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40 Cards in this Set

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  • Back
Give examples of conditions with chronic pain
Cancer
Trigeminal neuralgia
Post-therapeutic neuralgia
Pain receptors can be activated by?
Bradykinin
Prostaglandins
Histamine
Serotonin
Which pathway transmits fast pain?
Neospinothalamic

A Fibers
Which pathway transmits slow pain
Paleospinothalamic

C Fibers
What part of the brain senses the quality of the pain?
Cerebral cortex
Name the 3 classes of endogenous opiods
Dynorphin
Enkephalins- in brain
Endorphins- endogenous morphine
What are the 5 major classes of opiod analgesics
Phenanthrenes- codeine
Phenylheptylamines
Phenylpiperidines- Demerol
Moriphans- Butorphanol
Benzomorphans- Pentazocine
Name some effects of morphine on the CNS
Drowsiness
Analgesia
Resp depression
Cough suppresion
Emesis
Euphoria- releases dopamine

Miosis
< body temp
< release of GH
> ADH
> release of prolactin
Inhibits ACH and GnRH
name some effects of morphine in the periphery
Antidiarrheal
Constricts biliary smooth muscle(ampulla of vater)
< renal plasma flow
> Urethral and bladder tone
Name some effects of morphine in the cardiovascular system
vasodilation; leads to orthostatic hypotension

> histamine release; leads to itching and bronchospasms

< myocardial oxygen demand
Name medications used with moderate pain
Hydrocodone
Oxycodone
Tramadol
Codeine
Name medications used with severe pain
Morphine
Methadone
Hydromorphone
Fentanyl
Levorphanol
Oxycodone
What is the sustained release oxycodone?
Oxycontin
What 2 drugs make up vicodine?
Hydrocodone + tylenol
Name a drug more potent than morphine
Hydromorphone (Dilaudid)
This drug causes convulsions, especially with the elderly

It is not used as an antitussive
Meperedine (Demerol)
T/F Meperidine causes constipation
False, it does NOT cause constipation
Should Demerol be avoided with renal dysfunction?
YES
Which analgesics are fast acting with the shortest duration of action and are good for surgical procedures
Fentanyl and Sufentanil
T/F Fentanyl and Sufentanil cross the BBB and affect the MU receptors
TRUE

Monitor resp rate because Mu receptors < resp
Which analgesic is only used as an antidiarrheal and never used for pain?
Diphenoxylate

It is very constipating
this analgesic is very lipophillic and causes hallucinations, vivid dreams, and weird thoughts at high doses
Benzomorphans
Which analgesic stops nociceptive input in the spinal cord and not in the supraspinal loci
Pentazocine (Talwin)

It's a Benzomorphan
What drug is used to prevent migraine attacks (nasal spray)
Butorphanol (Stadol)

Its a Morphinan
Name a narcotic antagonist
Naloxone (Narcan)
What is the MOA of Narcan?
Competitive inhibitor at mu,kappa, delta and sigma opiod receptors
What is a side effect of Narcan?
Hypotension
Name a phenylheptylamine
methadone
Name a phenylpiperadine
Demeral
Name a Moriphan
Stadol
Name a Benzomorphan
Talwin
Pentazocine
Name the phenanthrenes
Codeine
Morphine
What do you give if a pt is allergic to Codeine
Demerol; If truly opiod allergic give Lyrica
Where is the location of Analgesia receptors?
Dorsal horn of spinal cord
Raphae Magnus
Where is the location of Emesis and Resp.depression receptors?
Ventral Brainstem
What do Mu 1 receptors cause?
Supraspinal Analgesia
What do Mu 2 receptors cause?
RED

Resp depression
Euphoria
Dependance
What do Kappa receptors cause?
SSR

Spinal analgesia
Sedation
Resp Depression
What do Sigma receptors cause?
DHS

Dysphoria
Hallucinations
Stimulates respiration
What are these drugs made of?
Vicodin
Lortab ASA
Percocet
Percodan
Darvocet
Vicodin- hydrocodon/Tylenol
Lartab- hydrocodon/ASA
Percocet- Oxycodone/Tylenol
Percodan- Oxycodone/ASA
Darvocet- Propoxyphen/ASA