Pharm: Analgesics

Front 1

3 classes of analgesics named on the WHO pain ladder?

Back 1

non-opioids
weak opioids
strong opioids

Front 2

name two weak partial opioid agonists

Back 2

Tramadol
Codeine

Front 3

define pain

Back 3

pain is a subjective, unpleasant, sensory and emotional experience associated with actual or potential tissue damage

Front 4

state the three stages of pain perception

Back 4

nociception
pain transmission
onward passage

Front 5

the main pain impulse pathway

Back 5

spinothalamic tract

Front 6

define nociception

Back 6

perception of painful stimuli

Front 7

non-opioid agents - peripherally or centrally acting?

Back 7

peripherally acting

Front 8

opioid agents - peripherally or centrally acting?

Back 8

centrally acting

Front 9

the WHO pain ladder is...?

Back 9

a three-step logical approach to pain management

Front 10

name the combined analgesic that pods have access to

Back 10

Co-dydramol

Front 11

what does co-dydramol contain?

Back 11

paracetamol & dihydrocodeine

Front 12

is morphine or diamorphine more potent?

Back 12

diamorphine

Front 13

Paracetamol - class?

Back 13

non-opioid analgesic

Front 14

Paracetamol - actions?

Back 14

analgesic
antipyretic

Front 15

Paracetamol - MOA?

Back 15

inhibits prostaglandin synthetase in CNS

Front 16

Paracetamol - indications?

Back 16

mild-moderate pain
fever reduction
post-op pain
where aspirin not tolerated

Front 17

Paracetamol - ok to use in children/elderly? and why?

Back 17

yes
no GI tract side effects

Front 18

Paracetamol - don't use if...?

Back 18

liver or kidney impairment
alcoholic

Front 19

Paracetamol - effect of overdose? and why?

Back 19

liver damage
not enough gutathione to detoxify

Front 20

Paracetamol - why not an antiinflammatory?

Back 20

inhibition of prostaglandin synthetase is in CNS not peripheral tissues

Front 21

Paracetamol - advantages?

Back 21

no GI side effects
safe for children/elderly
quickly absorbed
easily bought

Front 22

Paracetamol - effect on potency of IV administration?

Back 22

increases potency to that of morphine

Front 23

Paracetamol - side effects?

Back 23

Few, but Rash, Hypotension & Blood dyscrasias

Front 24

Opioids - MOA?

Back 24

agonist action at opioid receptors

Front 25

Opioids - indications?

Back 25

moderate-severe visceral pain
- postoperatively and palliatively

Front 26

Morphine - 4 adverse effects?

Back 26

(DrowN-IT)
drowsiness/sedation
nausea & vomiting
itching
tolerance/dependence

Front 27

Morphine - advantage?

Back 27

most potent analgesic

Front 28

Morphine - duration of action?

Back 28

4-6 hours

Front 29

Morphine - what effect if patient has liver failure?

Back 29

COMA

Front 30

Morphine + head injury = ...?

Back 30

respiratory depression

Front 31

Morphine - what pain doesn't it alleviate?

Back 31

neurogenic pain

Front 32

Morphine - duration until tolerance develops?

Back 32

24-48 hours

Front 33

Diamorphine - two advantages over morphine?

Back 33

less nausea
less hypotension

Front 34

One disadvantage of diamorphine over morphine?

Back 34

more euphoric =
greater addiction risk

Front 35

Codeine - class?

Back 35

weak opioid

Front 36

Codeine - MOA?

Back 36

weak agonist at opioid receptors

Front 37

Codeine - indicated for type of pain?

Back 37

mild to moderate
visceral & somatic

Front 38

Codeine - main adverse effect that is useful in another context?

Back 38

constipation

Front 39

Codeine - ok for alcoholics?

Back 39

no

Front 40

Codeine - 2 contraindications?

Back 40

head injury
acute respiratory depression

Front 41

Codeine - apart from constipation, one other side effect?

Back 41

nausea

Front 42

Codeine - 4 advantages?

Back 42

good oral bioavailability
anti-tussive
anti-diarrhoeal
rarely addictive

Front 43

Tramadol - class of drug?

Back 43

weak opioid

Front 44

Tramadol - two MOAs?

Back 44

1. partial agonist at opioid receptors
2. inhibits reuptake of serotonin and noradrenaline

Front 45

Tramadol - useful if patient cannot tolerate which class of drugs?

Back 45

NSAIDs

Front 46

Tramadol - 4 advantages?

Back 46

- well absorbed
- no respiratory depression
- can use in renal failure
- can use in asthma

Front 47

Tramadol - 3 disadvantages?

Back 47

- dizziness
- confusion
- possible dependency

Front 48

Tramadol - 3 side effects?

Back 48

1. abdominal pains
2. confusion
3. hyper- or hypotension

Front 49

State four therapeutic uses of opioids.

Back 49

1- pain relief
2- anxiety reduction
3- cough suppression
4- anti-diarrhoeal

Front 50

Name the peripheral vascular effect of opioid use.

Back 50

Arteriolar and venous dilatation

Front 51

What effect do opioids have on smooth muscle?

Back 51

reduce contractions, increase tone