCBs

Answer 11

• palpitations
• ankle oedema
• flushing/headaches
• constipation