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Chapter 5 pt.2
Drugs for pain control pt.2
81
Pharmacology
Professional
03/15/2013

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Cards

Term
What kind of drug is ibuprofen?
Definition
NSAID
Term
What are some brand names for ibuprofen?
Definition
-Advil
-Motrin
-Nuprin
-Panafen
Term
What are the therapeutic uses of ibuprofen?
Definition
-fever
-symptoms of arthritis
-mild/moderate pain
-low risk if MI(cuts down on chances of heart attack)
Term
What is naproxyn?
Definition
NSAID
Term
What are some common brand names of naproxin?
Definition
-Naprosyn
-Aleve(naprosyn+sodium)
Term
WHat are some therapeutic uses of naproxyn?
Definition
-arthritis
-gout
-fever
-inflammation/severe pain
-low risk of MI
Term
What may naproxyn do to a pregnant woman?
Definition
may have teratogenic effects in the first trimester
Term
What else does naproxyn do?
Definition
increases bleeding
Term
WHat is Celebrex(celecoxib)?
Definition
reversible COX-2 inhibitor, NSAID
Term
What have studies not shown with Celebrex?
Definition
studies not demonstrated a true decrease in anti-COX-1 side effects compared to other NSAIDS
Term
How does Celebrex compare to other NSAIDS?
Definition
-NSAIDS so not carry the other cardiovascular risks(higher chance of heart attack and stroke on this medication)therefore it is only prescribed to certain patients
Term
How do reversible drug's effects compare to nonreversible?
Definition
reversible drugs have a shorter effect than nonreversible because it can be knocked off of the enzyme, with irreversible the body has to excrete the enzyme and make more to get rid of the drug
Term
What are endogenous opioids?
Definition
natural ligands(agonists) for opioid reeptors
Term
What are the opioid receptors?
Definition
-Enkeplalins
-Beta-endorphins
-Dynorphins
Term
What do opioids do? What is a bad thing about them?
Definition
-work as analgesics(pain relievers)
-have a high addiction potential b/c they change receptors in the body
Term
What does prolonged exposure to opioids do?
Definition
decreases receptor production, so the person taking them needs more(a higher dose) to achieve the same high
Term
What are some agonists/mixed agonists of opioid drugs? (5)
Definition
-analgesics(primarily)
-sedatives
-anxiety-medictions
-cough suppressants(cough syrup w/codiene)
-depressed GI tract activities (someone w/ ulcer will take to give body time to heal)
Term
What are some antagonists uses of opioids?
Definition
treats overdoses of agonists/partial agonists
-helps prevent relapse of opioid addicts
Term
What is a physiological addiction?
Definition
when a production in the number of receptors for a drug decreases with extended use, so the person has to take a higher dose to get the same effect
Term
What is the adsorption of opioids?
Definition
oral, injection, nasal, or transdermal patch
Term
What is the distribution of opioids?
Definition
-lipophilic so they bind quickly to receptors
-low bioability compared to oral dose
Term
WHat is the metabolism of opioids like?
Definition
-onset within 1 hour
-4-6 hours until therapeutic effects ware off due to phase I metabolism
Term
What type of excretion do opioids go through?
Definition
glomerular filtration
Term
What type of metabolism do opioids go through? What does one have to be careful of when taking opioids?
Definition
-phase one
-since it is lipophilic you have to be careful of drug interactions
Term
What are some common adverse reactions of opioids?
Definition
-respiratory depression
-nausea/vomiting
-constipation
-myosis
-urinary retention
-CNS effects(decreases CNS)
-cardiovascular effects(slows heart rate)
-biliary tract constriction
-histimine release(itchy, hives)
-pregnancy and nursing
-overdose(happens easy)
-addiction(withdrawl)
-allergic reactions
-drug interactions
-physiological tolerance
Term
WHat is myosis?
Definition
pulpil restriction
Term
How can opioids effect pregnancy and nursing?
Definition
can cross placenta and is excreted through mammary glands
Term
What does biliary tract constriction caused by opioids do?
Definition
slows bile release, this causes issues with nutrient absorption
Term
What is heroin?
Definition
a schedule I opioid not used for therapeutic reasons
Term
What kind of feelings does heroin cause?
Definition
feelings off europhia
Term
What does heroin metabolize into when administered orally? How is it usually administered?
Definition
-leads to metabolism into morphine before crossing the BBB when administered orally
-usually injected
Term
When are symptoms of withdrawl seen with heroin?
Definition
6-8 hours after last dose
Term
What is a physiological addiction?
Definition
actual changes of receptors in your body
Term
What is a psychological addiction?
Definition
it is routine, things you do, people you hang out with etc.
Term
What is known as the "standard" of opioids?
Definition
morphine, it is the strongest available
Term
What is codeine? What is it used in combination with?
Definition
-weakly analgesic alone
-used in combination with nonopiods for increased analgesia with decreased side effects
Term
What are codiene combined with nonopioids commonly used in?
Definition
dentistry
Term
What are some examples of this combination?
Definition
-Tylenol 1-4(with codiene)
-Phenaphen
-Empirin
Term
What is hydrocodone?
Definition
an opiod agonist used for moderate or severe pain relief(decreases perception of pain, works directly on the CNS)
Term
What is hydrocodone?
Definition
an opiod agonist used for moderate or severe pain relief(decreases perception of pain, works directly on the CNS)
Term
Where is hydrocodone commonly used? What is it commonly paired with?
Definition
in dental practices, often combined with nonopiods
Term
What are some trade/brand names of hydrocodone?
Definition
-Vicodin(hydrocodone+aceteminophen)
-Lortab
-Lorcet
-Vicoprofen(hydrocodone+ibuprofen)
Term
What is a synergistic effect?
Definition
seen with opioid is combined with a nonopioid(both at lower doses), and getting a higher therapeutic effect than you would see individually
Term
What does a nonopioid do?
Definition
blocks COX enzymes so you cannot feel pain
Term
What is oxycodone? What is it used for?
Definition
-opioid agonist
-used for relief of moderate to severe pain
Term
What is the trade name for oxycodone?
Definition
OxyContin
Term
What is oxycodone often combined with? What are some examples of this combination?
Definition
-nonopioids
-Percodan(oxy+aspirin)
-Percoset(oxy+aceteminophen)
-Roxicet(oxy+aceteminophen)
-Tylox(oxy+aceteminophen)
Term
What is oxymorphone?
Definition
an opioid agonist used for moderate to severe pain relief
Term
How is oxymorphone administered?
Definition
via injection, suppository, or pill
Term
What is the trade name of a oxymorphone?
Definition
Opana ER(extended release)
Term
What are some medications that may interact with opioid gonsists?
Definition
any medication that also gets metabolized through phase I
Term
What does alcohol or barbituates + opioid agonists do?
Definition
depresses the CNS
Term
What does st john's wart(for depression)+ opioid agonist do?
Definition
increases sedation
Term
What does phenytoin+opioid agonists do?
Definition
increases liver clearance(increases metabolism), this leads to decreased opioid levels
Term
WHat does phenytoin+metadone cause?
Definition
increased clearance which leads to increased withdrawl symptoms
Term
What is the brand name for phenytoin?
Definition
Dilantin
Term
What type of drug is butorphanol?
Definition
-mixed agonist
-both agonist and antiagonist activity
Term
What is butorphanol used for? How is it administered?
Definition
-can't be administered orally b/c it is not well absorbed
-most often used in treatment of migraine treatment(nasal spay) or during surgery(IV)
Term
What is naloxone? What is it use to treat?
Definition
-opioid antagonist
-used to treat respiratory depression from opioid overdose, quickly precipitates withdrawl symptoms in opioid addicts
Term
How does naloxone work?
Definition
antagonizes known opioid receptors
Term
WHat is methadone?
Definition
used to treat opioid(primarily heroin) addiction, eases withdrawl
Term
What is the method of action of methadone like?
Definition
longer duration of action, helps decrease frequency of cravings
Term
What is another medication used to treat opioid addiction?
Definition
-buprenorphine & naloxone (Suboxone)
Term
what does Suboxone do? How is it administered?
Definition
-produces less of a high than straight opioids
-administered as a sublingual film
Term
What are some other treatments for neuopathic pain?
Definition
-anticonvulsants
-tricyclic antidepressants
Term
What are some examples of anticonvulsants? What is a side effect of these medications?
Definition
-Pregabalin
-Carbamazepine
**xerostomia**
Term
What is the brand name for pregabalin?
Definition
Lyrica
Term
What is the brand name for carbamazepine?
Definition
Tegretol
Term
What is an example of a Tricyclic antidepressant?
Definition
amytriptyline(Elavil)
Term
What does amytriptyline(Elavil) interact with?
Definition
vascoconstrictors in local anesthetics
Term
What are some legal types of drug use?
Definition
-alcohol
-tobacco
-opioids
-anxiolytics
Term
What are some illegal types of drug use?
Definition
-heroin
-cocaine
-methamphetamines
Term
What are some factors affecting drug dependence?
Definition
-type of drug
-time of drug onset(faster the high, the more you use)
-time to widthdrawl symptoms
-method of delivery
-ease of obtaining drug
Term
What are some signs of opioid abuse?
Definition
euphoria, tranquility, slowed GI tract activity, reduced anxiety and aggressiveness
Term
What are some sympoms of opioid abuse?
Definition
-pinprick pupils
-depressed respiration
-hyoptension
-reduced reflexes
Term
What should be administered in case of an opioid overdose?
Definition
naloxone(Narcan)
Term
What are some dental issues associated with opioid abuse?
Definition
-drug interactions
-tolerance to pain control response
-increase liklihood of disease
Term
Can chonic pain be effectively treated with opioids?
Definition
no
Term
What are some signs of opioid intoxication?
Definition
-activation(rush) with low doses, sedation/apathy with high doses
-euphoria/dysphoria
-feeling sof warmth, flushing, itching
-impaired judgemnet,attention or memory
-analgesia
-constipation
-pulpitary constriction
-drowsiness
-respiratory depression, hypotension
-tachycardia
Term
What are some signs of withdrawl from opioids?
Definition
-depressed mood and anxiety, dysphoria
-cravings
-high attention
-hyperalgesia(joint and muscle pain)
-dirrahea, gas, vomiting
-pilpital dilation/photophobia
-insomnia
-autonomic hyperactivity(hypertension, tachcardia, etc)
-yawning
Term
what is dysphoria?
Definition
not reacting appropriatly(ex: being told you have 20 cavitites and being okay with it like it is not a big deal)
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