Week 2 Pharmacology

Question 1

pain

Answer 1

-subjective in nature
- acute or chronic
-somatic or visceral vs neuropathic

Question 2

analgesics

Answer 2

meds that relieve pain

Question 3

what are 2 main types of analgesics

Answer 3

opioids and non opiods

Question 4

what are non opioid analgesics

Answer 4

nsaids
acetaminophen
antidepressants
anticovulsants

Question 5

nsaids

Answer 5

block cox1 & 2 enzymes
for fever and pain

ex.
ibuprofen
naproxen
celecoxib
ketorolac

Question 6

what happens when cox 1 enzymes blocked

Answer 6

less chemicals that promote
- gastric mucosal healing
- vasoconstriction
- platelet dumping

Question 7

what happens when cox 2 enzymes blocked

Answer 7

less chemicals that cause
-vasodilation
-inflammation
- pain
- reduce platelet clumping

Question 8

whats the definition of shunting

Answer 8

blocks one chemical and gets more production of another chemical

Question 9

how much do nsaids decrease pain by

Answer 9

1-3pts

Question 10

what are common adverse effects of nsaids

Answer 10

diarrhea
GI upset

Question 11

what are serious adverse effects of Nsaids

Answer 11

renal failure/dysfunction
GI bleeding

Question 12

what are nsaids contraindicated for?

Answer 12

hemorrhage
heart failure
recent MI
liver failure
GI ulceration/bleeding

Question 13

what do cox 2 selective inhibitors have a higher risk of

Answer 13

cardiovascular issues

Question 14

what drugs are commonly required when taking nsaids

Answer 14

stomach/ gastric protection drugs

Question 15

acetaminophen (tylenol)

Answer 15

works for fever and pain
no side effect of bleeding

Question 16

how much is acetaminophen likely to decrease pain by

Answer 16

0.5-2 pts

Question 17

whats the antidote of tylenol

Answer 17

acetylcysteine

Question 18

whats the MOA of antidepressants thought to be

Answer 18

NT modulation in brain

Question 19

what type of pain are antidepressants used for

Answer 19

neuropathic

Question 20

how long does it take to see effects of antidepressants

Answer 20

a month or longer

Question 21

what are the 2 main classes of antidepressants used for pain management

Answer 21

TCAs
SNRIs

Question 22

how can antidepressants help with pain management

Answer 22

alter NE and change the perception of pain

Question 23

what side effects do opioids cause

Answer 23

urinary retention
blurred vision
dry mouth/throat
constipation
tachycardia
feeling hot/decreased sweating
sedation
confusion
dizziness
hallucinations

Question 24

how do anticonvulsants work for pain

Answer 24

generally unknown act as a CNS depressant

Question 25

when should anticonvulsants be administered

Answer 25

low doses at bedtime

Question 26

what are adverse reactions to anticonvulsants

Answer 26

dizziness somnolence cerebellar toxicity peripheral edema

Question 27

what type of pain are anticonvulsants used for

Answer 27

neuropathic

Question 28

cerebellar toxicity signs are...

Answer 28

ataxia dysarthria drunk walk

Question 29

what are some examples of anticonvulsants

Answer 29

gabapentin (neurontin) pregabalin

Question 30

an opioid

Answer 30

any drug natural or synthetic that has actions similar to morphine ex. fentanyl methadone meperidine hydromorphone oxycodone

Question 31

Opiates

Answer 31

specific to drugs isolated from opium poppies ex. morphine codiene heroin

Question 32

what are opioids used for

Answer 32

moderate to severe - pain - sedation - depression - respiratory drive (palliative care)

Question 33

whats the MOA of opioids

Answer 33

they bind to mu and kappa opioid receptors in CNS to reduce pain

Question 34

what are narcotics

Answer 34

originally any drug that caused stupor or insensibility any medically used controlled substances legally: illicit or illegal substances

Question 35

what are adverse rxns of opioids

Answer 35

- respiratory depression - constipation - miosis (pinpoint pupils) - orthostatic hypotesnion - urinary retention -emesis -euphoria -sedation

Question 36

what should be evaluated prior to opioid admin and after

Answer 36

assessment of -pain -HR -RR -BP

Question 37

whos most likely to have an opioid overdose

Answer 37

opioid naive

Question 38

when are lower doses of opioids required

Answer 38

elderly hepatic impairment

Question 39

whats the best way to avoid opioid withdrawl

Answer 39

taper dose slowly

Question 40

whats a tolerance

Answer 40

- common physiological result of chronic treatment - once occurs, larger dose needed to require same level of analgesia

Question 41

whats is dependance

Answer 41

physiological adaptation of the body in the presence of an opioid

Question 42

what does addiction refer to

Answer 42

pattern of compulsive drug use despite harmful consequences

Question 43

what is potency referred to

Answer 43

term applied to drugs that all have the same MOA but need different does to reach same effects

Question 44

whats a breakthrough dose

Answer 44

PRN dose - as needed

Question 45

what determines when a med will take effect as well as when to reassess for efficacy

Answer 45

route

Question 46

whas the bioavailibility of oral opioids usually

Answer 46

50%

Question 47

signs of opioid overdose

Answer 47

- shallow/no breathing - vomiting/gurgling - skin is cold/pallor - unresponsive/unconscious

Question 48

how does naloxone work

Answer 48

competitive antagonism

Question 49

whats suboxone

Answer 49

- sublingually/buccally administered alternative to methadone - shown to improve patient lives, reduce risk of death, transmission of HIV/viral hepatitis, incarceration, crime

Question 50

what are some nursing analgesic implications

Answer 50

- perform thorough history before beginning therapy - obtain baseline vital signs - assess for potential contraindications - perform pain assessment - withhold and contact physician if abnormal vital signs - assess for constipation --> use laxatives liberally - opioids considered high alert med. --> double checks used to reduce risk of harm/abuse - DO NOT crush long acting/controlled release dosage forms

Question 51

what is a MOA of triptans

Answer 51

binding serotonin 1B or 1D receptors cause-vasoconstriction in intracranial blood vessels

Question 52

what are adverse effects of triptans

Answer 52

dizziness worsening nausea transient heavy arms or chest pressure

Question 53

what are some contraindications of triptans

Answer 53

coronary artery disease cerebrovascular disease periph vascular disease hypertension