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ClinMed > Pharmacology part 3: Final > Flashcards

Pharmacology part 3: Final Flashcards

(43 cards)

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1
Q

what are 2 types of analgesics

A

opiods and nonopiods

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2
Q

what are 2 types of antinflammatory agents

A

NSAIDS and glucocorticoids

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3
Q

function of opioids

A

alter pain perception

used with moderate to severe pain

indicated for use in chronic or acute pain

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4
Q

common opioids

A

codeine
fentanyl
hydrocodone
meperidine
morphine
oxycodone
propoxyphene
tramadol

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5
Q

what is an opioid agonist

A

binds to receptor and stimulates

strong and moderate types

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6
Q

what is an opioid antagonist

A

receptor blocker

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7
Q

how does a mixed agonist/antagonist opiod work

A

stimulates some receptors while blocking others

good for pts with addictive potential

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8
Q

where can opioids act

A

at pre/post synaptic neurons on brainstem or on peripheral neurons right in the joints to decrease excitability

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9
Q

where do opioids primarily react

A

brain and spinal cord

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10
Q

what are 3 ways opioids control pain

A

decreased synaptic activity in ascending pain pathways

decreased sensitivoty of sensory neurons that send painful impulses to cord

activate descending anti-pain pathways

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11
Q

minor adverse effects of opioids

A

sedation
mood changes
confusion
N&V
constipation

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12
Q

serious adverse effects of opioids

A

orthostatic hypotension
respiratory depression
potential for tolerance, dependence, and addiction

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13
Q

what is opiod tolerance

A

need more drug to achieve same effect

begins at 1st dose

obvious after 2-3 weeks

lasts up to 1-2 weeks after stop taking

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14
Q

what is opioid physical dependence

A

onset of withdrawal if drug is suddenly stopped

can begin 6-10 hours after last dose and peaks at 2-3 days

symptoms last about 5 days

NOT addiction

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15
Q

symptoms of phsycial dependence

A

body aches
gooseflesh
fever/shivers
N&V
diarrhea
cramps
uncontrollable yawn
weak/fatigue
leg cramps/tremors
sneezing/runny nose
loss of appetote
sweating
tachycardia

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16
Q

what is opioid addiction

A

chronic relapsing disease characterized by compulsive drug seeking and use despite negative consequences and by ling lasting changes in brain

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17
Q

risks of opioid addiction is low if…

A

only used for a limited period of time (i.e. 3-7 days)

dosage matches pt pain level

pt has no hx of substance abuse

pt doesn’t not misuse opioid

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18
Q

what is chronic opioid analgesic therapy (COAT)

Study These Flashcards
A

more than 90 days continuous therapeutic use

misues can occur in 21-29% pts

tolerance/dependence likely but addiction is only estimated to 8-12%

19
Q

what is the role of a patient controlled analgesia

Study These Flashcards
A

patient activates pump and self administers a small amount of opioid

pump is programmed to prevent overdose

20
Q

benefits of PCA

Study These Flashcards
A

may allow better pain control with fewer side effects

increased pt satisfaction

requires pt awareness and cognitive ability

21
Q

what is opioid induced hyperalgesia

Study These Flashcards
A

opioids may be ineffective or increase pain in certain patients

possible mechanism = opioids turn on nociceptive pathways that use glutamate

more likely in pts with hx of addiction

22
Q

rehabilitaion concerns for opioids

Study These Flashcards
A

be alert for orthostatic hypotension

monitor signs of respiratory depression

monitor pain levels and watch out for hyperalgesia

watch for signs of abuse/overdose

23
Q

characteristics of NSAIDs

Study These Flashcards
A

analgesics

anti inflammatory

anti coagulant

24
Q

mechanism of NSAIDS

Study These Flashcards
A

inhibits prostoglandins by oxyclyonase

*prostoglandins cause fever, inflammation, and pain when cell is injured

25
examples of over the counter NSAIDS
asprin ibuprofen naproxen ketoprofen
26
examples of prescription NSAIDS
fenoprofen piroxicam
27
major difference between over the counter and prescription NSAIDS is what
the cost
28
side effects and rehab concerns for NSAIDS
gastric irritation liver/kidney damage cardio problems (increase BP and cause cardiac/stroke) impair bone/cartilage healing overdose can cause hearing loss, tinnitis, HA, or confusion
29
describe type COX-1 enzyme
normal in certain cell types produce prostoglandins to protect cell i.e. in stomach, kidneys, and platelets
30
describe COX-2 enzyme
induced when cell is injured synthesizes PG to mediate pain and inflammation i.e. like RA
31
function of COX-2 selective drugs
inhibit synthesis of PGs in pain and inflammation they spare production of beneficial PGs in the stomach, kidneys, and platelets can decrease pain and inflammation with less toxicity compared to other drugs
32
concern with COX-2 inhibiting drugs
evidence that they promote infarction can cause heart attack or stroke some drugs have been recalled
33
only COX-2 drug remaining on market
celebrex
34
mechanism in which COX-2 inhibiting drugs promote infarction
normal body = nalance between PGs that cause vasodilation and vasoconstriction COX-2 selsctive drugs = inhibit the dilators and allow constricting PGs to dominate
35
characteristics of acetaminophen
analgesic and antipyretic effects no GI irritaion no anti inflammatory or anti coagulant effects high dose = liver toxicity
36
how can acetampnophen be liver toxic
too much byproduct of benzo can build up and damage liver due to not enough GSH
37
signs of liver toxicity
yellow skin loss of appetite bleeding/bruising N&V fever
38
how can acetominaphen combined with opiods be beneficial
allows better overall pain control with low overdose
39
what are anti infalmmatory steroids
aka glucocorticoids or adrenocorticosteroids powerful antiinflammatory and immunosupressive agents
40
common anti inflammatory steroids
betamethasone cortisone dexamethasone hydrocortisone paramethasone prednisolone prednisone
41
how do the anti inflammatory effects of anti inflammatory steroids
act on inflammatory cells drug binds to glucocorticoid receptor in cytoplasm drug receptor travels to nucleus and decreases expression of inflammatory proteins and increases expression of antiinflammatory proteins
42
administration methods of anti-inflammatory steroids
oral = for systemic; regular maintenance dose; dose packs injection = intra articular; 3-4 per year other = inhalation, topical, nasal, ophthalmic, otic, etc
43
primary problem with anti inflammatory steroids as well as other concerns
catabolic effect on bone, muscle, ligament, tendon, and skin other = salt/water retention, increased infextion, gastric ulcers, glucose intolerance, glaucome. adrenal supression

ClinMed (10 decks)

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