Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

BDS3 1 > Oral Surgery - analgesia > Flashcards

Oral Surgery - analgesia Flashcards

1
Q

Describe the mechanism of pain.

A

trauma/infection breaks down phospholipids and produces arachidonic acid

A Acid is broken down to form prostaglandins

prostaglandins sensitises the tissues to other inflammatory products

the inflammatory products cause pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

List the properties of Aspirin

A

NSAID

Antiplatelet

analgesia

antipyretic

metabolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the mechanisms of action for aspirin.

A

reduces the production of prostaglandins by inhibiting COX 1 & 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the action of COX 1 (inhibited in aspirin)

A

inhibits platelet aggregation and predisposes patients to gastric irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the action of COX 2 (inhibited in aspirin)

A

the enzyme responsible for the generation of inflammatory prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe how aspirin provides antipyretic properties.

A

prevents temperature increasing the effects of interleukin 1

prevents an increase in brain prostaglandin levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe how aspirin provides anti-inflammatory properties.

A

inhibits prostaglandins

P = redness and swelling as its is a vasodilator and affects capillary permeability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

List the side effects of aspirin.

A

GIT irritation and bleeding
hypersensitivity
overdose
mucosal burns if applied locally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how would a patient with an aspirin overdose present?

A

hyperventilation

tinnitus

vasodilation and sweating

metabolic acidosis

coma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When should we avoid prescribing aspirin?

A

PEPTIC ULCERS - current or previous

GORD

BLEEDING ABNORMALITIES - HAEMOPHILIA

COAGULATED PATIENTS - aspirin enhances action of warfarin

STEROIDS - common to develop an ulcer anyway

PREGNANT AND BFEEDING - reyes syndrome, haemorrhage @ birth, baby jaundice, prolong/delay labour

CHILDREN < 16 = reyes syndrome

Avoid when severe - RENAL/HEPATIC IMPAIREMENT

(caution - ASTHMA)

HISTORY OF HYPERSENSITIVITY TO NSAIDS

ELDERY

G6PD DEFICIENCY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the recommended dosage of aspirin for pain?

A

300mg

2 tablets 4x per day

for 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is recommended if you have to give someone with a peptic ulcer aspirin for pain?

A

give alongside a PPI

lansoprazole or gastro-resistant omeprazole
1 per day for 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What type of drug is ibuprofen?

A

NSAID

less side effects that aspirin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the recommended dosage of ibuprofen for pain?

A

1 tablet = 400mg

4 tablets a day

for 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the maximum daily dose of ibuprofen?

A

2.4g

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When prescribing ibuprofen, when should you exercise caution? (7)

A

PEPTIC ULCERS

ELDERLY

PREGNANT & BFEEDING

RENAL, HEPTIC CARDIAC IMPAIRMENT

HISTORY OF HYPERSENSITIVITY TO ASPIRIN AND OTHER NSAIDS

ASTHMA

LONG TERM SYSTEMIC STEROIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are side effects of ibuprofen?

A

GIT discomfort, bleeding and ulceration

hypersensitivity reactions

headaches

dizziness

drowsiness

tinnitus

fluid retention

vertigo

renal & peptic damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

List ibuprofen drug interactions.

A

ACE inhibitors

BB

Ca channel backers

clopidogrel

antibiotics

anticoagulant

antidepressants

corticosteroids

19
Q

How do you treat overdose of ibuprofen?

A

activated charcoal

20
Q

What type of drug is a selective COX 2 inhibitor e.g. celecoxib?

A

NSAID

21
Q

Describe the mechanism of selective COX 2 inhibitors.

A

inhibits COX 2 only and spares COX 1 as Inhibition of COX 2 is responsible for most of the analgesic properties of NSAIDS, cox 2 generates inflammatory prostaglandin

22
Q

What are the advantages of using selective COX 2 inhibitors?

A

Since COX 1 isn’t inhibited then the patient is less likely to suffer with gastric irritation.

no effect of platelet aggregation

23
Q

When would you avoid the use of selective COX 2 inhibitors?

A

this with current or a history of peptic ulceration

24
Q

What type of drug is paracetamol?

A

analgesic

  • no anti-inflammatory effect
25
Q

Describe the mechanism of action of paracetamol.

A

Main mode of action: reduction of prostaglandins in the pain pathways of the CNS in the thalamus.

Paracetamol indirectly inhibits COX (especially in the brain) via the inhibition of the positive feedback
Arachidonic acid is metabolised by COX to produce Hydroperoxides and creates a positive feedback to stimulate COX activity again

26
Q

with what patients should we exercise caution when prescribing paracetamol to?

A

hepatic and renal impairment

patient with alcohol dependance

drug interactions **

27
Q

What are the drug interactions of paracetamol?

A

Anticoagulants

cytotoxic

domperidone

lipid regulating drugs

metoclopramide

28
Q

What s the recommended dosage of paracetamol?

A

500mg

take 2 tablets 4x a day for 5 days

29
Q

what is the maximum daily dose of paracetamol?

A

4g

30
Q

What is the mechanism of opioids?

A

acts on the dorsal horn pathway of the spinal chord

31
Q

what are the problems associated with opioid analgesia?

A

dependence - withdrawals lead to psychological and physical illness

tolerance

effect on smooth muscle cause constipation, urinary and bile retention

32
Q

What do opioids suppress?

A

pain centre

respiratory centre

cough reflex

vasomotor

33
Q

What do opioids stimulate?

A

vomiting

saliva

pupillary constriction

34
Q

What are common side effects of opioids?

A

drowsiness

nauseam and vom

35
Q

What are opioids enhanced by?

A

alcohol

36
Q

with what patients should we avoid prescribing opioids to?

A

acute respiratory depression

alcoholism

raised intracranial pressure

37
Q

with what patients should we exercise caution when prescribing opioids to?

A

hypotension

hypothyroidism

asthma & decreased respiratory reserve

pregnancy & BF

prostatic hyperplasia

hepatic& renal impairment

those with dependance issues

38
Q

What s the recommended dosage of opioids?

A

30mg every 4-6 hours

39
Q

What are the major drug interactions with opioids?

A

antidepressants

dopaminergics for parkinsons

40
Q

How do you treat overdose of opioids?

A

Naloxone

41
Q

What drugs are licences for use in trigeminal neuralgia?

A

carbamazepine

42
Q

what is the dosages of carbamazepine?

A

start on 1 x 100mg tablet 1/2x per day

increase to;

1x 200mg tablet 3/4x per day

43
Q

with what patients should we avoid prescribing carbamazepine to?

A

AV conduction abnormalities

bone marrow depression

porphyria

44
Q

with what patients should we exercise caution when prescribing carbamazepine to?

A

hepatic, renal cardiac impairment

haematological reactions to drugs

glaucoma

pregnancy & BF

BDS3 1 (75 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions