B: 25-28

Question 1

Synthetic opiates

Answer 1

Hydromorphone- strong. analgesia
Fentanyl- strong. analgeisa and anesthetica
Tramadol- weak. analgesia. also inhibits 5HT reuptake
Merphidine- strong. analgesia
Oxycodone- analgesic
Loperamide, Diphenoxylate- weak. anti diarrhea
Codeine, Dihydrocodeine- antitussive. also inhib. 5HT reuptake
Methadone, Buprenorphine
Nalbuphine

Question 2

Opioid receptrors are coupled to

Answer 2

Gi protein

Question 3

Opioid receptrors

Answer 3

Miu- Presynaptic reduce Ca influx. postsynaptic increace K conductance. Endrophines>Enkephalin
Sedation, decrease respiration, decreased GI motility, analgesia
Delta- analgesia
Kappa- analgesia, psichomimetic

All modulate hormone and NT release

Question 4

Opiates antagonists

Answer 4

Naloxone
Naltrexone

No relax zone

Question 5

Natural opioids

Answer 5

Morphine- Analgestic, anasthesia, acute pulm. edema
Codeine- metabolised in the liver (CYP450) to produce morphine which is ten times more potent against the mu receptor. Binding of codeine or morphine to the mu opioid receptor results in hyperpolarization of the neuron leading to the inhibition of release of nociceptive neurotransmitters causing an analgesic effect and increased pain tolerance due to reduced neuronal excitability

Modulate transmission in many sites in the brain and spinal cord

Question 6

Opioid peptides

Answer 6

Endorphine
Enkephalin (Delta)
Dynorphine (Kappa)

Question 7

Which are the semi synthetics opioids

Answer 7

Hydromorphone
Oxycodone
Dihydrocodeine
Buprenophine
Nalbuphine

Question 8

NSAID’s general drugs

Answer 8

Aspirin-
Allopurinol- Inhibits Xantine Oxidase–>decreased purine metab.–>decreased uric acid
Rasburicase- It is an Urate oxidase enzyme that metabolize uric acid into Allantoin
Colchicine- inhibits tubulin polym.

Question 9

Acute gout

Answer 9

Give Naproxen, Colchicine, Prednisolone

Question 10

Chronic gout

Answer 10

Give Allopurinol, Rasburicase, Probenecid

Question 11

Dont give Allopurinol with

Answer 11

6MP

Question 12

Non Aspirin NSAID’s

Answer 12

Ibuprophen- closes PDA
Ketoprophen- short T1/2. keto is a short diet
Naproxen- menstrual cramps. when you nap it helps with cramps
Indomethacin- closure of PDA. indigo like blue blood bcs of PDA
Diclofenac- Dic like disc of vertabrae
Metamizole- very hematotoxic. אני מתה מזה
Phenylbutazone- stop after 1 week
Meloxicam- RA! COX2>COX1. so meloww
Celecoxib- COX2. less bleeding. sulfa drug

Question 13

Renal Aspirin SE

Answer 13

Anion gap metabolic acidosis

Question 14

Acetaminophen

Answer 14

Inhibit COX in brain so analgesia

When metab by CYP450 (10%), forms NAPQI that can cause acute liver failure