Pharmacology x Pain killers

Question 1

name some NSAIDS
NSAIK pneumonic
(5)

Answer 1

• Naproxen
• Salicyate acid (aspirin)
• Acetylsalicylic acid
• Ibuprofen
• ketrolac ( TORADOL)

Question 2

how do NSAIDS work 
break down (pharmacology )
non specific 
specific 
bad side effects 
good effects 
(10)

Answer 2

They target the COX1+ COX2 enzymes
- In inflammation , the phospholipid bilayer turns into Archidonic acid , which gets broken down.

1-Arachidonic acid—->Prostaglandin H2 via COX1,2 enzyme ( prostaglandins cause depolarisation and send AP which causes PAIN)
2-PGH2–>PGE2/F2 = cause fever and inflammation
IN platelets :
3-AA–>COX1 enzyme converts it to thromboxane A2, which causes platelet aggregation

NSAIDS target COX1 and COX2 = non selective such as : aspirin , ibuprofen

GOOD: reduce fever, pain relief , decreased inflammation
BAD :Anticoagulants can cause skin rashes, bronchospasm , dyspepsia , nausea and haemorrhage

TARGETED SPECIFIC NSAIDS = block COX2 ( inflammation reduced ) = less side effects

Question 3

How do opioids work
JUNGKOOK -EUPHORIA
-Physiology ( outline the intracellular activates )
(10)

Answer 3

Pharmacology :causes euphoria , pain relief
Natural Pain pathway :
neurotransmitters are released:
1- Glutamate –> binds to NMDA receptor = influc of Ca2+ to post synaptic neurone
–>BINDS to AMPA receptor ASWELL = influx of Na+ into cell
the cell becomes more positively charged=more likely to have an AP = sharp PAIN
2-SUBSTANCE P= binds to NK-1 receptor = intracellular signalling which case Arachidonic acid synthesis , NO synthesis, and NMDA receptor activation
how:
- the G-protein Nk-1 receptor goes on to activate protein kinase c => this moves Mg2+ away from NMDA receptor so that glutamate can BIND to NMDA receptor –>influx of ca2+

There are 3 types of Opioids receptor :
mew, Kappa, DELTA
Mew = most popular ( 1&2)
endogenous opioids :
- activation of mew receptor via agonists causes closure of V-G ca2+ channels in PRE SYNPATIC NEURONE= less ca2+ into the cell = less release of Neurotransmitters ( less pain )
-Actiavtion of new receptors also cause opening of K+ ion POST SYNAPTIC NEURONE , so K+ leaves cell , less chance of AP = reduction in PAIN

Question 4

when not to use NSAIDS AND OPIODS ?
PNEUMONIC IS NSAIDS ( for what is can do )
(10)
name a few times

Answer 4

N-not good for the entire body 
S-sticky blood
A-asthma worsens 
I-increased bleed risk 
D-dysfunctioning kidney
S-swelling of the heart , HT worsened 

Opioids:

• impaired pulmonary function
• impaired kidney function , liver
• Hypothyroidism
• Heart surgery

Question 5

natural Opioids ?
synthetic opiods?
name 3

natural:
encore
didn’t
end

Answer 5

Natural opioids :

• Enkephalins
• Dynorphins
• Endorphins

Synthetic Opioids :

• Fentanyl
• Methadone
• Hydromorphone
• Oxycodone
• Merperidine
• oxymorphone

Question 6

how to solve OPIOID OVERDOSE ?

3

Answer 6

NALOXENE 
- competitive antagonist 
CAUTIONS:
- MAY have withdrawn symptoms 
or relapse