Test # 5 Pain 2 Flashcards
What are three abortive treatments for Migraines?
NSAIDS - rarely works
Ergot alkaloids - mushrooms - LSD
Triptans - best one! 80% success in first dose
What are three -triptans that are used to treat migraines. They are 5-HT agonist (increase it in the brain).
They constrict intracranial BV (which is painful), decrease swelling, and decrease plasma extravasation
Sumatriptans
Naritryptan
Zolpitriptan
What are 4 other abortive drugs that can be used for migraines?
Phenothiazines
Isometheptene
Propranolol
Butorphanol
Many, Many prophylactic treatments for migraines.
Ca++ channel blockers Cyproheptadine Ergotamine Amitripyyline Clonidine Methysergide Sodium Valproate NSAIDS Fluoxetine
What is the prototype drug for:
Amides -
Esters -
Amides - Lidocaine - liver metabolism
Esters - Procaine - plasma hydrolysis
What is the main MOA of local anesthetics?
Na+ channel Blockers!!
But must cross membrane to work
What is the prototype drug for:
Amides - onset is 10min, duration 1hr
Lidocaine
A local that crosses the placental, (not good for c/s), duration 1-5hrs
mepivicaine
A local - amide, that can produce methemoglobinemia (blue man), little vasodilation
Prilocaine
a local that had a long duration (8-12hrs); don’t use in cardiac patients.
Bupivicaine
a local that had a long duration (8-12hrs); but can be used in cardiac patients
Ropivacaine
A local amide that has a fast onset (t like bc its too quick
Etidocaine
A local similar to lidocaine that Dentist LOVE. 60 min duration
Articaine
A local that is a potent Ester. In Aloe Vera. good topical
Tetracaine
What is the first synthetic local that has a 15min duration. Must frequently re-inject. More ppl are allergic to it
Procaine (Novacaine)
The first local - back to the stone age. It is a vasoconstrictor so don’t mix with epi!! First used a Charity in NOLA
Cocaine
What is one drug that only treats Gout pain by inhibiting the migration of granulocytes into inflamed area thus reducing the release of lactic acid
SE - inhibits cell division - slows things down
Colchicine
What drug helps with Gout. It inhibits the enzyme, Xanthine Oxidase
Must use low dose for renal compromised patients
Allopurinol
What is also a drug for Gout that is an Xanthine oxidase inhibitor. SE - liver probs, gout flares, and rash - guy carrying a Erlenmeyer flask
Febuxostat (uloric)
What is a uricosuric drug that increases the excretion of uric acid. Helps decrease excretion of penicillin so you can lower the dose
Probenecid
What is a uricosuric drug that increases the excretion of uric acid by inhibiting the re-absorption.
Sulfinpyrazone
What causes the neuropathic pain?
An increase production of Na channels = amplification in the pain message
What is the #1 antidepressant drug used as an analgesic?
They block the reuptake of 5-HT and NE
Amitriptyline
Dose is much lower for analgesia and work immediately rather than a few days for depression
What is the most popular anticonvulsant and which one is taking over the market?!? he said twice!!
Carbamazepine
Gabapentin - lower SE
