Ch. 5 Applied Pharmacology For The Dental Hygienist

Front 1

The physical component of pain and involves the message of pain carried to the cortex by nerves

Back 1

Perception

Front 2

The psychological component of pain and involves the patient's emotional response to the pain

Back 2

Reaction

Front 3

A greater reaction to pain associated with emotional instability, anxiety, fatigue, youth, certain nationalities, women, red heads, fear and apprehension is a decreased __________ ____________

Back 3

Pain threshold

Front 4

Nonopioids are also called _____, ____,___ and ______ ________

Back 4

Nonnarcotic, peripheral, mild, and antipyretic alangesics

Front 5

Nonopioid analgesics act primarily at the _______.

Back 5

Peripheral nerve endings

Front 6

Nonopioid antipyretic effect is mediated _________

Back 6

centrally

Front 7

Extracts of willow bark contain __________

Back 7

Salicin

Front 8

Most useful salicylate drug

Back 8

Aspirin

Front 9

Chemical name of aspirin (ASA)

Back 9

Acetylsalicylic acid

Front 10

A bottle of aspirin may no longer be good when it smells like this

Back 10

Vinegar

Front 11

Aspirin works because it inhibits this

Back 11

Prostaglandin synthesis

Front 12

ASA inhibits this enzyme

Back 12

Cyclo-oxygenase

Front 13

Prostaglandins and leukotrienes manufactured from this

Back 13

Arachidonic acid

Front 14

Prostaglandin sensitize pain receptors to ___________

Back 14

Bradykinin

Front 15

ASA works best when taken ______

Back 15

Before the painful stimuli

Front 16

ASA works best for this kind of pain

Back 16

Throbbing

Front 17

Onset of plain ASA

Back 17

30 minutes

Front 18

Onset of buffered ASA

Back 18

20 minutes

Front 19

ASA is metabolized by this type of kinetics

Back 19

Zero-order kinetics

Front 20

Half-life of ASA

Back 20

2-3 hours

Front 21

Ability of antipyretic action of ASA is due to inhibition of prostaglandin synthesis in the _______________

Back 21

Hypothalamus

Front 22

ASA has effects on these two substances involved in blood clotting

Back 22

Thromboxane A2 and Prostacyclin

Front 23

Both men and women over 50 should take this in low doses

Back 23

ASA

Front 24

The most frequent side effect of ASA is ___________

Back 24

GI dyspepsia

Front 25

Prostaglandins effects (which are blocked by ASA) are:

Back 25

Inhibition of gastric acid secretion and stimulation of protective mucus production

Front 26

ASA interferes with platelet adhesiveness by interfering with ________ release

Back 26

ADP (adenosine diphosphate)

Front 27

Platelets affected by ASA will not work for the rest of their lifetime which is :

Back 27

4-7 days

Front 28

This syndrome causes hepatotoxicity and encephalopathy in children with influenza or chickenpox given ASA

Back 28

Reye's syndrome

Front 29

Incidence of true aspirin allergy is:

Back 29

Less than 1% (0.2-0.4%)

Front 30

If someone has a true aspirin allergy they should also avoid this family of medicines

Back 30

NSAIDs

Front 31

Patients with this disease are likely to have hypersensitivity to aspirine with an incidence ranging from 5-10%

Back 31

Asthma

Front 32

With toxic levels of aspirin a pt. suffers from tinnitus, HA, N/V, dizziness, dimness of vision, electrolyte imbalances, and hyperthermia. This is called ____________

Back 32

Salicylism

Front 33

The lethal dose of aspirin for a child

Back 33

4 grams

Front 34

The lethal dose of aspirin for an adult

Back 34

10 to 30 grams

Front 35

Treatment of aspirin poisoning

Back 35

Induced emesis, activated charcoal, cooling blankets, treat acidosis, and electrolyte problems

Front 36

How does aspirin interact with warfarin (anticlotting drug)

Back 36

Warfarin highly protein bound but aspirin has higher afinity for protein and bumps warfarin off causing increased blood levels and bleeding

Front 37

Aspirin may precipitate an acute gout attack in patients taking this medication

Back 37

Probenecid

Front 38

Aspirin and methotrexate may cause:

Back 38

Bone marrow depression due to methotrexate toxicity

Front 39

Aspirin may interfere with the antihypertensive action of these medicines

Back 39

ACE inhibitors, Beta-blockers, thiazide and loop diuretics

Front 40

Aspirin dose for children is:

Back 40

10 - 15 mg/kg q 4-6 hours

Front 41

Other salicylates have these two advantages

Back 41

Have no or little effect on platelets and no cross-hypersensitivity with aspirin

Front 42

A salicylate that is classified as a NSAID

Back 42

Diflunisal (Dolobid)

Front 43

This drug group is the most useful for dental pain

Back 43

NSAIDs (Nonsteroidal anti-inflammatory drugs)

Front 44

Like aspirin, NSAIDs mechanism of action is to:

Back 44

Inhibit the enzyme COX (prostaglandin synthetase) resulting in decreased prostaglandin and thromboxane synthesis

Front 45

GI effects of NSAIDs include:

Back 45

Pain, bleeding, ulcers, reflux

Front 46

How do NSAIDs affect blood clotting?

Back 46

Reversibly inhibit platelet Aggregation by inhibiting thromboxane A2 production but only for as long as drug present in blood

Front 47

Oral manifestations reported with NSAIDs include:

Back 47

Ulcerative stomatitis, gingival ulcerations, and dry mouth

Front 48

Like aspirin, NSAIDs given late in pregnancy can:

Back 48

Prolong gestation, delay parturition, produce dystocia, and cause premature closure of the ductus arteriosus

Front 49

NSAID drug of choice for treating pregnant women

Back 49

Ibuprofen

Front 50

NSAID of choice for dental patients

Back 50

Ibuprofen

Front 51

The usual analgesic dose of ibuprofen is:

Back 51

400 to 800mg every 4-6 hours

Front 52

These NSAIDs has a longer half-life and can be dose on an 8-12 hour schedule but require a loading dose

Back 52

Naproxen and naproxen sodium

Front 53

This NSAID is also available in a parenteral form for IM or IV injection

Back 53

Ketoralac (Toradol)

Front 54

GI problems, decreased renal function, fluid retention, and reduced platelet function are effects of this type of cycl-oxygenase

Back 54

COX-I

Front 55

COX-II specific drugs have been found to be no more effective than other NSAIDs and also have an increased risk of ____________

Back 55

Cardiovascular disease

Front 56

Acetaminophen is also called:

Back 56

tylenol

Front 57

Large doses of accetaminophen may cause toxicity to these two organs

Back 57

Liver and kidneys

Front 58

Unlike aspirin, acetaminophen does not possess this effect

Back 58

Antiinflammatory effect

Front 59

The toxic metabolite of acetaminophen that causes hepatic necrosis

Back 59

N-acetyl-p-benzoquinonamine

Front 60

Dose of acetaminophen that may cause hepatic necrosis after the acute ingestion of a single dose

Back 60

20 to 25 gram

Front 61

Patients with disease of this organ should avoid using acetaminophen

Back 61

Liver

Front 62

Patients using alcohol should only use ___grams/day and those who don't drink should limit use to _____ grams/day

Back 62

2 grams/day 4 grams/day

Front 63

Treatment of acetaminophen overdose

Back 63

Lavage, activated charcoal, and N-acetylcysteine

Front 64

Colchicine is used to treat:

Back 64

Gout

Front 65

Allopurinol inhibits the synthesis of:

Back 65

Uric acid

Front 66

This drug increases the excretion of uric acid by the kidneys

Back 66

Probenicid