Pharmacology Unit 3 High Points

Front 1

Mech of action of naproxen, ibuprofen

Back 1

Competitive, reversible inhibitor of COX 1 and 2

Front 2

Celecoxib is (more/less) selective for COX 2 than tNSAIDS

Back 2

more (10x)

Front 3

Aspirin is (reversible/irreversible) and inhibits the function of ___ and blocks the synthesis of

Back 3

irreversible, platelets, PG

Front 4

What NSAID is contraindicated in kids?

Back 4

Aspirin

Front 5

What NSAID acts ONLY in the CNS?

Back 5

APAP

Front 6

T or F, Cox 2 selective drugs (celexocib) cause MORE GI distress

Back 6

False, less

Front 7

(acute/chronic) pain is important for survival and (somatic/visceral) pain is hard to locate

Back 7

acute, visceral

Front 8

Which 2 of these cause pain in ascending pathways and which 2 stop pain in descending pathways?

-5-HT
-Glu
-Substance P
-NE

Back 8

Pain = Glu, Sub P
Stop pain = 5-HT, NE

Front 9

What is the term for when you feel pain from something that should NOT produce pain at all?

Back 9

allodynia

Front 10

An increase in Na conductance in a cell will lead to (hypo/hyper) excitability

Back 10

hyper

Front 11

APAP effects (POX/COX) reaction the most

Back 11

POX

Front 12

True or False, celecoxib is safe in patients with CV or renal issues

Back 12

False

Front 13

Where is ibuprofen and naproxen metabolized?

Back 13

liver

Front 14

Morphine is good for (sharp/dull) pain

Back 14

dull

Front 15

What % of morphine is converted to M6g, the active opioid?

Back 15

10

Front 16

Which opioid is a prodrug?

Back 16

codeine

Front 17

True or False, codeine has NO anti-inflammatory properties

Back 17

T

Front 18

Morphine effects (mu/kappa/delta) most

Back 18

mu

Front 19

Codeine is (more/less/the same) efficacious than morphine

Back 19

less

Front 20

Tylenol + codeine is a schedule (#) drug

Back 20

3

Front 21

What are three ways opioids effect pain?

Back 21

alter neurotransmitter release, block GABA inhibitory pathway, alter perception of pain

Front 22

What drug is known for having both L and D isomers with different actions? Which one is a full mu agonist in this drug?

Back 22

Methadone (L isomer is full mu agonist, D is NMDA receptor antagonist)

Front 23

What drug is NOT readily reversed with naloxone?

Back 23

Meperidine (Demerol)

Front 24

How many times more potent than morphine is Fentanyl?

Back 24

80-100 (holy crap)

Front 25

True or False, Tramadol is a prodrug

Back 25

True

Front 26

Tapentadol is (more/less) potent than tramadol

Back 26

more

Front 27

What is the mech of action of Tramadol

Back 27

blockes 5-HT and NE reuptake

Front 28

Name 2 mixed k agonist/mu antagonists

Back 28

butorphanol, nalbuphine

Front 29

Naloxone is an opioid (agonist/antagonist) and has a (short/long) duration of action

Back 29

antag, short

Front 30

non-opioids (do/do not) have a ceiling effect

Back 30

do

Front 31

For step 1 pain, there is no need to include an anti-inflammatory, just step 2 and 3

Back 31

False, all steps!!!

Front 32

Aspirin is a (common/uncommon) pain manager that inhibits synthesis of ___ and should not be used in (adults/kids)

Back 32

uncommon, PG, kids

Front 33

T or F, APAP is the drug of choice bc of its low side effects and strong anti-inflammatory effect

Back 33

False, does NOT have strong anti-infl effect

Front 34

What is the max 24 dose of APAP?

Back 34

4gm

Front 35

NSAIDs have (reversible/irreversible) action on platelets

Back 35

reversible

Front 36

How does celexocib effect platelets?

Back 36

Has NO anti-platelet effect

Front 37

A patient comes in that has had GI problems in the past and said that ibuprofen made it worse. What type of drug should you use for his pain?

Back 37

COX 2 selective (like celecoxib)

Front 38

T or F, tramadol should never be used in patients with morphine addiction

Back 38

F, it is a good alternative to those at risk for drug abuse!

Front 39

You should not use Tramadol with (SSRIs/SNRIs/TCAs)

Back 39

SSRIs

Front 40

Tapentadol binds to what receptors in the CNS?

Back 40

mu opiate receptors

Front 41

For NSAIDs, you should start with the (lowest/max) dose, but with opioids, you should start with the (lowest/max) dose

Back 41

max, lowest

Front 42

T or F, both NSAIDs and opioids have a ceiling effect

Back 42

False, opioids do NOT!

Front 43

T or F, never schedule opioids around the clock, only as needed

Back 43

F, should schedule long-acting opioids ATC

Front 44

A patient has a short bout of pain, they should take __% of their normal opioid dose every __ hours as needed

Back 44

15-20, 4

Front 45

The "gold standard" for severe pain is ___

Back 45

morphine

Front 46

What step 3 drug (strong opioid) is used in an ORAL form renal dysfxn patients?

Back 46

oxycodone

Front 47

What drug is known as the "champagne of opioids" and is best for patients with renal problems?

Back 47

hydromorphone

Front 48

Fentanyl is usually reserved for (acute/chronic) pain

Back 48

acute

Front 49

Methadone has a (short/long) and unpredictable half life

Back 49

long (thus, hard to titrate)

Front 50

suboxone (is/is not) safe in pregnant patients

Back 50

is

Front 51

What two broad drug categories can sometimes be used for patients with neuropathic pain?

Back 51

Antidepressants, anticonvulsants

Front 52

Corticosteroids are good for pain in what area of the body?

Back 52

bone pain

Front 53

T or F, caffeine has good analgesic properties

Back 53

False, only used to increase NSAID efficacy

Front 54

What is the MOA of caffeine that allows it to assist NSAIDS?

Back 54

increase NE release

Front 55

What sedative increases duration of GABA receptor Cl- channel opening?

Back 55

fiorinal (butalbitol)

Front 56

Equagesic (meprobamate) is a ___ agonist and may produce dependence

Back 56

GABA receptor

Front 57

What is the drug of choice for facial and neuropathic pain? What are this drugs big adverse effects as it pertains to dentists?

Back 57

amitriptyline (it's a TCA), stomatitis, glossitis and dry mouth

Front 58

What drug is the gold standard for trigeminal neuralgia and what is its MOA?

Back 58

carbamazopine (an anticonvulsant), block Na channels

Front 59

Gabapentin (enhances/inhibits) GABA and (enhances/inhibits) Ca channels

Back 59

enhances, inhibits

Front 60

Pregabalin (Lyrica) is a schedule (#) drug, meaning it has a (high/low) abuse potential

Back 60

5, high

Front 61

What is a common injectable treatment for TMJ problems?

Back 61

corticosteroids

Front 62

What are the two big AEs with corticosteroids?

Back 62

poor wound healing, decreases infection resistance

Front 63

Capsaicin is a (injectable/topical) agent that acts on ____ receptors

Back 63

topical, TRPV1

Front 64

Clonidine is a ___ receptor agonist, with what main AE?

Back 64

alpha 2, hypOtension

Front 65

Ketamine is a ___ receptor ANtagonist

Back 65

NMDA

Front 66

Sodium Hyaluronate stimulates the production of ____ to augment joint fluidity

Back 66

hyaluronic acid

Front 67

What is the DMARD of choice? (DMARD = disease modifying anti-rheumatic drug)

Back 67

methotrexate

Front 68

Cyclosporine has an AE of nephrotoxicity and what other dental related AE?

Back 68

gingival hyperplasia

Front 69

Name 1 gold compound used in RA

Back 69

Auranofin (Ridaura)

Front 70

What is the drug of choice for pain in PUD?

Back 70

APAP

Front 71

PPIs have 2 BIG adverse effects and 2 BIG drug interactions... what are they?

Back 71

AE: osteoporosis, C. diff infections due to decrease in stomach acid

DI: warfarin, benzodiazepine

Front 72

Antacids such as Mg and Al salts, and CaCO3 can intact with what to main drugs?

Back 72

fluoroquinolones and tetracycline (bc of metal ions)

Front 73

If someone has an NSAID induced ulcer, they should stop the NSAIDS and start taking a ___

Back 73

PPI

Front 74

Sucralfate decreases absorption of what two drugs?

Back 74

fluoroquinolones and tetracycline

Front 75

What GERD/PUD drug is considered pregnancy category X?

Back 75

Misoprostol (Cytotec)

Front 76

Antisialagogues can cause (increase/decrease) in salivation by (opening/blocking) ACh on muscarenic receptors

Back 76

decrease (that's what they're for!), blocking

Front 77

Sialagogues are good for (decreasing/increasing) salivation

Back 77

increasing

Front 78

What are the three main targets of antiemetics?

Back 78

The GI, CTZ, and vestibular apparatus (CN VIII)

Front 79

What two antiemetics can cause EPS?

Back 79

prochlorperazine and Metoclopramide

Front 80

Which antiemetic is also a D2 receptor antagonist?

prochlorperazine
metoclopramide
dimetnhydrinate

Back 80

Meto...

Front 81

1st generation H1 receptor antagonists can cause CNS (excitation/depression) and xerostomia (among other things)

Back 81

depression

Front 82

What types of laxatives are preferred for opioid induced constipation?

Back 82

stimulants (bisacodyl, senna)

Front 83

Polycarbophil Calcium and Bismuth Subsalicylate have what common drug interactions? (they both contain what??? hint!)

Back 83

fluoroquinolones and tetracycline (both contain a metal)