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Pharmacology II > Quiz 5 Reverse > Flashcards

Quiz 5 Reverse Flashcards

(63 cards)

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1
Q

Non-opiod analgesic

A

Tx mild pain

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2
Q

Weak opiod + non-opiod analgesic

A

Tx mild to moderate pain

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3
Q

Strong opiod w/ or w/o non-opiod analgesic

A

Tx moderate to severe pain

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4
Q

Numeric Rating Scale for pain

A

NRS

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5
Q

Tissue injury

A

What type of injury is nociceptive pain?

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6
Q

Nerve injury

A

What type of injury is neuropathic pain?

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7
Q

Neuropathic pain

A

Which type of pain doesn’t respond as well to opiod therapy?

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8
Q
  1. CNS depression w/ mu & kappa receptors2. Inhibition of painful stimuli in the substantia gelatinosa of spinal cord, brainstem, RAS, thalamus & limbic system
A

MOA opiates

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9
Q
  1. Located in brain (usually preacqueductal area)2. Somatic pain & some visceral3. Assoc. w/ respiratory depression, euphoria, dependence, dec. GI motility & miosis
A

Mu receptors

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10
Q
  1. Located in spinal cord 2. Visceral pain3. Assoc. w/ sedation, miosis & dysphoria
A

Kappa receptors

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11
Q
  1. Located in spinal cord2. Antagonistic activity3. Assoc. w/ tachycardia, tachypnea, dysphoria, hallucinations, mydriasis, hypertoniaDoesn’t really affect pain but does cause side effects
A

Delta receptors

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12
Q
  1. Big 1st pass effect2. CYP450/2D6 3. Urine excretionWatch w/ renal failure & liver disease
A

Opiates kinetics

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13
Q

inc. affect

A

Protease inhibitors effect on opiates

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14
Q
  1. Fentanyl2. Methadone
A

Which opiates are metabolized by CYP3A4?

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15
Q
  1. Alcohol2. Sedatives 3. Muscle relaxants4. Phenothiazines
A

Which drugs have a big depressant affect w/ opiates?

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16
Q
  1. Allergy2. Acute bronchial asthma/upper airway obstruction3. MAOI w/in 2 wksCareful with:1. Hx of intolerance, serious side effects, lack of efficacy2. Pt w/ sleep apnea not on CPAP3. COPD Pts
A

Contraindications w/ opiates

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17
Q

No mammary glandsMove to different chemical groupingTrue allergies rare

A

Is there a class effect w/ allergies & opiates?

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18
Q
  1. Start w/ lowest possible dose2. Tx Pts for 48hrs w/ immediate release then convert 2/3 daily dosing to XR regimen No ceiling dose
A

Dosing opiates

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19
Q
  1. Codeine - Inc. CV risk2. Meperidine - high risk of delirium, seizures, excessive sedationUse acetaminophen
A

Which opiates should you avoid in the elderly?

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20
Q

Yes - it has hydrocodone & acetaminophen so it is limited by that

A

Does vicodin (hydrocodone) have a ceiling dose?

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21
Q

FentanylLess sedation & constipationNo histamine, quick onset, short duration of action, safest w/ renal faiure?

A

Which drug is 100x more potent than Morphine?

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22
Q

Fentanyl

A

Which opiate is safest w/ renal failure?

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23
Q

Methadone 1. Inhibition of reuptake monoamines (serotonin, NE)2. Inhibition of NMDA receptors Longest & most variable 1/2 life Higher freq. at 1st till builds up then taper to avoid toxicity Used for opiate detox.

A

Which opiate causes risk of QTc prolongation?

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24
Q

Both nociceptiveS - Inhibits & promotes pain perceptinoNE - Inhibits pain

A

Serotonin & NE affect on pain

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25
Dec. Ca2+ entry, dec. excitatory transmission - dec. pain Big effect on presynaptic N-type channel Antiseizure drug
Pregabalin MOA
26
Anti-depressantSerotonin _ NE reuptake
Cymbalta MOA
27
1. Wt loss 2. Exercise 3. Pt eduSteps:1. Acetaminophen PRN 2. NSAID if inflammation3. Intraarticular steroids
Tx osteoarthritis
28
Same except ASA better w/ inflammation
Aspirin vs. tylenol
29
Liver damage 10-15 gDeath 20-25 g Measured by ALT & ASTAcetylcysteine antedote
Toxic levels of acetaminophen
30
GI toxicity Ulcer/perforationCheck albumin in old people
What are NSAIDs at risk for?
31
Ketorolacequal to morphine also avail. orally
What is the only IV NSAID?
32
NSAID - COX2 inhibitor people w/ sulfa allergies Lower GI toxicity
Who shouldn't you give Celecoxib (Celebrex) to?
33
1. Adjust dose w/ CrCl <30 2. Adjust dose w/ liver failureCYP3A4 may reactAdditive effect on serotonin levels
Kinetics & drug interactions w/ tramadol
34
Respiratory depressionMu partial agonist, kappa antagonist Thebaine derivative 25-50x more potent than morphine
What is the black box warning for Buprenorphine?
35
1. NSAID2. DMARD - hydroxychloroquine/sulfasalzine
Tx mild RA
36
1. NSAID/corticosteroid2. DMARD - methotrexate
Tx moderate to severe RA
37
Every 2-3 wks for ~3 mo then 2-3mo for 6 mo then q3mo
How often should you check RA Pts blood?
38
DMARD1. RA2. Lupus3. Malaria prevention/Tx
Uses for hydroxychloroquine
39
Takes months for responseEasily built up in melanin tissues1. Eye issues2. GI issues3. CNS issues4. Hemolysis assoc. w/ G6PD deficiency
ADRs hydroxychloroquine
40
DMARD1. RA2. Ulcerative colitis3. Crohn'sRisk of hemolytic anemia w/ G6PD deficiency
Uses for sulfasalazine
41
Give folic acid every day of the week except when you give methotrexate
How might you be able to avoid toxicity w/ methotrexate?
42
DMARD1. RA2. Psoriasis3. Juvenile idiopathic arthritis4. Oncology
Uses for methotrexate
43
ProdrugDO NOT give w/ NSAID b/c reduce renal clearanceAdjust dose w/ renal impairmentAvoid booze
Methotrexate clearance
44
1. Alosetron2. Xelnorm
Serotonin antagonists for IBD
45
1. Bentyl2. Levsin
Antispasmodics for IBD
46
1. Bone deposition in youth2. Exercise3. Diet4. Estrogen
What determines a good bone future?
47
1000mg/day1500 post-menopausal women1200 teens
How much Calcium should you get per day?
48
600 IU/dayCholecalciferol
How much Vitamin D should you get per day?
49
Soon after onset of menopauseStop after ~5yrs
When should you start estrogen supplements for osteoporosis?
50
w/ osteoporosis when you can't use othersfor post-menopausal women onlyinc. hot flash rate
When should you use selective estrogen receptor modulators?
51
w/ osteoporosis when you can't use other drugs & painful Fx Need Ca2+ & Vit D ADR - rhinitis
When do you use calcitonin?
52
1. Alendronate2. Ibandronate3. Risedronate4. Zoledronic acidUse if >75 yo, males, risk of DVT
What are the bisphosphenates?
53
ex. AlendronateOsteonecrosis of jawGIinc. Fx risk
ADRs of bisphosphenates
54
BisphosphenatesAlendronate
Which drug can cause osteonecrosis of the jaw?
55
Forteo - osteoporosis1. Ca2+2. Renal function3. Uric acid levelsReplenish Vit D Inc. dizziness D/c after 2 yrs due to osteosarcoma
What labs to check with PTH?
56
Forteo - PTHdiscontinue after 2 years
What drug has a risk of osteosarcoma?
57
Monoclonal Ab 1. Oncology 2. OsteoporosisRisk of 1. Osteonecrosis2. Infection
What is Prolia used for?
58
90% - underexcretion of uric acid10% - overproduction of uric acid
Causes of gout
59
1. NSAIDs - Naproxen & indomethicin2. Corticosteroids3. Colchicine
Tx gout
60
1. Naproxen2. Indomethicin
Which NSAIDs are used for gout?
61
Interferes w/ cell division1. Mitosis2. MicrotubulesDeals w/ inflammatory cells
How does colchicine work?
62
CYP3A4 - inc. levels - poisonousRenal & hepatic adjustment Risk of diarrhea & fatality
Colchicine drug interactions & adjustment
63
people over-producing uric acid Adjust renally Don't start by itselfCan cause SJS
Who needs allopurinol?

Pharmacology II (10 decks)

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