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Pharmacology II > Quiz 5 Reverse > Flashcards

Quiz 5 Reverse Flashcards

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
Q

Dec. Ca2+ entry, dec. excitatory transmission - dec. pain Big effect on presynaptic N-type channel Antiseizure drug

A

Pregabalin MOA

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26
Q

Anti-depressantSerotonin _ NE reuptake

A

Cymbalta MOA

27
Q
  1. Wt loss 2. Exercise 3. Pt eduSteps:1. Acetaminophen PRN 2. NSAID if inflammation3. Intraarticular steroids
A

Tx osteoarthritis

28
Q

Same except ASA better w/ inflammation

A

Aspirin vs. tylenol

29
Q

Liver damage 10-15 gDeath 20-25 g Measured by ALT & ASTAcetylcysteine antedote

A

Toxic levels of acetaminophen

30
Q

GI toxicity Ulcer/perforationCheck albumin in old people

A

What are NSAIDs at risk for?

31
Q

Ketorolacequal to morphine also avail. orally

A

What is the only IV NSAID?

32
Q

NSAID - COX2 inhibitor people w/ sulfa allergies Lower GI toxicity

A

Who shouldn’t you give Celecoxib (Celebrex) to?

33
Q
  1. Adjust dose w/ CrCl <30 2. Adjust dose w/ liver failureCYP3A4 may reactAdditive effect on serotonin levels
A

Kinetics & drug interactions w/ tramadol

34
Q

Respiratory depressionMu partial agonist, kappa antagonist Thebaine derivative 25-50x more potent than morphine

A

What is the black box warning for Buprenorphine?

35
Q
  1. NSAID2. DMARD - hydroxychloroquine/sulfasalzine
A

Tx mild RA

36
Q
  1. NSAID/corticosteroid2. DMARD - methotrexate
A

Tx moderate to severe RA

37
Q

Every 2-3 wks for ~3 mo then 2-3mo for 6 mo then q3mo

A

How often should you check RA Pts blood?

38
Q

DMARD1. RA2. Lupus3. Malaria prevention/Tx

A

Uses for hydroxychloroquine

39
Q

Takes months for responseEasily built up in melanin tissues1. Eye issues2. GI issues3. CNS issues4. Hemolysis assoc. w/ G6PD deficiency

A

ADRs hydroxychloroquine

40
Q

DMARD1. RA2. Ulcerative colitis3. Crohn’sRisk of hemolytic anemia w/ G6PD deficiency

A

Uses for sulfasalazine

41
Q

Give folic acid every day of the week except when you give methotrexate

A

How might you be able to avoid toxicity w/ methotrexate?

42
Q

DMARD1. RA2. Psoriasis3. Juvenile idiopathic arthritis4. Oncology

A

Uses for methotrexate

43
Q

ProdrugDO NOT give w/ NSAID b/c reduce renal clearanceAdjust dose w/ renal impairmentAvoid booze

A

Methotrexate clearance

44
Q
  1. Alosetron2. Xelnorm
A

Serotonin antagonists for IBD

45
Q
  1. Bentyl2. Levsin
A

Antispasmodics for IBD

46
Q
  1. Bone deposition in youth2. Exercise3. Diet4. Estrogen
A

What determines a good bone future?

47
Q

1000mg/day1500 post-menopausal women1200 teens

A

How much Calcium should you get per day?

48
Q

600 IU/dayCholecalciferol

A

How much Vitamin D should you get per day?

49
Q

Soon after onset of menopauseStop after ~5yrs

A

When should you start estrogen supplements for osteoporosis?

50
Q

w/ osteoporosis when you can’t use othersfor post-menopausal women onlyinc. hot flash rate

A

When should you use selective estrogen receptor modulators?

51
Q

w/ osteoporosis when you can’t use other drugs & painful Fx Need Ca2+ & Vit D ADR - rhinitis

A

When do you use calcitonin?

52
Q
  1. Alendronate2. Ibandronate3. Risedronate4. Zoledronic acidUse if >75 yo, males, risk of DVT
A

What are the bisphosphenates?

53
Q

ex. AlendronateOsteonecrosis of jawGIinc. Fx risk

A

ADRs of bisphosphenates

54
Q

BisphosphenatesAlendronate

A

Which drug can cause osteonecrosis of the jaw?

55
Q

Forteo - osteoporosis1. Ca2+2. Renal function3. Uric acid levelsReplenish Vit D Inc. dizziness D/c after 2 yrs due to osteosarcoma

A

What labs to check with PTH?

56
Q

Forteo - PTHdiscontinue after 2 years

A

What drug has a risk of osteosarcoma?

57
Q

Monoclonal Ab 1. Oncology 2. OsteoporosisRisk of 1. Osteonecrosis2. Infection

A

What is Prolia used for?

58
Q

90% - underexcretion of uric acid10% - overproduction of uric acid

A

Causes of gout

59
Q
  1. NSAIDs - Naproxen & indomethicin2. Corticosteroids3. Colchicine
A

Tx gout

60
Q
  1. Naproxen2. Indomethicin
A

Which NSAIDs are used for gout?

61
Q

Interferes w/ cell division1. Mitosis2. MicrotubulesDeals w/ inflammatory cells

A

How does colchicine work?

62
Q

CYP3A4 - inc. levels - poisonousRenal & hepatic adjustment Risk of diarrhea & fatality

A

Colchicine drug interactions & adjustment

63
Q

people over-producing uric acid Adjust renally Don’t start by itselfCan cause SJS

A

Who needs allopurinol?

Pharmacology II (10 decks)

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