Pharmacology > Pain > Flashcards

Pain Flashcards

(46 cards)

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1
Q

Steroidal anti-inflammatory drug prototype

A

corticosterone

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2
Q

Steroidal anti-inflammatory MOA

A

Inhibit arachidonic acid synthesis

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3
Q

NSAIDS MOA

A

inhibit Cox 1 and 2

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4
Q

Cox 1 constituative means

A

always there

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5
Q

Cox 2 inducible means

A

get inflammation and get increase in Cox 2

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6
Q

Undesirable effects of NSAIDS

A

GI irritation, bleeding ulcers, perforations

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7
Q

Cox 2 inhibitor examples

A

celecoxib, rofecoxib, valdecoxib

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8
Q

Major indications for NSAIDS

A

inflammatory pain (RA, osteoarthrosis), post-traumatic or post-operative pain, HA, dysmenorrhea

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9
Q

Acetaminophen MOA

A

distribues to CNS, weak inhibitor COX

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10
Q

Which has less gastic distress NSAIDS or Tylenol?

A

tylenol

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11
Q

Undesirable effects of acetaminophen

A

liver damage with OD

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12
Q

Treatment of acetaminophen OD

A

N-acetylcysteine

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13
Q

Major indications for acetaminophen

A

HA, fever, osteoarthritis

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14
Q

Do you develop tolerance to constipation with morphine

A

No

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15
Q

Is opioid withdrawal life-threatening?

A

No

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16
Q

What are some synthetic opioids?

A

meperdine, fentanyl, methadone

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17
Q

Meperidine properties

A
  1. has toxic metabolite that can build up and cause seizures
  2. fewer smooth muscle spasms than morphine
  3. no meiosis
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18
Q

Fentanyl properties

A
  1. 80-100 x more potent than morphine
  2. fast onset, short duration
  3. available as duragesic patch
  4. available orally
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19
Q

Opioid antagonist examples

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A

naloxone, naltrexone, nalmefene

20
Q

Signs of opioid OD

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A
  1. stuporous or coma
  2. decreased RR
  3. meiosis (pinpoint pupils)
  4. low body temp
  5. flacid skeletal muscles
21
Q

Migraine abortive treatments

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A
  1. ergot alkaloids- ergotamine

2. Triptans (sumatriptan, naritryptan, zolpitriptan)

22
Q

What are triptans MOA

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A

selective 5-HT1D agonist causing

  1. constricts intracranial vessels
  2. decreases inflammation
  3. decreases plasma extravasation
23
Q

Which drug is used for prophylactic treatment of migraines?

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A

Amitriptyline

24
Q

Local anesthetics MOA

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A

block Na channels

25
Two classes of locals are
1. amides (lidocaine) | 2. esters (procaine)
26
Local anesthetics are acids or bases?
weak bases
27
What effect does pH have on locals?
have less effect in acidic environments such as infected areas
28
Differential sensitivity of nerves to locals occur in these steps
1. sensory- pain, heat/cold, touch, pressure 2. autonomic 3. Motor
29
Recovery from local anesthetics occurs in these steps
1. motor 2. autonomic 3. sensory
30
Local anesthetics toxicity
1. CNS reactions- low systemic levels cause insomnia and apprehension and high levels cause CNS depression, convulsions, resp depression 2. CV- arrhythmias, decreased contraction, low BP, cardiovasular collapse
31
Local anesthtic uses
1. surface anesthesia 2. infiltration anesthesia 3. nerve block 4. spinal anesthesia 5. epidural anesthesia
32
What are the ester locals?
procaine and tetracaine
33
Most commonly used local
lidocaine
34
What local causes methemoglobinemia (turns ppl blue)?
prilocaine
35
What local has high CV toxicity?
bupivicaine- longest duration of action | **DO NOT use in CV compromised patients**
36
Local used for dentistry
articaine
37
Which local has lowest CV toxicity?
procaine
38
What drugs treat Gout?
1. colchicine 2. allopurinol 3. febuxostat
39
Allopurinol MOA
inhibits xanthine oxidase
40
Febuxostat MOA
xanthine oxidase inhibitor
41
Why is Febuxostat superior to allopurinol?
does not require lower doses to those with renal problems
42
Neuropathic pain descriptors
burning, shooting, stabbing, shock-like, tingling, numb
43
Indications for use of antidepressants as analgesics
1. migraine and tension HA 2. postherpetic neuralgia 3. diabetic neuropathy 4. fibromyalgia 5. post-stroke pain
44
Specific anti-depressants used as analgesics
1. amitriptyline 2. desipramine 3. nortipyline 4. imipramine 5. tramadol 6. doxepin
45
Indications for anti-convulsant as analgesics
1. trigeminal neuralgia 2. diabetic neuropathy 3. post-herpetic neuralgia
46
Anti-convulsants used as analgesics
1. gabapentin | 2. pregabalin
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