Drugs for Pain and Inflammation Flashcards Preview

System Screenings I > Drugs for Pain and Inflammation > Flashcards

Flashcards in Drugs for Pain and Inflammation Deck (40):
1

Name the two categories of drugs that treat pain

1. Opioid
2. Nonopioid

2

What severity of pain do opioids relieve

Moderate to severe

3

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

Morphine

4

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

Mu, Kappa, and Delta

5

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

Mu

6

Opiod receptor that causes sedation, constipation and psychotic effects

Kappa

7

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

Delta

8

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

Mu

9

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)

Kappa and Delta; Mu

10

What is classification of different opioids based on?

Their interaction with opioid receptors

11

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

Strong agonists

12

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

Mild-to-Moderate agonists

13

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

Mixed agonist-antagonist

14

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

Butrophanol

15

What is used to treat opioid overdoses and addiction? u

Antagonists

16

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

Nalmefene and naloxone

17

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

Naltrexone

18

What metabolically inactivates opioids?

Liver

19

How are opioids excreted?

Kidneys excrete the drug metabolite

20

How do opioids work?

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

21

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

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

22

Other than pain management, what are opioids used for?

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

23

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

2 weeks

24

When will doses of opioids need to be increased?

After 2-3 weeks

25

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

Therapeutically

26

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

Methadone

27

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

Buprenorphine

28

How would opioid analgesics in patients requiring rehab be helpful?

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

29

How would opioid analgesics in patients requiring rehab be detrimental?

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

30

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

30 mins - 1 hour

31

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

Coworkers or family members stealing opioids

32

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

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

33

What does NSAIDs inhibit the synthesis of?

Prostaglandins

34

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

Prostaglandins

35

Name 3 Eicosanoids

1. Prostaglandins
2. Trombones
3. Leukotrienes

36

What enzymes do NSAIDs inhibit?

COX

37

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?

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

What is the primary concern for COX2 selective drugs?

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

39

What is the only COX2 inhibitor on the market?

Celecoxib (Celebrex)

40

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

Acetaminophin