Pharmacology

Question 1

APAP Pregnancy Category

Answer 1

Category B

Question 2

Kappa receptor activation produces

Answer 2

Analgesia, hallucinations, dysphoria

Question 3

Delta receptor activation produces

Answer 3

Analgesia, and some can cause seizures at high doses

Question 4

Carbamazepine MOA

Answer 4

Blocks voltage dependent Na channel
Acts centrally and peripherally
Suppresses firing of C and A-delta fibers
Chemically related to TCAs
Has some anti inflammatory effects

Question 5

Least chondrotoxic LA

Answer 5

Ropivicaine

Question 6

Tertiary amine TCA with less anticholinergic s/e

Answer 6

desipramine, nortriptyline

Question 7

TCA used for pain secondary to…

Answer 7

• Post stroke pain
• Post herpetic neuralgia
• DM neuropathy
• Non diabetic polyneuropathy
• Post-mastectomy pain syndrome

NOT from HIV neuropathy, phantom limb pain, pain due to SCI

Question 8

Baclofen MOA

Answer 8

GABA-B receptor agonist

Question 9

Propionic derivatives

Answer 9

• Ibuprofen
• Naproxen
• Ketoprofen
• Oxaprozin

Question 10

Soma derivative

Answer 10

Meprobamate -> dependence and abuse potential

Question 11

HIGHEST MME

Answer 11

Hm> oxycodone>morphine =hydrocodone

Question 12

Long term use of NSAIDs causes

Answer 12

Mildly prolonged bleeding time

Question 13

Opioids causes ventilatory changes such as

Answer 13

rightward shift and decrease slope of CO2 response curve

Question 14

What is the half life of oxaprozin?

Answer 14

40-60 hours

Question 15

Acetic acid derivative

Answer 15

Ketorlac, etodolac, diclofenac, indomethacin

Question 16

Ketorlac inhibits…

Answer 16

Both COX1 and COX 2

Question 17

Clonidine causes

Answer 17

decrease postop O2 consumption

Question 18

Converting morphine to methadone

Answer 18

<90mg morphine 4:1
90-300mg morphine 8:1
>300mg morphine 12:1

Question 19

Carbamazepine metabolite is …

Answer 19

equipotent anticonvulsant activity

Question 20

Ziconotide side effects include

Answer 20

• Hallucinations
• Blurred vision
• VertigO, dizziness
• Hypotension
• Ataxia
• CPK elevations
• Headache, somnolence, confusion

N-type voltage gated calcium channel blocker

Question 21

St Johns Worts can…

Answer 21

Elevate serotonin levels

Question 22

Butalbital tapering requires phenobarbital bridging

Answer 22

Withdrawal is life threatening

Question 23

Opioid antagonist

Answer 23

• Methylnaltraxone (subcutaneous injecion) for opioid induced constipation, Mu antagonist
• Naltrexone
• Naloxegol (oral route)
• Naldemedine

-Lubiprostone treats opioid induced constipation, PGE analogue, not an opioid antagonist

Question 24

Acetaminophen MOA

Answer 24

Reducing heme at peroxidase site and preventing COX activation

Question 25

Corticosteroids MOA for analgesia

Answer 25

Inhibition of phospholipase A2 activation

Question 26

2mg morphine/24h =

Answer 26

1mcg/h transdermal fentanyl

Question 27

Which has the most tolerated S/e profile of TCAs

Answer 27

desipramine and nortriptyline

Question 28

Nalbuphine MAO

Answer 28

Kappa agonist, Mu antagonist

Question 29

Naltrexone MAO

Answer 29

mu and kappa antagonist

Question 30

Naloxone infusion used for

Answer 30

opioid induced N/V in peds

Question 31

Corticosteroid MOA

Answer 31

Switch of genes that encode inflammatory molecule

Question 32

TCA MOA

Answer 32

creates sympatholytic through antagonism of alpha-1 adrenoreceptors leading to orthostatic hypotension in addition to sedation

Question 33

Acetaminophen

Answer 33

- peak plasma 30-60 minutes - rectal bioavailability is half the oral dose - primary metabolic pathway through conjugation with glucuronic acid

Question 34

TCA

Answer 34

Older class of antidepressants, by inhibiting serotonin and norepinephrine. Aids depression and chronic pain states the onset of analgesia and proceeds onset of antidepressant effects.

Question 35

Pregabalin

Answer 35

approved for neuropathic pain, DPN, PHN for partial onset seizures or fibromyalgia binds to the alpha-2-delta subunit of the voltage dependent calcium channel in the CNS

Question 36

ASA MOA

Answer 36

COX1 - irreversible acetylation of COX1 | COX2- modifies enzymatic activity

Question 37

Propoxyphene

Answer 37

weak opioid agonist, high risk of cardiac arrythmias so taken off market in 2010

Question 38

Superior hypogastric plexus block

Answer 38

pain associated with cervical, bladder, rectal and prostate cancer