Analgesics Flashcards

(40 cards)

1
Q

What receptors are responsible for the analgesic effects of opiates

A

Mu receptors

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2
Q

What drug class is morphine

A

opioid

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3
Q

What is a narcotic

A

A narcotic is an opioid (opiate) drug- dervived from unripe opium poppy (papaver somniferum)

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4
Q

What is the administration route of morphine

A

PO, PR, IM, IV

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5
Q

In which acute situation is morphine often used

A

acute MI because of the vasodilation, anxiolytic, and pain relief effects

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6
Q

What are common side effects of morphine (7)

A

respiratory depression, miosis, itching, constipation, paralytic ileus, N/V, dependence

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7
Q

What category is morphine

A

category C (may have adverse effects on fetus, but no human studies) Morphine crosses placenta and can cause dependance in fetus

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8
Q

How does Fentanyl (duragesic) differ from morphine

A

It is 80x more potent, which means it has a much greater respiratory depression

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9
Q

how is fentanyl administered

A

transdermal patch, lollipop or lozenge (sublingual), IV

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10
Q

what are side effects of fentanyl

A

constipation and paralytic ileus, N/V, addiction

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11
Q

What drug type cannot be used with fentanyl

A

concomitant CYP450 inhibitors can lead to fatal blood levels of fentanyl (like grapefruit juice)

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12
Q

What can effect the efficacy of the fentanyl patch

A

cutting the patch will mess up the timed release, and heating the patch affects the dose delivered as well

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13
Q

What are the uses of codeine

A

It is an anti-tussive in addition to being an analgesic

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14
Q

How does codeine compare to morphine

A

It is converted to morphine by the body, but is a much weaker analgesic. codeine is much better at cough relief.

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15
Q

what category is codeine

A

category C

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16
Q

what are common side effects of codeine

A

sedation, constipation, itching. ultra-rapid metabolizers can die from normal doses of codeine, essentially a morphine OD

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17
Q

What neuro effect does tramadol (Ultram) have

A

affects dopamine and serotonin as well as weak mu-receptor agonist, which makes the person tolerate pain better, as well as reducing pain

18
Q

how does heroin differ from morphine

A

it is more lipid soluble, and thus crosses BBB and induces a greater euphoric effect. it is 2x as potent, and way more addictive than morphine

19
Q

What is methadone used for

A

opioid used in the controlled withdrawal of heroin and morphine in addicted patients

20
Q

What is Naloxone (narcan) used for

A

opioid OD, reverses coma and respiratory depression

21
Q

What is the MOA of Naloxone (narcan)

A

Opioid ANTAGONIST bind with high affinity to opioid receptors but do not activate the receptor mediated response.

22
Q

What is dextromethorphan

A

The dextro-isomer of codeine

23
Q

How does dextromethrophan differ from codeine

A

It has little to no analgesic, sedative, or GI effects (non constipating)

24
Q

what drug class is Aspirin/ Acetylsalicylic acid (ASA)

25
Is aspirin a reversible or irreversible COX inhibitor
it is irreversible, thus no aspirin 14 days before surgery
26
What is a risk of kids using aspirin
Reye's syndrome, salicylism (dizziness, tinnitus, hyperventilation, craziness)
27
Is ibuprofen (motrin, advil) reversible or irreversible COX inhibitor
reversible, so no platelet aggregation issues
28
What drug class is celecoxib (celebrex)
NSAID, selective COX-2 inhibitor
29
Why was vioxx (rofecoxib) pulled from the market
increased cardiovascular events after 7 months of use
30
What class is acetaminophen (tylenol)
NSAID, inhibits COX-3
31
What NEVER mixes with tylenol
alcohol
32
What happens in an acetaminophen overdose
The byproduct NAPQI builds up in the liver and binds to vital proteins in the lipid bilayer in hepatocytes, causing cell death and necrosis
33
What category is acetaminophen
category B
34
How is acetaminophen antidoted
N-acetylcysteine administration ASAP
35
What is the maximum dose of tylenol in the absence of any alcohol or liver disease (considered safe adult dose)?
4 grams/ 24 hours
36
What is considered an overdose of tylenol?
>7 grams/24 hours
37
indication for celebrex?
inflammation, pain, treatment of adenomatous polyps, can also be used in people with peptic ulcers
38
Which analgesic agent would not cause constipation?
dextromethorphan
39
What DEA category is Heroin?
DEA category CI
40
What are endogenously made opiates called?
Opiopeptins : endorphins, enkephalins