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System Screenings I > Drugs for Pain and Inflammation > Flashcards

Drugs for Pain and Inflammation Flashcards

1
Q

Name the two categories of drugs that treat pain

A
  1. Opioid

2. Nonopioid

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2
Q

What severity of pain do opioids relieve

A

Moderate to severe

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3
Q

What is the prototypical opioid analgesic used for comparing other drugs to?

A

Morphine

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4
Q

What are the 3 opioid receptors that effect spinal and supra spinal analgesia?

A

Mu, Kappa, and Delta

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5
Q

Opioid receptor that causes sedation, respiratory depression, constipation, inhibits neurotransmitter (ACh, dopamine) release, increases hormonal release (prolactin, growth hormone)

A

Mu

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6
Q

Opiod receptor that causes sedation, constipation and psychotic effects

A

Kappa

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7
Q

Opioid receptor that increases hormonal release (growth hormone) and inhibits neurotransmitter (dopamine) release

A

Delta

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8
Q

The most important opioid receptor in mediating the analgesic effects of morphine and other opioids; located in specific locations in the brain and spinal cord; opioids have high affinity to this receptor type; mediate problematic side effects

A

Mu

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9
Q

Opioids that selectively stimulate _____ and _____ receptors may provide sufficient analgesia while less likely causing respiratory depression and abuse if they avoid or block _____ receptors (mixed agonist-antagonist opioids)

A

Kappa and Delta; Mu

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10
Q

What is classification of different opioids based on?

A

Their interaction with opioid receptors

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11
Q

Opioid classification: Used to treat severe pain; high affinity for certain receptors (primarily mu); i.e., morphine, fentanyl, hydromorphone

A

Strong agonists

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12
Q

Opioid classification: not as high of an affinity or efficacy as strong agonists; i.e., codeine, hydrocodone, oxycodone

A

Mild-to-Moderate agonists

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13
Q

Opioid classification: Exhibit some agonist and antagonists like activity at the same time; produces adequate analgesia while decreasing the risk of respiratory depression; i.e., butorphanol, nalbuphine, pentazocine

A

Mixed agonist-antagonist

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14
Q

Causes analgesia by binding to activating kappa receptors while blocking (or partially activating) mu receptors

A

Butrophanol

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15
Q

What is used to treat opioid overdoses and addiction? u

A

Antagonists

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16
Q

Rapidly and dramatically reverse the respiratory depression which usually causes death in a person

A

Nalmefene and naloxone

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17
Q

Used in conduction with with behavioral therapy to maintain an opioid-free state in people recovering from addiction; blocks receptors so that if a person shoots up with heroin, they will not feel the effects

A

Naltrexone

18
Q

What metabolically inactivates opioids?

A

Liver

19
Q

How are opioids excreted?

A

Kidneys excrete the drug metabolite

20
Q

How do opioids work?

A

Inhibit afferent pain transmission, allow descending pathways to become more helpful in controlling pain by reducing painful sensations at the spinal cord level

21
Q

When compared to other forms of analgesia, why are opioids unique?

A

The alter the perception of pain rather than eliminating the painful sensation entirely

22
Q

Other than pain management, what are opioids used for?

A
  1. Anesthesia (premedication or adjunct)
  2. Cough suppression (codeine)
  3. Decrease GI motility (in cases of diarrhea
  4. Adjunct for acute pulmonary edema
23
Q

How long does it take to decrease tolerance to the point where you can begin taking the original prescribed dose?

A

2 weeks

24
Q

When will doses of opioids need to be increased?

A

After 2-3 weeks

25
Q

Problems with addiction, tolerance, and dependence are minimized when opioid medications are used _______.

A

Therapeutically

26
Q

Strong opioid agonist used to treat addiction; used as substitute for the abused opioid and slowly tapered down and withdrawn along with the pt in counseling; low success rate

A

Methadone

27
Q

Mixed agonist-antagonist (agonist at mu, antagonist at kappa); sustains opioids effects to prevent withdrawal; blocks cellular changes that promote addiction

A

Buprenorphine

28
Q

How would opioid analgesics in patients requiring rehab be helpful?

A

Pt is in less pain, so more able to do exercises

29
Q

How would opioid analgesics in patients requiring rehab be detrimental?

A

Pt could injure themselves being confused, could be drowsy, could affect respiratory function

30
Q

When should a pt take their opioid relative to their rehab?

A

30 mins - 1 hour

31
Q

What is something else you may have to watch out for while at work?

A

Coworkers or family members stealing opioids

32
Q

What are the uses for Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)?

A
  1. Decrease inflammation
  2. Relieve mild-to-moderate pain
  3. Decrease elevated body temp
  4. Decrease blood clotting
33
Q

What does NSAIDs inhibit the synthesis of?

A

Prostaglandins

34
Q

Produced by all cells except RBCs; hormones that act locally to help regulate cell fxn under normal conditions; thromboxjnes and leukotrienes also derived from the same precursor

A

Prostaglandins

35
Q

Name 3 Eicosanoids

A
  1. Prostaglandins
  2. Trombones
  3. Leukotrienes
36
Q

What enzymes do NSAIDs inhibit?

A

COX

37
Q

The blockage 2 COX enzymes causes both beneficial and adverse side effects. Which enzyme is it beneficial to block and which causes side effects if blocked?

A

COX2 is beneficial; this produces pain and inflammation, and overactive enzymes cause problems
COX1 causes side effects; enzyme produces prostaglandins that protect the stomach lining, maintain renal function, and regulate normal platelet activity

38
Q

What is the primary concern for COX2 selective drugs?

A

Increased risk for serious CV events such as heart attack and stroke

39
Q

What is the only COX2 inhibitor on the market?

A

Celecoxib (Celebrex)

40
Q

Equal to NSAIDs in terms of analgesic and antipyretic effects; no anti-inflammatory or anticoagulant effects; not associated with GI irritation; High doses are toxic to the liver and can be fatal

A

Acetaminophin

System Screenings I (23 decks)

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