Integrated Science-Nsaids, Opiods Other Analgesics

Front 1

Acetylsalicyclic acid (Aspirin)
Indomethacin (Indocin)
Meloxicam (Mobic)
Ibuprofen (Motrin, Advil)
Naproxen (Naprosyn)
Ketorolac (Toradol)

Class?
AE?
AEs specific for aspirin?

Back 1

Acetylsalicyclic acid (Aspirin)
Indomethacin (Indocin)
Meloxicam (Mobic)
Ibuprofen (Motrin, Advil)
Naproxen (Naprosyn)
Ketorolac (Toradol)

Class: NSAID (Non-steroidal anti-inflammatories)

AE:Bleeding, gastric distress, heartburn, nausea, gastric ulceration, sweating, headache, hypothermia

AE specific to aspirin: the above + aspirin induced hypersensitivity (salicylism), tinnitus, Reye's syndrome (children)

Front 2

Acetylsalicyclic acid (Aspirin)

Class?
Indications?
MOA?

Back 2

Class: NSAID

Indication: "*gold standard, reduce inflammation and fever, produce analgesia, pain reliever, used as blood thinner to prevent MI
*rheumatoid arthritis therapy treats symptoms only (higher dose, more adverse effect)

MOA: Irreversible inhibitor of COX I & II; Prevents synthesis and release of prostaglandins by interrupting the cyclooxygenase pathway

Front 3

Indomethacin (Indocin)
Meloxicam (Mobic)
Ibuprofen (Motrin, Advil)
Naproxen (Naprosyn)

Class:
Indication:
MOA:

Back 3

Indomethacin (Indocin)
Meloxicam (Mobic)
Ibuprofen (Motrin, Advil)
Naproxen (Naprosyn)

Class: NSAIDs

Indication: reduce pain, fever, inflammation, used for rheumatoid arthritis, gouty arthritis, osteoarthritis, and other inflammatory disease


MOA: reversible, nonspecific inhibitor of COX I & II

Front 4

Ketorolac (Toradol)

Class?
Indication?
MOA?
Why different from other NSAIDs

Back 4

Ketorolac (Toradol)

Class: NSAID

Indication: short term management of pain and severe post-op pain

MOA: Inhibits protaglandin synthesis, producing peripeherally mediated analgesia

Not recommended for >5 days due to liver toxicity; reserved for post-op analgesia

Front 5

Acetaminophen (Tylenol)

Indication?
MOA?
Caution due to?

Back 5

Acetaminophen (Tylenol)

Uses: Cold medicine, reduce pain and fever, general systemic action

MOA: Weak prostaglandin synthetase inhibition in the CNS

Can cause hepatoxicity

Front 6

Celecoxib (Celebrex)

Class?
Indication?
MOA?
AE/Caution?

Back 6

Celecoxib (Celebrex)

Class: COX II inhibitor

Indication: analgesia; Reduces inflammatory prostaglandins while sparing those that protect the stomach, reduce pain, inflammation- arthritis

MOA: Selective blockade of cyclooxygenase II enzyme (4th line agent)

AE: Increased risk of CV problems/CVA

Front 7

Morphine
Codeine
Hydromorphone (Dilaudid)
Hydrocodone w/ acetaminophen (Lorcet, Vicodin)
Oxycodone (Roxicodone)
(with acetaminophen Percocet)

Class?
MOA?
AE?
Which from above list are strong agonists? (2)
Which is used for pain relief associated w/an MI?
Which is most potent when given orally?

Back 7

Class: Opoids

MOA: inhibition of K+ channels @ mu & kappa opiod receptors, inhibiting release of substance P

AE: respiratory depression, constipation, urinary retension, orthostatic hypotension, increased intracranial pressure, sedation, miosis

Strong agonists: Morphine, hydromorphone (Diaudid)

Morphine used w/MI

Hydromorphone (Dilaudid) more potent than morphine when given PO

Front 8

Meperidine (Demerol)
Fentanyl (Duragesic)
Methadone (Dolophine)
Propoxyphene (Darvon)

Class?
MOA?
AE?
Which from above list is a strong agonists? (1)
Which has multiple methods of administration?
Which is used to aid heroin addicts with withdrawal symptoms?

Back 8

Class: Opoids

MOA: inhibition of K+ channels @ mu & kappa opiod receptors, inhibiting release of substance P

AE: respiratory depression, constipation, urinary retension, orthostatic hypotension, increased intracranial pressure, sedation, miosis

Fentanyl is a strong agonist & has multiple methods of administration (patches, lollipops, IV, PO)

Methadone is used to wean heroin addicts and help avoid w/drawal symptoms

Front 9

Tramadol (Ultram)

Indication?
MOA?
AE?

Name when tramadol is combined w acetominophen?

Back 9

Tramadol (Ultram)

Indication: Analgesia, decrease moderate to moderately severe pain

MOA: binds to mu -opioid receptors and inhibits reuptake of NE and 5HT

AE: eizures, dizziness, headache, constipation, N/V/D, pruritus, sweating, tolerance,
seizure, suicide, serotonin syndrome, anaphylactic shock, respiratory depression, drug interactions with alcohol, CNS depressant, dependence, withdrawal

Ultracet is tramadol 37.5mg + acetaminophen 325mg-used for short term management of acute pain. MOA & AE the same as tramdol + that of acetamin

Front 10

Lidocaine (Lidoderm)

General indication?
Indication as a cardiac med?
AE?

Back 10

Indication: local analgesia
Cardiac: used for ventricular arrhythmia

MOA: stabilizes neuronal membranes; inhibits ion fluxes required for initiation and conduction of pain impulses

AE: seizure, confusion, drowsiness, decreased mucosa,cardiac arrest, N/V, bronchospasm, stinging, anaphylaxis

Front 11

Nalbuphine (Nubain)
Butorphanol (Stadol)

Class?
Indication?
MOA?
AE?
Which is available as a nasal spray?

Back 11

Nalbuphine (Nubain)
Butorphanol (Stadol)

Class: mixed opioid agonist & antagonist

Indication: analgesia without as much potential for abuse & fewer AE

MOA: Acts as agonist @ kappa receptors and antagonist @ mu

AE: sedation, respiratory depression, dry mouth, N/V, urinary urgency, confusion

Butophanol (Stadol) is available as a nasal spray for migraines

Front 12

Name an opiate antagonist.

What is it used for?

What is its MOA?

AE?

Back 12

Naloxone (Narcon)

Indication: Treatment for acute opiod overdose; reverses analgesia and respiratory depression

MOA: Competitively binds to opiate receptors(mu) and prevents bind ing of agonists

AE: ventricular arrhythmias, N/V, HTN/hypotension