Shared Flashcard Set

Details

Drugs for Pain and Inflammation
Drugs for pharm exam 4
58
Pharmacology
Graduate
03/27/2011

Additional Pharmacology Flashcards

 


 

Cards

Term
Opioids MOA
Definition
stimulate mu receptor on neurons in the spinal cord and brain to inc pain threshold and dec pain perception
Term
NSAID MOA
Definition
act on peripheral nerves by blocking synthesis of substances that stimulate peripheral nerve endings in damaged tissue to change how a person responds to pain
Term
Rx mild to moderate pain (pain scale 1-3)
Definition
acetaminophen, asa, NSAIDS
Term
Rx moderate to severe pain (pain scale 4-7)
Definition
codeine, hydrocodone (usually with nonopioid)
Term
Rx severe pain (pain scale 7-10)
Definition
morphine, oxycodone, fentanyl
Term
Opiod SE
Definition
sedation, N/V, ataxia, urinary retention, constipation
Term
most serious opiod SE
Definition
respiratory depression (COPD, cor pul, dec respiratory reserve)
Term
CI for opioids
Definition
closed head injuries and dec pulm fxn
Term
opioid uses
Definition
relief of mod to severe pain, CHF, pul edema, or dyspnea, relief of cough, diarrhea
Term
Kinetics of opioids
Definition
well abs SC, IM, no morphine to neonates, opioid toxicity in breast feeding infants
Term
manifestations of opioid toxicity
Definition
pin point pupils, respiratory depression, and LOC
Term
antidote for respiratory depression caused by opioid toxicity
Definition
naloxone
Term
withdrawal symptoms of opioids
Definition
resemble the flu with inc respirations, BP and temperature (use clonidine)
Term
Black Box warning with opioids
Definition
potential for fatal dose dumping when the opiod adminstered with alcohol
Term
morphine sulfate (MS Contin)
Definition
mod to severe pain (IV); dec rate then depth of breathing; dose dumping with etoh; respiratory depression, hypotension, urinary retention; crossed BB, antidote of naloxone
Term
Codeine
Definition
DEA C II, c asa DEA C III, with cough DEA C V; mild to moderate pain usually c peripheral analgesic; metabolized to morphine for analgesic effect; metabolized by 2D6
Term
oxycodone (oxycontin)
Definition
more effective than codein and mroe potent than oral morphine; DEA C II; controlled release prep for moderate to severe pain
Term
Meperidine (Demerol)
Definition
synthetic derivative; acute to mod pain; shorter duration of action than morphine; dysphoria, irritability, seizures; not with MAOI
Term
Nalbuphine (Nubain)
Definition
mixed antagonist at mu receptor and agonist at kappa receptor; mild to mod analgesic; produce analgesia with less respiratory depression and less abuse potential than pure agonists; sedation, not with pure opioid agonist
Term
naloxone (narcan)
Definition
PO antagonize opioid induced respiratory depression; reverse opoid effects in OD; short acting; titrate carefully to reverse OD but not too much or pain will return
Term
Naltrexone (Trexan, ReVia)
Definition
narcotic antagonist; prevent readdiction in narcotic addicts; injection for alcoholics and appetite suppreseant in obestiy; no euphoria with narcotic; GI sx, hepatocellular damage rare
Term
Ketorolac (Toradol)
Definition
NSAID; alternate to morphine or meperidine; strong analgesic; indicated only for short term management of mod severe acute pain--> PUD; CI in pts at risk fo bleeding and labor
Term
Tramadol HC (Ultram)
Definition
centrally acting synthetic analgesic not DEA controlled; moderate pain; MOA unknown; dependence, withdrawal sx; severe serotonin syndrome; dizziness/vertigo, NVC, HA, somnolence
Term
non opiod analgesics general info
Definition
with high doses, ASA, APAP, and NSAIDs all reeach max analgesic effect
Term
Aspirin MOA
Definition
irreversible inhibition of COX enzymes to inhibit prostaglandin synthesis and thromboxane
Term
aspirin (ASA) SE
Definition
confusion, tinnitus, hypoglycemia, abn bleeding time, ductus arterosis, GI upset, NV, sodium and water retention --> edema
Term
aspirin (ASA) indications
Definition
DOC for most articular and MS disorders; first line for RA & OA
Term
Aspirin actions
Definition
analgesic, antipyresis, anti-inflammatory (RA and OA), prevents platelet aggregation
Term
Aspirin (ASA) CI
Definition
prolonged labor, Reye syndrome in children, inc potential for bleeding and ulcers; interaction with methotrexate
Term
Salicylism
Definition
asa toxicity characterized by dizziness, confusion, neuromuscular changes, vomiting, tinnitus, dec hearing, HA, GI upset
Term
NSAIDS MOA
Definition
non selective vs COX-2 inhibitors (Celebrex and Mobic); inhibit formation of COX
Term
NSAID Indications
Definition
dysmenorrhea, fever, pain, knflammation, temp platelet aggregation
Term
NSAID kinetics
Definition
rapidly and almost completely absorbed. highly protein bound and eliminated via hepatic biotransformation
Term
NSAID SE
Definition
same as ASA; weak acids that concentrate in tissues with acidic environ; cross allergy with asa
Term
NSAID BB warning
Definition
CV problems (COX has cardioprotective effect on heart)
Term
NSAID CI
Definition
GI bleeding, poor renal fxn, asa allergy
Term
NSAID interactions
Definition
effectiveness by the ACE inhibitors and BB- no major interactions
Term
Indomethacin sodium trihydrate (Indocin IV)
Definition
cause more SE than other NSAIDS; closure of PDA, severe arthritis; same as ASA but reversible; inc gastric ulcers, nephrotoxicity; cross allergy to asa; interfere with diuretics
Term
Ibuprofen
Definition
mild to mod pain, fever, inflammatory conditions (RA); same SE as asa but reversible; inc risk gastric ulcers, nephrotoxicity; cross allergy to asa; interfere c diuretic effects
Term
Naproxen (Naprosyn) OTC Aleve
Definition
longer acting than ibuprofin so BID; NSAID; same SE as asa but reversible; inc risk gastric ulcers, nephrotoxicity; cross allergy c asa; interfere c diuretics
Term
Ketoralac (Toradol)
Definition
NSAID; equal to morphine in analgesic potency; short term management of pain; same SE as asa but reversible; BB warn of peptic ulcers and renal failure; CI for L&D
Term
Celecoxib (Celebrex)
Definition
NSAID; inflammation and pain of OA & RA c fewer ulcers; selective COX-2 inhibitor; less GI upset than other NSAIDS; BB warn of GI ulceration and perforation
Term
Acetaminophen (APAP) or Tyelenol
Definition
DOC for OA; NO anti inflammatory effect; MOA unclear; hepatic injury and leading cause of liver transplant; cross BBB
Term
Antidote to APAP toxicity
Definition
N-acetylcysteine (Mucomyst)
Term
DMARDS
Definition
stops destruction of the joint and may reverse the damage; start w/in 3 mo of dx
Term
Methotrexate (Trexall)
Definition
immunosuppressant; most widely used DMARD; RA and CA; MOA unknown; methotrexate-induced lung dx; warning that deaths have occurred so use only after failure of other agents; PG X and reduces folic acid
Term
Classes of antirheumatics
Definition
Immunosuppresants, biologic response modifiers, TNF inhibitors
Term
Infliximab (Remicade)
Definition
IV Tx of RA c methotrexate first line and Crohn's; monoclonal antibody binds TNF; inc risk of infection, infusion injection
Term
Gout
Definition
high levels of uric acid either from hypoexcretion or excessive production or both; uric acid precipitation in joints; commonly affects big toe
Term
generalized tx for acute attack of gout
Definition
intra-articular corticosteroids, NSAIDS, colchicine
Term
NSAIDs (gout)
Definition
first choice for acute gouty arthritis; suppresses inflammation; impaired renal fx, GI ulcers, fluid retention, CV events
Term
Colchicine (Colcrys)
Definition
pain in acute gouty attacks; MOA unknown; stop tx when diarrhea occurs; teratogen, N/V dehydration
Term
Probenacid (Benemid)
Definition
DOC for hyperuricemia in pts who are hypoexcreters; uricosuric so it inhibits the reabsorption and inc urinary excretion; STAY HYDRATED; anorexia, N/V, worsening of gout
Term
Allopuriol(zyloprim)
Definition
tx of hyperuricemia in pts who are excessive producer of uric acid; blocks the xanthine oxidase enzyme responsible for formation of uric acid; preferred in impaired renal fx; must stay hydrated; GI upset and skin rashes; CI in other xanthine oxidase drugs
Term
Febuostate (Uloric)
Definition
chronic management of hyperuricemia; xanthine oxidase inhibitor; liver fxn abnormalities, nausea, rash
Term
treatment for tension h/a
Definition
aspirin
Term
Sumatriptan (Imitrex)
Definition
serotonin 5HT receptor agnonists; acute tx of cluster H/A and acute migraine prophylaxis; cranial vessel constrictiona nd inhibitition of proinflammatory neuropeptides; elevates BP, coronary vasospasms, tingling, MAOI inc effect, PG C; CI IV and CAD pts
Term
Propranolol (Inderal)
Definition
preferred method for prophylaxis of migrain; MOA unclear
Supporting users have an ad free experience!