Analgesics

Question 1

COX-1 vs COX-2

Answer 1

1: GI mucosa, plt fx, RBF
2: inflammation, pain, fever

Question 2

NSAID SE

Answer 2

-bleeding (inhibit plts) GI ulcer/bleeding
-tinnitus
-↓osteoblast/osteoclast activity (bone healing)
-↓RBF
-↑leukotrienes (bronchospasm)
-↑CV risk (HTN, MI, HF - more w/ -coxib)

Question 3

NSAID drug interactions

Answer 3

-Displace albumin-bound drugs (warfarin, phenytoin, valproic acid)
-↓lithium & dig clearance

Question 4

NSAID drug interactions

Answer 4

-Displace albumin-bound drugs (warfarin, phenytoin, valproic acid)
-↓lithium & dig clearance

Question 5

NSAID contraindications:

Answer 5

-active bleeding
-renal failure
-asthma

Question 6

Centrally acting a2 agonist MOA

Answer 6

-↓SNS outflow (inhibits NE release) = ↓HR & ↓BP
-Postsynaptic alpha-2 agonist = transient HTN, ↓HR, mild diuretic effect

Question 7

Centrally acting a2 agonist contraindications

Answer 7

-HTN crisis
-clonidine w/ OB, bradycardia

Question 8

Centrally acting a2 agonist use with caution

Answer 8

-2nd/3rd degree heart block
-severe ventricular dysfx
-hypovolemia
-HoTN
-hx liver or renal failure

Question 9

dexmedetomidine vs clonidine a2:a1

Answer 9

dexmedetomidine: 1,600:1
Clonidine: 250:1

Question 10

dexmedetomidine antidote

Answer 10

atipamezole