Pharmacotherapy

Question 1

For the reduction of pain to promote function.

Answer 1

Pharmacotherapy

Question 2

Analgesics include:

Answer 2

• NSAIDs
• Acetaminophen
• Corticosteroids
• Injections (LA)
• Opioids

Question 3

These suppress the action of prostaglandins and thromboxanes by inhibiting cyclooxygenases.

Answer 3

NSAIDs

Question 4

Effects of NSAIDs.

Answer 4

• Analgesic
• Anti-inflammatory
• Anti-pyretic
• Anti-coagulant

Question 5

Selective NSAIDs inhibit…

Answer 5

COX-2

Question 6

Non-selective NSAIDs inhibit…

Answer 6

COX 1 and 2

Question 7

A type of NSAID that’s called Advil

Answer 7

Ibuprofen

Question 8

These are used for mild to moderate pain, or post-surgical pain.

Answer 8

NSAIDs

Question 9

NSAIDs cannot be used in these patients:

Answer 9

• Renal disease
• Asthma
• GI ulcers

Question 10

Avoid these COX inhibitors if there’s an allergy to sulfa meds.

Answer 10

2

Question 11

AKA Tylenol

Answer 11

Acetaminophen

Question 12

The drug of choice for pregnancy.

Answer 12

Acetaminophen

Question 13

Tylenol MOA

Answer 13

Inhibits COX-3, which acts in the CNS.

Does NOT suppress prostaglandins!

Question 14

Acetaminophen max dose.

Answer 14

3g/day

Question 15

Avoid use of Acetaminophen in:

Answer 15

• Liver disease

- Chronic alcoholics

Question 16

These prevent the breakdown of cell mediators.

Answer 16

Corticosteroids

Question 17

These are for moderate to severe pain, and TMJ SURGERY.

Answer 17

Corticosteroids

Question 18

How do you discontinue corticosteroids?

Answer 18

Taper the dose.

Question 19

Where do corticosteroids work?

Answer 19

Peripherally at the tissue level.

Question 20

These block voltage-gated Na channels on nociceptors.

Answer 20

Local anesthetics

Question 21

Long-acting LA.

Answer 21

Bupivacaine

Question 22

Avoid LA’s in what?

Answer 22

Myositis

Question 23

These act at nociceptors.

Answer 23

LA’s

Opioids

Question 24

Act on Mu, Kappa, and Delta receptors.

Answer 24

Opioids

Question 25

Do not give this drug to someone with chronic pain, bc it can cause dependence.

Answer 25

Opioids

Question 26

These drugs act on peripheral and central nociceptors.

Answer 26

Opioids

Question 27

Adjunct analgesics

Answer 27

- Muscle relaxants - Anxiolytics - Benzodiazepines - Antidepressants (TCA's) - NMDA Receptor Antagonist

Question 28

Where do adjunct analgesics act?

Answer 28

Centrally

Question 29

These are not designed to control pain.

Answer 29

Adjunct analgesics

Question 30

Common muscle relaxants.

Answer 30

- Baclofen - Tizanidine - Cyclobenzaprine

Question 31

Clinical uses of muscle relaxants.

Answer 31

- Masticatory muscle pain - Muscle pain upon awakening - Sleep disturbance associated with pain

Question 32

These drugs act at the tissue level.

Answer 32

NSAIDS | Steroids

Question 33

These drugs act centrally

Answer 33

Muscle relaxants Acetaminophen Opioids

Question 34

Muscle relaxants act centrally or peripherally.

Answer 34

Centrally

Question 35

Benzos cause the release of what?

Answer 35

GABA

Question 36

Function of GABA

Answer 36

Inhibit the motor endplate to cause muscle relaxation.

Question 37

Benzos end in what?

Answer 37

"azepam"

Question 38

Benzos may worsen this.

Answer 38

Depression

Question 39

These are given for chronic pain with sleep disturbances.

Answer 39

Tricyclic antidepressants

Question 40

Tricyclic antidepressants MOA

Answer 40

Inhibit the reuptake of Serotonin and NE.

Question 41

Increase the inhibitory descending bulbospinal pathway.

Answer 41

TCA's.

Question 42

These drugs are used for chronic pain.

Answer 42

NMDA receptor antagonists

Question 43

Examples of NMDA receptor antagonsits.

Answer 43

Ketamine Dextromorphan

Question 44

You need 2400 mg/day of this drug in order to have anti-inflammatory effects. A lower does only has anti-analgesic effects.

Answer 44

Ibuprofen

Question 45

Pain from injury or disease to the nervous system (PNS and CNS).

Answer 45

Neuropathic pain

Question 46

Classifications of neuropathic pain.

Answer 46

1) Continuous | 2) Episodic

Question 47

Meds used for neuropathic pain.

Answer 47

Anticonvulsants & Capsaicin

Question 48

Anticonvulsants

Answer 48

Carbamazepine Oxaycarmazepine Gabapentin Pregabalin

Question 49

Anticonvulsant that decreases the conductance of Na and K, suppressing alpha delta and C fibers.

Answer 49

Carbamazepine

Question 50

Blocks voltage-gated Na and Ca channels.

Answer 50

Oxycarbazepine

Question 51

Anticonvulsant that affects voltage gated Ca channels, but the mechanism is uncertain.

Answer 51

Gabapentin

Question 52

Anticonvulsant that's similar in effect to gabapentin, binds to a subunit of Calcium channel and reduces neuronal activity.

Answer 52

Pregabalin

Question 53

Activation of this receptor destroys nociceptive fibers.

Answer 53

TRPV1

Question 54

This drug activates the TRPV1 Receptor.

Answer 54

Capsaicin

Question 55

This drug is used as/for: - Diagnostic aid - Burning Mouth - Atypical odontalgia

Answer 55

Capsaicin

Question 56

Avoid this NSAID in asthma patients.

Answer 56

Ibuprofen

Question 57

Avoid this drug if have a sulfa allergy.

Answer 57

Celecoxib

Question 58

This NSAID is for MODERATE pain intensity.

Answer 58

Acetaminophen

Question 59

This drug is contraindicated for osteoporosis.

Answer 59

Methyl prednisone (osteoporosis)

Question 60

Avoid this in gastric ulcer.

Answer 60

Ibuprofen

Question 61

Avoid this in hypercholesterolemia.

Answer 61

Celecoxib

Question 62

Used for inflamation and severe pain.

Answer 62

Methyl Prednisone

Question 63

Avoid this type of drug if have gastric ulcers.

Answer 63

NSAIDs

Question 64

This drug is for CHRONIC pain

Answer 64

.Amitriptyline (Tricyclic Antidepressants)