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45 Cards in this Set
- Front
- Back
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What is an Analgesic? |
Drugs used for the relief of pain. |
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Non-opiod Analgesics |
-Tylenol -NSAIDS |
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Pain Threshold |
Level of stimulus needed to create a pain sensation |
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Acetaminophen - Mechanism of Action |
Antipyretic Analgesic Inhibits prostaglandin synthesis in the CNS DOES NOT work on inflammation. |
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Acetaminophen - Adverse Effects |
Rare at therapeutic levels Interacts with Alcohol, Warfarin Acute Toxicity Liver damage and death due to hepatic necrosis. |
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Treatment of Acetaminophen Toxicity |
Mucomyst (Acetylcysteine) - if given within 10 hours, then 100% prevention of severe liver injury. |
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COX 1 and 2 Enzymes |
COX1 found in all tissues and is helpful: housekeeping enzyme.
COX2: Shows up during inflammation |
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What class of drugs are Cyclooxygenase inhibitors? |
NSAIDS NOT TYLENOL |
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COX1 |
Converts arachidonic acid into prostaglandins. Beneficial! Protects gastric mucosa, supports renal function, and promotes platelet aggregation |
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COX2 |
Harmful Mediates inflammation, sensitizes receptors to painful stimuli. |
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First Generation NSAIDS |
Inhibit both COX 1 and 2 nonselectively. |
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Aspirin- Therapeutic Uses |
Suppressed Inflammation Analgesic Antipyretic Suppression of platelet aggregation |
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Aspirin- Adverse Effects |
GI Effects Increased bleeding Renal Impairment Salicylism Reye's Syndrome |
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Reye's Syndrome |
Use of Aspirin for children, increased child mortality rate
Encephalopathy and Fatty Liver degeneration |
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Aspirin Drug Interactions |
Warfarin: Gastric Hemorrhage - both affect blood clotting; high risk of bleeding Glucocorticoids: Gastric Ulcers Alcohol: Gastric Bleeding Ibuprofen: Decreases anti-platelet effect of Aspirin |
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Salicylism |
Aspirin Overdose: Tinnitus, irratibility, dizziness |
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Ibuprofen |
One of the First Generation NSAIDS Helps with fever, arthritis, dysmennorea |
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Naproxen |
One of the first generation of NSAIDS Prolonged half lives, so dosing is less frequent |
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Indocin |
First generation NSAID Arthritis, gout |
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Toradol |
Ketorolac (generic name) Used only for short term therapy - High kidney toxicity usually used in cesarean section |
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Celebrex (celecoxib) |
Selective COX-2 Inhibitor Suppresses inflammation Less GI side effects |
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Side effects of celebrex |
Linked to CV events Increased risk of bleeding with coumadin Cannot take if a sulfa allergy is present |
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What is an opiod |
An analgesic that has properties similar to morphine |
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Opioid receptors |
2 types Mu and Kappa |
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Mu Receptors |
an opioid receptor responsible for analgesia, respiratory depression, euphoria and sedation |
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Kappa Receptor |
an opioid receptor also responsible for analgesia and sedation |
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Pure Opioid Agonists |
Morphine
Demerol Fentanyl |
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Opioid Agonist-Antagonist |
Work as antagonists at the mu receptor, but as agonists at the kappa receptor. Provides low abuse potential, but less analgesic effects |
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Opioid Antagonists |
Acts to block receptors completely Narcan |
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Morphine: Mechanism of Action |
Mimics actions of endogenous opioids Works on Mu receptors |
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Morphine: Therapeutic Use |
Pain relief for a variety of reasons Post-op pain Cancer Constant, dull pain. |
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Morphine: Pharmacokinetics |
Can be given PO, IM, IV NOT lipid soluble Inactivated by hepatic metabolism |
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Morphine: Adverse Effects |
Respiratory Depression Constipation (anticholinergic) Orthostatic Hypotension Urinary retention Emesis Sedation Increase in intercranial pressure |
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Morphine: Dependence issues |
Tolerance Physical Dependence: Abstinence syndrome Sweating, anorexia, irritability, nausea |
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Morphine: Drug Interactions |
CNS Depressants: Alcohol, Benzos Anticholinergic Drugs: Antihistimines Hypotensive Drugs Opioid Antagonists |
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Morphine Toxicity |
Pinpoint Pupils Respiratory Depression Coma |
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What are examples of strong opiods? |
Fentanyl Demerol Methadonne Heroin Dilaudid |
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Methadone |
Strong opioid agonist Used in alcohol withdrawl Can become addicted |
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Demerol |
Strong Opioid agonist Used post surgery |
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Fentanyl |
Mostly transdermal, really easy to abuse |
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Dilaudid |
Small doses can give high amounts of pain relief. |
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Codeine |
Opioid Agonist Metabolized into a stronger drug in the body - similar to morphine Has a lot of side effects - anticholinergic effects |
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Oxycodone |
Opioid agonist Opioid with tylenol |
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Darvocet |
Opioid agonist more lethal that other moderate opioids |
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Tramadol |
Non-opioid analgesic |
