Brainscape's Knowledge GenomeTM

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


See full index

4th yr- CMS- drugs and medication > Commonly prescribed analgesic > Flashcards

Commonly prescribed analgesic Flashcards

1
Q

What are commonly prescribed analgesics Called

A

Non steroidal anti inflammatory drugs (NSAIDS)

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

What do we need to consider before prescribing NSAIDS

A
  1. Drug interactions

2. Patient factors

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

What is the major ode of action of NSAIDS

A

Inhibition of the cyclo-oxygenase enzymes 1 and 2 to reduced prostaglandin synthesis

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

Talk through the synthesis of prostaglandins

A 
1. Phospholipid 
(Phosphlipase)
2. Arachidonic acid
(Cyclic oxygenase COX1, COX2)
3. Cyclic endopeloxides PGG2
(Cyclo oxygenase)
4. prostaglandin
5. PGE2, PGD2, PGF2,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What do prostaglandins produce

A
  1. Analgesic actions
  2. Antipyretic action
    3Inflammatory actions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Name the 2 Cyclic oxygenase enzymes

A

COX1

COX2

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

Describe COX 1

A
  1. It is constitutionally active
  2. Expressed in many tissues eg kidneys, blood vessels, stomachs
  3. Unwanted/ adverse affects of NSAID are predominately down to COX 1
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe COX 2

A

Is an inducible enzyme inducted by inflammatory cells

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

The unwanted effects of NSAIDS are due to which COX enzyme

A

COX1

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

What do several prostaglandin make

A

Nociceptors that response to mediators such as 5-HT, bradykinin

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

How are NSAIDS effective painkillers

A

They stop prostaglandin synthesis

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

Talk through the antipyretic effect of NSAIDS

A
  1. Bacteria leads to infection in a healthy body
  2. Bacterial toxin released
  3. Macrophages activated
  4. NSAIDS block COX2 metabolised PG synthesis
  5. This returns the body back to normal rather than pyrexia occurring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is pyrexia

A

Body temperature greater than 38

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

What are the anti inflammatory effects of NSAIDS

A

COX-2 inhibition of prostaglandins synthesis leads to:

  1. Less vasodilaiton
  2. Less tissue oedema
  3. Less sensitisation of nociceptors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does less vasodilation lead to

A

Reduced flushing and reduced redness of skin

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

What do we mean by less tissue oedema

A

Reduced swelling

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

What do we mean by less sensitisation of nociceptors

A

Analgesia

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

Name the most common NSAID agents

A
  1. Salicylates e.g. aspirin
  2. Paracetamol
  3. Proprionic acid derivatives EG ibuprofen, naproxen
  4. Selective COX-2 inhibitors
  5. Enoic acids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is aspirin made of

A

acetylsalicylic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Give examples of Proprionic acid derivatives

A

Ibuprofen

Naproxen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the half life of ibuprofen

A

2 hours

22
Q

What is the half life of naproxen

A

14 hours

23
Q

why might we prefer Proprionic acid derivatives over aspirin

A

As Proprionic acid derivatives are better tolerated in regards to gastrointestinal effects

24
Q

Give examples of selective COX-2 inhibitors

A

etoricoxib,
celecoxib,
parecoxib

25
Q

When are selective COX-2 inhibitors used

A

most commonly prescribed in Rheumatology

26
Q

Give example of Enoic acids NSAIDS

A

piroxicam,
meloxicam,
ketorolac,
diclofenac

27
Q

Aspirin and ibuprofen selectively inhibit which form of COX

A

Weakly COX-1 Selective

28
Q

How does aspirin work

A

It binds irreversibly to COX-1 hence the effects outlasts presence of the drug

29
Q

Diclofenac selectively inhibit which form of COX

A

Weakly COX-2 selective

30
Q

Celecoxib selectively inhibit which form of COX

A

Moderately COX-2 selective

31
Q

Etoricoxib selectively inhibit which form of COX

A

Very COX-2 Selective

32
Q

How does paracetamol work

A

It is a reversible non competitive COX inhibitor

33
Q

What is paracetamol effective against

A

Pain relief and anti pyretic actions

34
Q

What are gastrointestinal effects of NSAIDS

A
  1. Dyspepsia
  2. Nausea
  3. Gastritis
  4. Intestinal damage
  5. Bleeding
  6. Oral ulcerations
35
Q

what are the bleeding risks of NSAIDS

A
  1. Anti platelets activity exacerbates gastrointestinal bleeding
  2. Increased risk of thrombotic effects eg MI or stroke
36
Q

What other side effects may NSAIDS have

A
  1. May have irritant effect on skin or mucosa
  2. Skin rashes
  3. Bronchospasm
  4. Nephritis and papillary necrosis
37
Q

What does aspirin overdose have an impact on

A

Acid base balance

38
Q

What can changes in acid base balance lead to

A

respiratory alkalosis or respiratory and metabolic acidosis

39
Q

What can overdose of aspirin cause

A
  1. Hyperpyrexia
  2. Nausea and vomiting
  3. Vertigo, tinnitus and haring impatient
40
Q

What is Hyperpyrexia

A

Body temperature of 40 plus

41
Q

What is reyes syndrome

A

A syndrome present in children given aspirin for viral infections to lower their high temper

42
Q

What is the mortality rate for reyes syndrome

A

20-40%

43
Q

How do we avoid reyes syndrome

A

Never prescribe aspirin for those under the age of 16

44
Q

Above what dose can paracetamol start causing problems

A

A dose of 10-15g

45
Q

What is the maximum dose of paracetamol for a Healthy adult

A

1g per day in 4 divided doses

46
Q

What are the major side effects of paracetamol overdose

A

Severe liver damage

47
Q

How does liver damage manifest as a consequence of paracetamol over dose

A

Hepatitis which can be severe enough to end in acute liver failure and death

48
Q

What is the toxic metabolite produced as a consequence of paracetamol overdose

A

N-acetyl-p-benzoquinone

49
Q

Why is N-acetyl-p-benzoquinone toxic

A

There is limited capacity for the body to remove this

50
Q

How is N-acetyl-p-benzoquinone toxic usually metabolised

A

In conjugation with GLUTATHIONE

51
Q

What are paracetamol overdose patients given

A

given IV N-acetylcysteine or PO methionine to increase glutathione production to mop up the excess toxic metabolite

4th yr- CMS- drugs and medication (4 decks)

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