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pharmacology > exam 1 > Flashcards

exam 1 Flashcards

1
Q

2 types of pain pathways

A

Nociceptive & neuropathic

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2
Q

3 types of opioid receptors

A

mu, kappa, and delta

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3
Q

receptor stimulated by opioid drugs

A

mu receptor

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4
Q

adverse effects of mu receptor stimulation

A

respiratory depression, sedation, physical dependence, euphoria

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5
Q

2nd receptor stimulated by opioid drugs

A

kappa receptor

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6
Q

adverse effects of kappa receptor stimulation

A

sedation and psychotomimetic effects

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7
Q

receptor that does not produce any effects when stimulated

A

delta receptors

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8
Q

what produces cortisol to suppress inflammation

A

adrenal glands

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9
Q

what do the adrenal glands release to suppress inflammation

A

cortisol

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10
Q

ACTH

A

adreno-cortico-tropic hormone

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11
Q

what releases ACTH

A

pituitary gland

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12
Q

what affects fluid balance in the body

A

aldosterone

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13
Q

3 types of non opiod analgesics

A

NSAIDS
Acetaminophe
Centrally Acting Non-Opiods

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14
Q

1st generation NSAIDS

A

aspirin (ASA)

ibuprofen (advil, Motrin)

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15
Q

2nd generation NSAIDS

A

celcoxib (Celebrex)

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16
Q

therapeutic uses of NSAIDS

A 
anti-inflammation
analgesia mild to mod pain
fever reducer
dysmenorrhea (cramps)
Inhibition of platelet aggregation (ASA)
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17
Q

NSAID contraindications/precautions

A 
pregnancy
hypersensitivity to ASA and NSAIDS
peptic ulcer disease
bleeding disorders
children w/ viral infections
prior to coronary artery bypass grafting (non ASA NSAIDS)
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18
Q

NSAIDS cause increased risk of bleeding when interacting with

A

anticoagulants
glucocorticoids
alcohol

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19
Q

NSAIDS interaction with ibuprofen

A

decreased anti-platelet effects of ASA

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20
Q

NSAIDS interaction with ACE inhibitors and angiotensin

A

increased risk of kidney failure

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21
Q

ASA cannot be given 1 week before?

A

surgery

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22
Q

Last choice NSAID for chronic pain because it can cause cardiovascular events

A

Celecoxib

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23
Q

Client instructions for NSAIDS

A

take with food etc
dont chew or crush
avoid alcohol

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24
Q

adverse drug reactions of NSAIDS

A 
gastric upset
bleeding (non ASA)
kidney dysfunction 
salicylism (ASA)
ototoxicity (ASA)
Reyes syndrome (ASA)
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25
Q

therapeutic use of acetaminophen

A

analgesia for mild to mod pain

fever reduction

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26
Q

antidote of acetaminophen

A

acetylcysteine

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27
Q

adverse drug reactions of acetaminophen

A

liver damage

hypertension (women)

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28
Q

acetaminophen contraindications/ precautions

A 
pregnancy
alcohol use 
anemia
immunosuppression
hepatic or kidney disease
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29
Q

acetaminophen interactions

A

alcohol
warfarin (Coumadin)
cholestryramine (questran)

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30
Q

Tylenol interaction with warfarin

A

increased bleeding risk

31
Q

tylenol interaction with cholestyramine

A

reduces absorption

32
Q

tylenol client instructions

A

do not exceed 4g/day
report abdominal discomfort
check BP regularly

33
Q

centrally acting nonopioids

A

tramadol (ultram)

34
Q

adverse drug reactions to tramadol

A 
sedation, dizziness
headache nausea
respiratory depression 
seizures 
urinary retention
35
Q

contraindications/ precautions of tramadol

A 
alcohol 
opioids 
psychotropic drugs 
seizure disorders
liver/kidney disease
36
Q

administration of tramadol

A

takes 1 hr to take effect

makes sure swallowed whole

37
Q

client instructions for tramadol

A 
dont drive
sit or lie down 
increase fluid/fiber 
take with food
report urinary retention
38
Q

opioid agonists

A

morphine

39
Q

therapeutic uses of morphine

A

mod to severe pain relief
sedation
reduction of bowel motility
cough supression

40
Q

contraindications of morphine

A

pregnancy
kidney failure
increased intracranial pressure
biliary colic

41
Q

morphine interactions

A 
cns depressants
anticholinergic agents
MAOIS
antihypertensives
st john wort
42
Q

adverse drug reactions of morphine

A

respiratory depression
orthostatic hypertension
urinary retention

43
Q

giving morphine

A

get baseline vitals

give iv slowly over 4-5 mins

44
Q

notify provider if respiratory rate is lower than?

A

12/min

45
Q

agonist-antagonist opioids

A

butorphanol

46
Q

therapeutic uses of butorphanol

A

mod to severe pain
treats opioid dependence
adjunct to balanced anesthesia

47
Q

contraindicatoins/precautions of butorphanol

A

myocardial infarction

opioid dependence

48
Q

butorphanol interactions

A

cns depressants

decreases opioid effects

49
Q

adverse reactions of butophanol

A

respiratory depression
increased cardiac workload
abstinence syndrome (withdrawls)

50
Q

giving butophanol

A

obtain baseline vitals

have naloxone available

51
Q

patient instructions for butophanol

A

use PRN and short term
no driving
dont use for anginal pain
no opiod use

52
Q

opioid antagonist

A

naloxone

53
Q

therapeutic use of naloxone

A

reverses opiods

reverses neonatal respiratory depression

54
Q

contraindications/precautions of naloxone

A

opioid dependence

respiratory depression

55
Q

interactions of naloxone

A

opioid effects decrease
pregnancy risk
acute hepatitis or liver failure

56
Q

adverse drug reactions of naloxone

A 
ventricular arrhythmias 
increased resp. rate
blood pressure
heart rate
abstinence syndrome
57
Q

giving naloxone

A

IM, IV or SC
titrate doses carefully
monitor vitals

58
Q

adjuvant medications

A 
tricyclic antidepressants
anticonvulsants
cns stimulants
antihistamines
glucocorticoids
bisphososphonates
NSAIDS
59
Q

antihyperuricemics

A

allopurinol (zyloprim)

60
Q

therapeutic use of allopurinol

A

hyperuricemia due to gout, chemo and blood dyscrasias

61
Q

contraindications/precautions of allopurinol

A 
hypersensitivity of allopurinol 
bone marrow depression
liver/kidney dysfunction
peptic ulcer disease
lower GI tract disease
62
Q

allopurinol interactions

A 
hypersensitivity
GI disturbances
metallic taste
cataracts
agranulocytosis
63
Q

glucocorticoids

A

prednisone

64
Q

therapeutic use of glucocorticoids

A 
pain and inflammation
skin disorders
delays rheumatoid arthritis
prevents organ rejection 
adjunctive therapy for cancer
65
Q

contraindications/precautions of prednisone

A

vaccines
fungal infections
cataracts

66
Q

prednisone interactions

A

lasix
digoxin
NSAIDS
diabetics

67
Q

predinisone interacton with lasix

A

increases risk for hypokalemia

68
Q

prednisone and digoxin

A

dysrhythmias

69
Q

prednisone and NSAIDS

A

GI bleeding and ulcers

70
Q

Prednisone and diabetes

A

decrease insulin and hypoglycemics effects

71
Q

prednisone and vaccines

A

decreased antibody response

72
Q

prednisone adverse drug reactions

A 
adrenal function suppression
hyperglycemia 
myopathy 
peptic ulcer disease
infection
fluid/electrolyte imbalance
fat redistribution
73
Q

giving prednisone

A

taper off
only short term, largest dose on first day smaller doses for next 8 days
take in morning using alternate day dosing for long term use
give more doses in times of stress

74
Q

prednisone patient instructions

A

report muscle pain
avoid NSAIDS
take with food
report GI bleeding

pharmacology (4 decks)

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