Term
|
Definition
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|
Term
| drug more potent than heroin |
|
Definition
|
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Term
|
Definition
propoxyphene
(also contains caffeine, aspirin) |
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Term
| has highest affinity for opioid receptor |
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Definition
|
|
Term
Mu 1 operates at
Mu 2 operates at |
|
Definition
1- supraspinal analgesia
2- spinal analgesia |
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Term
|
Definition
delta- supraspinal
kappa- spinal |
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Term
| natural pain relief mechanism of body, during stress |
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Definition
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Term
| what drug can be added to opiod regiment to increase effects |
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Definition
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Term
| opiod mechanism of action in supraspinal pathway... |
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Definition
| stimulates inhibitory descending pathway |
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Term
| opioid mechanism in spinal pathway |
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Definition
1) decrease adenylate cyclase, cAMP
2) increase K+ EFFLUX
3) hyperpolarization
4) decrease Ca INFLUX
5) decrease substance p release |
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|
Term
| opioids produce hypo/hyper tension and how? |
|
Definition
HYPOTENSION
directly: depresses CNS
indirect: histamine release=peripheral vasodilation |
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Term
| opioids may produce miosis/mydriasis? |
|
Definition
miosis, pupillary CONSTRICTION
-can be problematic in dark lighting |
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|
Term
| opioids increase/decrease smooth muscle tone |
|
Definition
INCREASE TONE
primarily in non-vascular smooth muscle
which makes you shit bricks |
|
|
Term
| potential problem of codeine for cough |
|
Definition
suppresses a normal reflex, i.e. ejecting mucous
-best used to suppress NON-PRODUCTIVE COUGH |
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Term
|
Definition
convulsions
increased intracranial pressure (trauma)
undiagnosed acute abdominal conditions |
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|
Term
| withdraw reactions are opposite/same as drug's effect |
|
Definition
|
|
Term
|
Definition
| an extended release formulation of oxycodone |
|
|
Term
|
Definition
extended release drug
morphine with naltrexone
-added so drug can't be abused |
|
|
Term
| why isn't meperidine used much |
|
Definition
weaker
in the sub-group of fentanyl
can produce a toxic renal metabolite with chronic use |
|
|
Term
|
Definition
partial agonist
used in drug treatment programs, will let pt. function |
|
|
Term
|
Definition
| --ve has short pain relief, but long resp. dep times |
|
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Term
|
Definition
hits BOTH mu receptors blocks reuptake of 5HT
only PARTIALLY reversed by naloxone |
|
|
Term
| agonist-antagonists act where... |
|
Definition
agonist at kappa
antagonist at mu 1 +2 |
|
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Term
|
Definition
| pentazocine with naloxone, to prevent abuse |
|
|
Term
|
Definition
originally marketed as non-addictive..but it is
can produce nightmares, hallucinations |
|
|
Term
|
Definition
| giving them a antagonist will determine if they have it in their system (naloxone=narcan) |
|
|
Term
|
Definition
longer acting narcan
(antagonist...)
treats narcotic AND ETOH addictions |
|
|
Term
| naltrexone mechanism on ETOH addiction |
|
Definition
1) decreases the increased cerebral blood flow to frontal/thalamic/limbic systems
2) pharmacoDYNAMIC- reduces euphoric effects of ETOH
3) enhances it's positive effects, so less needed |
|
|
Term
|
Definition
cerebral vasoCONSTRICTOR
enhances weak acid absorption (..combined with aspirin)
blocks inflammatory mediators |
|
|
Term
| NSAIDS with slight COX-2 blocking effect |
|
Definition
Diclofenac
Etodolac (Lodine)
Ketorolac
--> easier on GI as a result |
|
|
Term
|
Definition
|
|
Term
|
Definition
500 mg acetaminophen
5 mg Hydrocodone |
|
|
Term
|
Definition
325 mg aspirin
5 mg oxycodone |
|
|
Term
|
Definition
325 acetaminophen
5 mg oxycodone |
|
|
Term
| schedule of percocet, percodan, vicodin |
|
Definition
perc's are schedule II
vicodin is schedule III |
|
|
Term
| aspirin's effect on cox enzymes |
|
Definition
irreversible binding of cox 1 + 2
(cox 1 at lOW doses...i.e. baby aspirin daily) |
|
|
Term
-gold standard NSAID
-dosage amount |
|
Definition
ibuprofen (Advil, Motrin)
OTC max dose is 200mg |
|
|
Term
| naproxen compared to ibuprofen |
|
Definition
longer half-life
more cox-1 selective (so rougher on stomach) |
|
|
Term
| meclofenamate compared to ibuprofen |
|
Definition
4x as powerful (50mg meclo=200mg Ibu)
produces stomach cramps, diahrrea after several days |
|
|
Term
|
Definition
nsaid
Dolorbid
-slow onset, requires a loading dose |
|
|
Term
| diclofenac, etodolac (Lodine) |
|
Definition
slightly cox 2 favoring
so don't inhibit platlet agg as much |
|
|
Term
| NSAID associated with liver toxicity |
|
Definition
|
|
Term
| only NSAID approved as an IV, IM |
|
Definition
ketorolac
-very effective pain reduction
-i.e. kidney stones
BUT highly cox-1 selective (BLEEDING!!) |
|
|
Term
| reason for cox-2 development |
|
Definition
blocking cox-2 only avoids GI issues
-less bleeding + ulcers |
|
|
Term
| what led to removal of coxibs |
|
Definition
rofexcoxib and valdecoxib removed
due to increased CV problems
also stephen johnsons |
|
|
Term
| which pain drugs do not interact with Lithium |
|
Definition
aspirin
acetaminophen
narcotics |
|
|
Term
| why codeine, hydrocodone, oxycodone effective orally? |
|
Definition
their metabolites are active
so as first pass kicks in, they can still be effective |
|
|
Term
|
Definition
fever goes UP
(even though its antipyretic at therapeutic dose) |
|
|
Term
| compared to aspirin, NSAIDS have _____ platlet binding |
|
Definition
| NSAIDS reversible antiplatlet action |
|
|
Term
| which drug has no affect on platelets |
|
Definition
|
|
Term
|
Definition
dizziness
drowsiness
psychomotor impairment
constipation |
|
|
Term
| alkalizing urine is antidote for ____ overdose |
|
Definition
aspirin
NSAIDS
cox-2 inhibitors |
|
|
Term
| acetaminophen overdose treatment |
|
Definition
n-acetyl cysteine
(Mucomist) |
|
|
Term
|
Definition
naltrexone
-has higher half-life...which is good because some opioids have longer half-lives than naloxone |
|
|
Term
| drug(s) which reduce HTN drug effects |
|
Definition
NSAIDS
COX-2
aspirin (at high dose) |
|
|
Term
| which drugs increase methotrexate (cancer drug) levels |
|
Definition
aspirin, nsaids, cox-2
all INCREASE levels of this anti-cancer drug
(*not when taking low amounts for RA) |
|
|
Term
|
Definition
SSRI's oppose aggregation, lead to bleeding
-possible issues when taking ASPIRIN, NSAID, COX-2 |
|
|
Term
| SSRI's block activation of ____ |
|
Definition
codeine, tramadol
(upregulate enzyme) |
|
|
Term
| hepatotoxicity associated with |
|
Definition
NSAID
-drugs have warning for alcoholics.. |
|
|
Term
| don't work on anyone with an INR above.. |
|
Definition
|
|
Term
|
Definition
occurs after viral infection
fatty degeneration of nervous tissue, organs
linked to receiving aspirin with viral infection |
|
|
Term
| 5% of asthmatics are sensitive to ____ |
|
Definition
aspirin
but also can't take nsaid, cox-2 |
|
|
Term
| 5% of acetaminophen goes to ____ via ____ |
|
Definition
NAPQI via CYP-2E1
*but is then inactivated by Glutathione in healthy individual |
|
|
Term
| where does the efficacy come from in a combination analgesic |
|
Definition
it comes from the NSAID
(side effects come from opioid component) |
|
|
Term
| advil liquigel effect on pharmacodynamic and kinetics |
|
Definition
higher Cmax (higher peak blood level_
lower Tmax (quicker onset) |
|
|
Term
| a benefit of naproxen sodium |
|
Definition
increased staying power
(--ve not as good on GI) |
|
|
Term
| study of arthritis and autoimmune diseases |
|
Definition
|
|
Term
|
Definition
| synovial membranes of diarthrodial joints |
|
|
Term
| most significant factor in dependence |
|
Definition
|
|
Term
|
Definition
increased dopamine
tachycardia
hypertension
hyperthermia |
|
|
Term
| a primary screen is qualitative/quantitative |
|
Definition
| qualitative--tells WHAT is in system |
|
|
Term
| cocaine has a low/high T 1/2 and is biotransformed by ______ |
|
Definition
LOW (only 30-60 min drug duration
plasma cholinesterase |
|
|
Term
| active metabolite of cocaine when consuming alcohol |
|
Definition
|
|
Term
|
Definition
|
|
Term
| developing tolerance very quickly |
|
Definition
|
|
Term
| drugs used to combat cocaine addiction |
|
Definition
bromocryptine (DA agonist, parkinson drug)
antidepps |
|
|
Term
| belladonna alkaloids include which 2 drugs, and have what pharmacological activity |
|
Definition
atropine, scopolamine
anticholinergics |
|
|
Term
| active metabolite in shrooms |
|
Definition
psilocin
(metabolized from psilocybin) |
|
|
Term
tryptaminergic drugs are similar to which endogenous substance
-and include which abused drug |
|
Definition
similar to serotonin
LSD is a tryptaminergic |
|
|
Term
| T/F LSD produces hallucinations, illusions, synethesia |
|
Definition
NOT hallucinations (unless person psychotic)
but does produce illusions and synethesia (hearing a color...) |
|
|
Term
which drugs produce visual pseudohallucinations?
which drugs also produce audio pesudohallucinations? |
|
Definition
LSD, mescaline, psyocybin, amphetamines
belladonna alkaloids have visual AND audio pseudohallucinations |
|
|
Term
| a very common side effects of belladonna alkaloids |
|
Definition
|
|
Term
| writing a schedule II prescription requires... |
|
Definition
DEA registration
state medical license |
|
|
Term
| protocol for emergency schedule II prescription |
|
Definition
limited to amount required
original Rx within 7 days |
|
|
Term
| requirements for office use substances.. |
|
Definition
detailed inventory
site-specific DEA registration
detailed dispensing records |
|
|
Term
| an opioid addict can develop tolerance to many effects except for... |
|
Definition
pupillary constriction
constipation |
|
|
Term
| an early sign of an NSAID overdose |
|
Definition
|
|
Term
| which type of diabetes is ketosis prone |
|
Definition
type 1
-breakdown in mm./fat to produce ketone bodies as energy
-leads to kidney problems |
|
|
Term
| type of diabetes that involves an imbalanced supply and demand |
|
Definition
type II
-body can't produce enough insulin for the high CHO |
|
|
Term
|
Definition
CV
kidney failure
neuropathy
blindness (optic nerve damage)
infections --> amputation |
|
|
Term
| oral presentation of an uncontrolled diabetic |
|
Definition
dry mouth
exaggerated response to irritants (think dentures) |
|
|
Term
insulin action on
-fat
-ptein
-CHO |
|
Definition
fat: increased synth, decreases lipolysis
ptein: decrease breakdown, increase synth and AA uptake
CHO: increased CHO mvmt, less gluconeogenesis, increased glycogen synth |
|
|
Term
| T/F insulin has 3 chains, and has a pro form |
|
Definition
insulin has 2 chains (A + B)
it does have a pro form: proinsulin |
|
|
Term
| pathway of insulin release...starting with glucose entry |
|
Definition
glucose entry
ATP produced
K channel closes
cell depolarizes (++++)
Ca ENTERS (more ++++)
Insulin released |
|
|
Term
|
Definition
|
|
Term
|
Definition
pentazocine
nalbuphine
dezocine |
|
|
Term
| morphine's active metabolite |
|
Definition
M-6-G morphine-6-glucuronide
-high affinity for mu receptor
-high buildup in chronic user (so they can take less drug) |
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