| What are the 2 most important receptors in pain management? | Mu + Kappa |
| What are the drugs of choice for moderate to severe pain? | Opioids |
| How are Opioids classified? | Effectiveness |
| What 2 categories are opiates placed in? | strong + moderate |
| Definition: the standard against which the effectiveness of every other opioid is compared | representative drug |
| What opioid agonist is the representative drug used to treat severe pain? | morphine |
| Drug action: suppress cough, slow GI motility, sedation, euphoria | Morphine |
| What is the most dangerous side effect of Opioid Agonists? | respiratory depression |
| Codeine, Oxycodone, Propoxyphene are all common opioid agonists with _________ effectiveness | moderate |
| Demerol, Dilaudid and Duramorph are all common opioid agonists with ___________ effectiveness | high |
| What 2 classes of drugs work synergistically to relieve pain? | opioids + non-narcotic analgesics |
| What non-narcotic analgesic is used the most in combination with an opioid? | acetaminophen (Tylenol) |
| What do Vicodin, Percocet and Darvocet all have in common? | combinations with acetaminophen |
| Definition: substances that prevent the effects of opioid agonists | opioid antagonists |
| What analgesic category is used to treat an opioid overdose or respiratory depression? | Opioid Antagonist |
| Naloxone (Narcan) is an opioid_________. | antagonist |
| What is the drug of choice in an acute opioid overdose? | Narcan |
| What is important to remember when reversing the effects of opioids? | patient may experience rapid loss of analgesia and feel pain |
| __________ inhibit cyclooxygenase. | NSAIDs |
| cyclooxygenase is an enzyme that inhibits ___________. | prostaglandins |
| What is the drug of choice for mild-moderate pain? | NSAIDS |
| A high dose of NSAIDS can increase the risk of what? | heart attack + stroke |
| What is an adverse effect of NSAIDS? | GI bleeding/irritation |
| What is a side effect of Celebrex? | Heart Attack |
| Celecoxib (Celebrex) | selective COX-2 inhibitor |
| Ibuprofen (Advil, Motrin) and Naproxen Sodium (Aleve) | Non Selective |
| Why were many of the COX-2 inhibitors removed from the market? | Cardiovascular reasons |
| What is the most common analgesic used for relief of slight-moderate pain? | Aspirin |
| __________ inhibit platelet aggregation. | Aspirin |
| What is a side effect of Aspirin? | GI bleeding |
| True/False: Acetaminophen (Tylenol) is an anti-inflammatory agent. | False: anti-pyretic |
| What is the maximum Tylenol dosage in a day? | 4 grams |
| What is the most common kind of headache? | tension headache |
| What is one of the most common complaints of patients? | Headache |
| What is the most painful type of headache? | migraine |
| Definition: characterized by throbbing or pulsating pain, sometimes proceeded by an aura | migraines |
| What are the 2 primary goals for pharmacology therapy of a migraine? | Stop + Prevent |
| sumatriptan | Imitrex |
| Definition: stimulate serotonin receptors which constricts certain vessels within the brain in order to stop migraine | Triptans |
| What are Ergot Alkaloids used for? | patients unresponsive to triptans |
| Ergot Alkaloids are a pregnancy category___. | X |
| What is the action of headache medications? | vasoconstriction |
| what drug class prevents migraines? | Beta Blockers |
| Definition: group of neurotransmitters released from neurons in CNS | endogenous opioids |
| __________ opioids block the release of substance P in the spinal cord | Endogenous |
| What are the 2 basic categories of analgesics? | Opioids + Non-opioids |
| Definition: medications used to relieve pain | analgesics |
| Definition: substances that produce analgesia and CNS depression | Narcotics |
| popoxyphene hydrochloride | Darvon |
| hydromorphone hydrochloride | Dilaudid |
| meperidine hydrochloride | Demerol |
| Morphine sulfate | Duramorph |
| What are the benefits of combination medications? | lower dose, less side effects, no addiction |
| oxycodone | Percocet |
| popoxyphene napsylate | Darvocet |
| Salicylates | Aspirin |
| clonidine | Catapres |
| tamadol | Ultram |
| Catapres + Ultram | centrally acting non-opioid drugs |
| Imitrex is a type of ________. | Triptan |
| The nervous system is divided into what 2 systems? | CNS + Peripheral |
| Definition: consists of brain + spinal cord | CNS |
| The Peripheral Nervous System is divided into 2 divisions? | Motor(somatic) + Autonomic |
| Definition: voluntary control over skeletal muscles | Motor (Somatic) |
| Definition: involuntary control over smooth muscle, cardiac muscle/glands | Autonomic |
| The autonomic system is divided into 2 sub-systems? | Sympathetic + Parasympathetic |
| Fight or Flight | Sympathetic |
| Rest + Digest | Parasympathetic |
| Definition: junction between neurons | synapse |
| What are the 2 primary Neurotransmitters? | Norepinephrine +Acetylcholine |
| Sympathetic nerves | Adrenergic |
| Parasympathetic nerves | Cholinergic |
| Beta blocker that affects the heart? | Beta1 |
| Beta blocker that affects the lungs | Beta2 |
| What are the 2 receptor subtypes of Acetylcholine? | nicotinic + muscarinic |
| Sympathomimetics | adrenergic agents |
| Parasympathomimetics | cholinergic agents |
| Sympatholytics | adrenergic blockers |
| Anticholinergics | cholinergic blockers |
| ________ agents are used for their effects on the heart, bronchial tree and nasal passages | adrenergic |
| albuterol (Proventil) stimulates beta2 receptors in the _____. | lungs |
| What is the disadvantage of nonselective agents? | more side effects |
| Definition: stimulate more than 1 type of receptor | nonselective |
| Definition: stimulate one receptor | selective |
| pseudoephedrine (__________ )stimulates alpha + beta receptors | Sudafed |
| phenlyephrine | Neo-Synephrine |
| dobutamine | Dobutrex |
| dopamine | Inotropin |
| albuterol | Proventil |
| epinephrine | Adrenalin |
| isoproterenol | Isuprel |
| norepinephrine | Levophed |
| salmeterol | Serevent |
| What are adrenergic blockers used to primarily treat? | HTN |
| What is the most widely used class of autonomic drugs? | adrenergic blockers |
| A direct acting cholinergic agent used to reduce intraocular pressure? | Pilocarpine |
| A direct acting cholinergic agent used to stimulate the smooth muscle of the bowel or urinary tract after anesthesia? | Bethanechol |
| _________ acting agent inhibits acetlcholinesterase (the breakdown of Ach) | Indirect |
| bethanechol | Urecholine |
| pyridostigmine | Mestinon |
| _________ is a cholinergic agent used to treat myasthenia gravis. | Mestinon |
| What are anti-cholinergic agents primarily used for? | Asthma + Dry secretion |
| What are the side effects of Anticholinergic agents? | Dry mouth, constipation,urinary retention, tachycardia |
| __________ is an anticholinergic agent used to dry secretions prior to anesthesia. | Atropine |
| _________ is an anti-cholinergic agent used to treat asthma. | Atrovent |
| __________ is an anti-cholinergic agent used to treat IBS + motion sickness | Hyoscine |
| Definition: disorder characterized by recurrent seizures | Epilepsy |
| Definition: involuntary violent spasms of the large skeletal muscles | Convulsions |
| Definition: disturbances of electrical activity in the brain caused by abnormal/uncontrollable neuronal discharges | Seizures |
| Some ant seizure medications may _________ effectiveness of oral contraceptives during pregnancy | decrease |
| Antiseizure meds are pregnancy category____ | D |
| How long is seizure medication withdrawn? | 6-12 weeks |
| What is the goal of an anti-seizure medication? | to suppress neuronal activity JUST ENOUGH to prevent abnormal or repetitive firing |
| High concentrations of sodium,calcium and chloride located________the cell. | outside |
| High concentrations of _________ inside the cell. | potassium |
| What are the 3 mechanisms for ant seizure drugs? | 1. Stimulating chloride 2. Delay sodium 3. Delay calcium |
| What is the primary inhibitory neurotransmitter in the brain? | GABA |
| What 2 drug classes intensify GABA action? | Barbiturates + Benzodiazapines |
| Benzodiazepines are used for _______ control. | short term |
| What drug is used to treat status epilepticus? | Diazepam (Valium) |
