Font size
WorksheetsPCOL ANALGESICS PART 2
Total questions: 127
Worksheet time: 1hrs 4mins
has a very long half-life
Oxaprozin
Mefenamic acid
Phenylbutazone
Indomethacin
more useful in gout than some other NSAIDs.
Oxaprozin
Mefenamic acid
Phenylbutazone
Indomethacin
Oxaprozin
Daypro
Ansaid
Orudis
Flurbiprofen
Daypro
Ansaid
Orudis
Ketoprofen
Daypro
Ansaid
Orudis
has a very long half-life
Daypro
Ansaid
Orudis
more useful in gout than some other NSAIDs.
Daypro
Ansaid
Orudis
used to accelerate closure of patent ductus arteriosus
Indomethacin
Ibuprofen
Nabumetone
Piroxicam
used to accelerate closure of patent ductus arteriosus
Indocin
Anturane
Novalgin
Relafen
prolongs indomethacin’s half-life by inhibiting both renal and biliary clearance
Probenecid
Naloxone
Nabumetone
– NSAID that has the highest chance to cause kidney as well as damage in the stomach. Most toxic NSAID
Indocin
Anturane
Novalgin
Relafen
– NSAID that has the highest chance to cause kidney as well as damage in the stomach. Most toxic NSAID
Indomethacin
Ibuprofen
Nabumetone
Piroxicam
Peptic ulcer risk is as much as 9.5 times
Indomethacin
Ibuprofen
Nabumetone
Piroxicam
Piroxicam
Feldene
Mobic
Probenecid
Meloxicam
Feldene
Mobic
Probenecid
NSAID that causes higher tendency of PUD (higher with piroxicam than with other NSAIDs)
Piroxicam and Meloxicam
Nabumetone
Indomethacin
Oxaprozin
Mefenamic acid 250mg (OTC) Mefenamic acid 500mg (Rx)
true
false
Should not be used more than 5 days (acute mgt.of pain)
Mefenamic acid
Flufenamic acid
Meclofenamic acid
Piroxicamic acid
Contraindicated: <14 Y/0
Mefenamic acid
Flufenamic acid
Meclofenamic acid
Piroxicamic acid
Powerful analgesics & Good anti-inflammatory effects
Phenylbutazone (Zolandin), Dipyrone (Novalgin), Sufinpyrazone (Anturane)
Mefenamic acid (Dolfenal, Ponstan) Flufenamic acid, Meclofenamic acid
Piroxicam (Feldene) and Meloxicam (Mobic)
Phenylbutazone
Zolandin
Novalgin
Anturane
Dipyrone
Zolandin
Novalgin
Anturane
Sufinpyrazone
Zolandin
Novalgin
Anturane
A/E: Anasarca (generalized edema)
Phenylbutazone (Zolandin), Dipyrone (Novalgin), Sufinpyrazone (Anturane)
Mefenamic acid (Dolfenal, Ponstan) Flufenamic acid, Meclofenamic acid
Piroxicam (Feldene) and Meloxicam (Mobic)
only nonacid NSAID in current use
Nabumetone
Piroxicam
Indomethacin
Oxaprozin
only nonacid NSAID in current use
Relafen
Feldene
Indocin
Daypro
converted to the active acetic acid derivative in the body
Relafen
Feldene
Indocin
Daypro
converted to the active acetic acid derivative in the body
Nabumetone
Piroxicam
Indomethacin
Oxaprozin
given as a ketone prodrug that resembles naproxen
Nabumetone
Piroxicam
Indomethacin
Oxaprozin
given as a ketone prodrug that resembles naproxen
Relafen
Feldene
Indocin
Daypro
NSAID that is less damaging to the gastrointestinal tract
Relafen
Feldene
Indocin
Daypro
NSAID that is less damaging to the gastrointestinal tract
Nabumetone
Piroxicam
Indomethacin
Oxaprozin
Associated with pseudoporphyria and photosensitivity
Nabumetone
Piroxicam
Indomethacin
Oxaprozin
Associated with pseudoporphyria and photosensitivity
Relafen
Feldene
Indocin
Daypro
All NSAIDs, including aspirin, are about equally efficacious. Thus, NSAIDs tend to be differentiated on the basis of toxicity and cost-effectiveness.
1st correct
2nd correct
both wrong
both correct
Analgesic, antipyretic, and anti-inflammatory effects similar to those of NSAIDs
COX-2 Selective inhibitors
COX-1 Selective inhibitors
COX-2 Non Selective inhibitors
COX-1 Non Selective inhibitors
Adv: probably safest for patients at high risk for GI bleeding
COX-2 Selective inhibitors
COX-1 Selective inhibitors
COX-2 Non Selective inhibitors
COX-1 Non Selective inhibitors
relatively expensive
COX-2 Selective inhibitors
COX-1 Selective inhibitors
COX-2 Non Selective inhibitors
COX-1 Non Selective inhibitors
Disadv: higher risk of cardiovascular toxicity (cardiovascular thrombotic event)
COX-2 Selective inhibitors
COX-1 Selective inhibitors
COX-2 Non Selective inhibitors
COX-1 Non Selective inhibitors
inhibit prostaglandin synthesis by the COX-2 isozyme induced at sites of inflammation without affecting the action of the constitutively active “housekeeping” COX-1 isozyme found in the GI tract, kidneys, and platelets.
COX-2 Selective inhibitors
COX-1 Selective inhibitors
COX-2 Non Selective inhibitors
COX-1 Non Selective inhibitors
Celecoxib
Celebrex, Celcox
Mobic
arcoxia
Vioxx
Bextra
Meloxicam
Celebrex, Celcox
Mobic
arcoxia
Vioxx
Bextra
Etoricoxib
Celebrex, Celcox
Mobic
arcoxia
Vioxx
Bextra
Rofecoxib
Celebrex, Celcox
Mobic
arcoxia
Vioxx
Bextra
Rofecoxib
Celebrex, Celcox
Mobic
arcoxia
Vioxx
Bextra
Valdecoxib (Bextra) and Rofecoxib (Mobic) are COX 2 selective that are not widely available today, in fact they have been withdrawn specially in the market in the US
true
false
also known as opium tincture
Laudanum
Paregoric
camphorated opium tincture
Laudanum
Paregoric
employed opium to battle headaches, coughing, asthma and melancholy
Hippocrates
Galen
Friedrich Wilhelm Adam Sertürner
German Pharmacist that isolated Morphine in 1805
Hippocrates
Galen
Friedrich Wilhelm Adam Sertürner
Greek god of dream & sleep
Morpheus
Morphies
Morphus
Opioid-like substances produced in the brain
ENDOGENOUS OPIOIDS
OPIOID ANALGESICS
NARCOTIC ANLAGESICS
MILD ANALGESICS
a.k.a. “Endorphins”
ENDOGENOUS OPIOIDS
OPIOID ANALGESICS
NARCOTIC ANLAGESICS
MILD ANALGESICS
Generic term contracted from endogenous and morphine, all used for brain peptides with opiate like activity. Once it activate the receptors, it reduces pain and inc. sensation of well being (feel good hormone)
ENDOGENOUS OPIOIDS
OPIOID ANALGESICS
NARCOTIC ANLAGESICS
MILD ANALGESICS
Leu- Enkephalin is Also known as (pentapeptide methionine- enkephalin). Met- Enkephalinis Also known as (eucine- enkephalin)
1st correct
2nd correct
bith correct
both wrong
analgesia, bradycardia, and sedation
MU 1
MU 2
respiratory depression, euphoria, and physical dependence
MU 1
MU 2
endorphins
mu
kappa
delta
sigma
orl receptor
dynorphins
mu
kappa
delta
sigma
orl receptor
common in women
mu
kappa
delta
sigma
orl receptor
enkephalins
mu
kappa
delta
sigma
orl receptor
aka nociceptin receptor
mu
kappa
delta
sigma
orl receptor
central modulation of pain
mu
kappa
delta
sigma
orl receptor
reserve in the management of severe pain
Analgesic
Acute Pulmonary Edema
Applications in Anesthesia
Prototype opioid analgesic
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
is the golden standard among opioid analgesics to which the structure and strengths of all other drugs are compared
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Poor bioavailability (pref. administered IV or rectal suppository)
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Very strong pain reliever but also very addictive
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Management of acute pulmonary edema
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Diacetylmorphine, diamorphine
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Incredibly addictive (MOST addicting)
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
sold as cough suppressant and pain killer (10x stronger than morphine)
HEROIN
METHADONE
MEPERIDINE
FENTANYL
binds to the μ receptor
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Greater oral efficacy, longer duration, less rapid development of tolerance
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Given in patients addicted to morphine or heroin- It is used for controlled withdrawal from heroin & morphine.
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Valdecoxib
Celebrex, Celcox
Mobic
arcoxia
Vioxx
Bextra
Dolophine®
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Demerol®
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
synthetic opioid & shortest duration of analgesia
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
a.k.a. “Pethidine”
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Preferred for analgesia during labor
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Causes: Antimuscarinic effect (reverse DUMBELS effect) contraindicated if tachycardia would be a problem)
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Derivative: Loperamide (Diatabs, Lomotil)
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
(Available as patch) cannot be used in nonambulatory patients
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
+ heroin (fat soluble) produce intense “rush” of euphoria
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
With droperidol = dissociative anesthesia
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
100x potent than morphine (analgesic)
LEVORPHANOL
HEROIN
METHADONE
MEPERIDINE
FENTANYL
is a synthetic opioid analgesic closely resembling morphine in its action
LEVORPHANOL
HEROIN
METHADONE
MEPERIDINE
FENTANYL
Optical isomer of dextromethorphan (less addicting isomer w/ anti-tussive effect)
LEVORPHANOL
HEROIN
METHADONE
MEPERIDINE
FENTANYL
(cough depressant potency is 1/4 of morphine)
CODEINE
PROPOXYPHENE HCL
OXYCODONE & HYDROCODONE
DIPHENOXYLATE
Analgesic potency is 1/12 of morphine
CODEINE
PROPOXYPHENE HCL
OXYCODONE & HYDROCODONE
DIPHENOXYLATE
Less sedating and addicting
CODEINE
PROPOXYPHENE HCL
OXYCODONE & HYDROCODONE
DIPHENOXYLATE
3-methyl ether of morphine
CODEINE
PROPOXYPHENE HCL
OXYCODONE & HYDROCODONE
DIPHENOXYLATE
Metabolized by CYPD2D6 and demthylation--> Morphine
CODEINE
PROPOXYPHENE HCL
OXYCODONE & HYDROCODONE
DIPHENOXYLATE
Derivative of methadone
CODEINE
PROPOXYPHENE HCL
OXYCODONE & HYDROCODONE
DIPHENOXYLATE
Dextro – analgesic; Levo – antitussive
true
false
Combinations of hydrocodone or oxycodone with acetaminophen are the predominant formulations of orally administered analgesics for the treatment of mild to moderate pain
OXYCODONE & HYDROCODONE
Lomotil-combined w/ Atropine
Is a strong κ receptor agonist and a μ receptor antagonist.
NALBUPHINE
BUPRENORPHINE
NALMEFENE
TRAMADOL
Antidiarrheal drug- used in combination with atropine (reduce addicting potential)
DIPHENOXYLATE
OXYCODONE (Oxycontin) & HYDROCODONE
PROPOXYPHENE HCL
NALOXONE
Is a strong κ receptor agonist and a μ receptor antagonist.
Nubain
Buprenex
ULTRAM®
REVEX
This agent is a partial agonist at μ receptors producing morphine-like effects in naïve users but precipitating withdrawal in morphine dependents.
NALBUPHINE
BUPRENORPHINE
NALMEFENE
TRAMADOL
This agent is a partial agonist at μ receptors producing morphine-like effects in naïve users but precipitating withdrawal in morphine dependents.
Nubain
Buprenex
ULTRAM®
REVEX
Its main use is in opioid detoxification as its withdrawal syndrome appears less severe and of shorter duration than methadone.
Nubain
Buprenex
ULTRAM®
REVEX
Its main use is in opioid detoxification as its withdrawal syndrome appears less severe and of shorter duration than methadone.
NALBUPHINE
BUPRENORPHINE
NALMEFENE
TRAMADOL
It is central-acting analgesic whose mechanism of action is predominantly based on enhanced serotonergic transmission
NALBUPHINE
BUPRENORPHINE
NALMEFENE
TRAMADOL
It also inhibits norepinephrine transport function and is a weak μ receptors agonist, since it is only partially antagonized by naloxone.
NALBUPHINE
BUPRENORPHINE
NALMEFENE
TRAMADOL
It is central-acting analgesic whose mechanism of action is predominantly based on enhanced serotonergic transmission.
Nubain
Buprenex
ULTRAM®
REVEX
It also inhibits norepinephrine transport function and is a weak μ receptors agonist, since it is only partially antagonized by naloxone.
Nubain
Buprenex
ULTRAM®
REVEX
is a decrease in response to the effects of the drug requiring even larger doses to achieve the same effects.
Tolerance
Physical Dependence
Psychologic Dependence
is the occurrence of a characteristic withdrawal or abstinence syndrome when the drug is stopped or an antagonist is administered.
Tolerance
Physical Dependence
Psychologic Dependence
a state of compulsive drug seeking behavior for personal satisfaction.
Tolerance
Physical Dependence
Psychologic Dependence
Opioid triad of toxicity/ overdose: EXCEPT
Coma
Pinpoint pupils
Respiratory depression
bradycardia
used to reverse the coma and respiratory depression associated with opioid overdose.
NALOXONE
NALMEFENE
ALVIMOPAN
CAPSAICIN
methylnaltrexone bromide (Relistor) for the treatment of constipation in patients with late-stage advanced illness
NALOXONE
NALMEFENE
ALVIMOPAN
CAPSAICIN
The newest agents derivative of naltrexone but is available only for intravenous administration.
NALOXONE
NALMEFENE
ALVIMOPAN
CAPSAICIN
it has longer half-life of 8-10 hours.
NALOXONE
NALMEFENE
ALVIMOPAN
CAPSAICIN
peripherally acting μ-opioid receptor antagonist
NALOXONE
NALMEFENE
ALVIMOPAN
CAPSAICIN
for the treatment of postoperative ileus following bowel resection surgery
NALOXONE
NALMEFENE
ALVIMOPAN
CAPSAICIN
it has longer half-life of 8-10 hours.
ENTEREG
REVEX
NARCAN
CAPSAICIN
used to reverse the coma and respiratory depression associated with opioid overdose.
ENTEREG
REVEX
NARCAN
CAPSAICIN
peripherally acting μ-opioid receptor antagonist
ENTEREG
REVEX
NARCAN
CAPSAICIN
for the treatment of postoperative ileus following bowel resection surgery
ENTEREG
REVEX
NARCAN
CAPSAICIN
Brand: Zostrix® From cayenne peppers It is topical indicated for post-herpetic neuralgia, neuropathic pain
ENTEREG
REVEX
NARCAN
CAPSAICIN
Inhibit Substance P at nerve fibers
NALOXONE
NALMEFENE
ALVIMOPAN
CAPSAICIN
burning sensation at site of application
NALOXONE
NALMEFENE
ALVIMOPAN
CAPSAICIN
Activation of TRPV1 (transient receptor potential cation channel subfamily V) which provides a sensation of scalding heat
NALOXONE
NALMEFENE
ALVIMOPAN
CAPSAICIN
Demerol®
MORPHINE
HEROIN
METHADONE
MEPERIDINE
FENTANYL
