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D&T2 Exam 2 > Treatment of pain - Egleton > Flashcards

Treatment of pain - Egleton Flashcards

1
Q

class of drug: aspirin, acetaminophen, NSAIDS, COX-2 inhibitors

A

non-opioid analegesics

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2
Q

class of drug: morphine, methadone, heroin, hydrocodone, oxycodone, hydromorphone

A

opioids

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3
Q

class of drug: Clonodine

A

alpha 2 adrenergic agnoists

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4
Q 
class of drug: TCA- Amitriptyline
SNRI- Venlafaxine, Duloxetine
A

antidepressents

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5
Q

class of drug: alpha 2 durgs

A

antiepiletpic

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6
Q

class of drug: lidocaine, capsaicin

A

topical local analgesics

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7
Q

class of drug: ketamine

A

NMDA antagonist

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8
Q

class of drug: baclofen, diazepam, Carisoprodol

A

muscle relaxants

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9
Q

non-opioid analgesics target what component of the pain cascade

A

inflammatory

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10
Q

what is the number one cause of liver failure in the US

A

Acetaminophen

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11
Q

what are side effects of NSAIDS, and Aspirin

A

gastric ulcers

inhibit platelet aggregation

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12
Q

what are the two receptors opioid drugs target

A

mu and kappa

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13
Q

Name the strong agonist opioids

A

Morphine
Methadone
Heroin
Fentanyl

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14
Q

Name the moderate to low agonist opioids

A

codeine

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15
Q

Name the mixed agonist/antagonist partial agonists opioids

A

Buprenorphine

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16
Q

Name the antagonists of opioids

A

Naloxone

Naltrexone

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17
Q

when are opioids prescribed to a patient

A
  • not 1st line
  • moderate-to-severe acute and chronic pain
  • pulmonary edema
  • preanesthetic medication
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18
Q

MOA of opioids

A

act at Mu receptors with high affinity

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19
Q

Opioids act on areas involved in

A

respiration
pain perceptor
mood emotion

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20
Q

what are CNS effects of Morphine? more info

A
  • analgesia without loss of consciousness
  • Euphoria/Dysphoria –> promotes abuse potential
  • Nausea and vomiting –> direction action on CTZ
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21
Q

what is pathognomonic of opiate intoxication? what causes this

A

miosis - due to excitation at the Edinger-Westphal nucleus of oculomotor nerve

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22
Q

what is the main cause of death in overdose of morphine

A

respiration

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23
Q

what is the biggest GI side effect for using opioids

A

constipation

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24
Q

name 2 antidiarrheal opioids with no CNS activity

A

Diphenoxylate

Loperamide

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25
Q

when taking opioids, tolerance does not develop to what

A

moisis
constipation
respiratory effects

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26
Q

How is opioid poisoning treated

A

ventilation

i.v. opiate antagonist

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27
Q

the source of opioid, opium, contains several alkaloids, name them

A

morphine, codeine, papaverine

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28
Q

what opioids are used for cough supression

A

codeine

hydrocodone

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29
Q

what are two precursors for morphine

A

Codeine

Herion

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30
Q

what converts codeine to morphine

A

CYP2D6

31
Q

what is Hydromorphone used for

A

severe pain

32
Q

what are predominant side effects of methadone

A

constipation

biliary spasms

33
Q

what opioid agonist is used for opioid withdrawal

A

methadone

34
Q

what forms of heroin have higher BBB penetration than morphine

A

Diacetylmorhpine

6-monoacetylmorphine

35
Q

what is the specific heroin metabolite detectable in urine tests

A

6-monoacetylmorphine

36
Q

what is hydrocodon usually mixed with

A

acetaminiophen

37
Q

Oxycodone is usually mixed with what

A

non-opioid analgesics
ibuprofen
aspirin
acetaminophen

38
Q

what about oxycontin ( oxycodone) gives it potential for abuse

A

delayed release formulation

39
Q 
Miperidine
Fentanyl
Sufentanyl
Alfentanil
Remifantanil
A

Synthetic derivatives

40
Q

What causes excitement at toxic doses when using Meperidine

A

Normeperidine ( CNS stimulant)

41
Q

can you use naloxone to treat overdose of Meperidine

A

no

42
Q

Meperidine combined with other drugs can cause excitation, delirium, hyperpyrexia, convulsions, respiratory depression

A

MAO inhibitors

43
Q

how can Fentanyl be given to a patient

A

patch
lozenge ( sucker)
I.V. pre/post surgery

44
Q

Sufentanil
Alfentanil
Remifentanil
are derivatives of what?

A

Fentanyl

mu opioid agonists

45
Q

slow metabolism of codeine results in

A

codeine ineffective analgesic

46
Q

fast metabolism of codeine results in

A

fast conversion to morphine - overdose

47
Q

Propoxyphene is an agonist to what

A

mu

moderate to low opioid agonist

48
Q

what drug is put into Pentazocine to prevent abuse

A

Naloxone

49
Q

what opioid is used for pregnant patients and how is this drug usually administered

A

Buprenorphine

sublingually

50
Q

MOA of Tramadol

A

inhibits NE and 5-HT reuptake

-not an opioid but binds opioid receptors

51
Q

in opioid-dependent subjects, antagonists can induce

A

withdrawal

52
Q

name 2 opiate antagnoists

A

Naloxone
Nalmefene
Naltrexone

53
Q

when is Dextromethrorphan (opioid) used? what is it found it? abuse potential

A

non-analgesic use
cough syrup
Robotripping in teens

54
Q

name an alpha 1 adrenergic agnoist

A

Clonodine

55
Q

what are Diphenoxylate and Leperamide used for

A

antidiarrheal

56
Q

what is MOA for Clonodine

A

NE inhibits pain by activation of pre and post alpha 2 receptors simulation in projection neurons of DORSAL HORN and primary afferents

57
Q

what is the most common TCA antidpressent that treats pain

A

amitriptyline

58
Q

MOA of TCA and SNRI

A

Ne and 5-HT reuptake inhibitors promote NE activation of pre and post alpha 2 receptors in projection neurons of dorsal horn and primary afferents
- can alter perception of pain

59
Q

name antiepileptic drugs used for pain

A

alpha 2 delta

Carbamazepine

60
Q

name two alpha 2 delta drugs

A

gabapentin

pregabalin

61
Q

MOA of alpha 2 delta drugs

A

reduce activation of N and P/Q Ca2+ channels

62
Q

MOA of Carbamazepine

A

stabilized inactive state of voltage gated sodium channels

63
Q

which antiepileptic drugs decreases tolerances of opioids

A

gabapentin

64
Q

what is lidocaine used for

A

local anesthetic

65
Q

what is Capsaicin

A

chilli pepper alkaloid adjunctive

66
Q

what is MOA for ketamine

A

blocks NMDA

glutamate signaling

67
Q

what is Baclofen used for? any warnings

A

spasticity and hiccups

-avoid abrupt withdrawal, will result in sequelae

68
Q

what id Diazepam used for

A

IV/IM muscle spasms

oral - muscle relaxant

69
Q

what muscle relaxant is not recommended for use in elderly or children under 16, used cation in patients with drug abuse history

A

Carisoprodol

70
Q 
Chorzoxazone
Cyclobenzaprine 
Metaxalone
Methocarbamol 
are used in care with who
A

elderly

71
Q

what is Cyclobenzaprine used for? Pharmacokinetics

A

acute muscle spasms
TMJ
-large half life
-Cyp3A4

72
Q

what is the main side effect of Metaxalone

A

Jaundice

73
Q

what is Methocarbamol used for

A

muscle spasm tetanus

74
Q

what is Tizanadine used for

A

tension headaches

low back pain

D&T2 Exam 2 (14 decks)

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