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nonopioid
| Question | Answer |
|---|---|
| pain receptors are noiceptors, this is how we feel pain | |
| Perception is the | physical pain |
| Reaction is the | emotional response |
| pain threshold define | the pain we feel before we reeact |
| What decreases pain tolerance? | anxiety, fatigue, anger, fear, depression, discomfort, pain, isolation |
| What increases pain intolerance? | sleep, rest, empathy, specific medications:analgisics, antidepression, antianxiety |
| describe nonopiodsanalgesic effect:mechanism of action (how and where they act):addictiveness: | nonnarcotic relieve mild painBlock 'cOXlocated at peripheral nerve endingsinteferes with perception (physical)antipyretic |
| describe opiodsanalgesic effect:mechanism of action (how and where they act):addictiveness: | narcotic (schedule 1 drug)relieve high paindepress CNS reaction to pain only by Rxcontrolled substance |
| define antipyretic | fever reducer |
| name 3 categories of nonopiods | salicylate (aspirin)anti inflammatory (NSAID-momtrine)actetamiophen (tylenol) |
| true or false: all salicylates are not aspirins | true |
| Salicylate mechanism of action? | Block COX-inhibit prostagladin(iinflammatory response)less prostagladin=no hypersensitivity to bradykinin |
| What does COX 1 do | responsible for homeostatic function (protective function)side affects |
| What does COX 2 do | inflammmatory response |
| Name 4 pharm effects of salicylates | Analgesic-pain relieverAntipyretic-fever reducerAntiinflammatoryAntiplatelet-thin blood (reduce blood clots)reduce heart attack |
| Aspirin is dose dependent | |
| ______place aspirin on any tissue seeking relief | DO NOTacid will burn tissue |
| Aspirin is rapidly absorbed from the stomach and small intestine with peak effect in about 30 minutes on an empty stomach. | Zero order kinetics-constant rate |
| 2 Forms of salicylates administration | oral and topical |
| What is the adult dose for aspirinWhat is the dose for MI stroke | 325-650mg per 4 hr81 mg daily |
| What is the adverse effect of aspirin | GI irritation increases Bleeding (decrease prothrombin)Reyes Syndromehepatic rebal effectpregnanytoxicityhypersensitivity |
| What is Reyes syndrome | Can occur when aspirin is given to children/adolescents with chicken pox or influenzacauses brain damage give tylenol instead |
| What are adverse reactions of aspirin | Kidney:necrosisPregnancy: cause still birth, congential birth defect,low birth weight, delay labor delivery, increased risk of hemorrhageexcreted in breastmilk |
| Aspirin allergy what is it called? | Asthmatic triadAsthmaNasal polypsAllergy to aspirin |
| define salicylism | aspirin toxicity |
| How to treat aspirin toxicity | Take patient to hospital Induce vomiting - to remove aspirin from the system Ingest activated charcoal to absorb aspirin |
| Drug interactions with aspirin | |
| Aspirin + Coumadin (Warfarin) = | increased bleeding (reduces the formation of blood clots) |
| Aspirin + antihypertensives = | reduced effect to lower blood pressure |
| Aspirin + Probenecid (Benemid) = | reduced uricosuric effect of probenecid.do not use to prevent gout could cause an acute gout attack. |
| Dental significance of taking aspirin | Avoid recommending drugs that cause GI irritation or prolong bleedingAsk patients about allergy to aspirinIf taken prior to instrumentation, may have more bleeding than normal. Do not take for dental pain |
| NSAID | |
| What drugs are NSAIDS | ibuprofen (advil,motrine) 400-800mg)naproxenmotrine |
| Administration? | orally (1-2)food slows rate |
| Mechanism of action | block COX |
| Pharm effect | analgesicantiinflammatoryantipyretic |
| NSAIDS reveres antiplatelet | |
| Why do ppl use NSAIDS | Tx of arthritis Reduce dental painreduce feverTx of gout (anti-inflammatory & analgesic effects)Tx of dysmenorrhea (menstrual pain) |
| Naproxen will not allow lithium to be removed. This causes danger | ppl that take lithium for psych disorders should not take naproxen |
| State the normal adult dose for ibuprofen. | 400-800mg |
| name a drug that inhibits only COX 2 | Celebrax(for arthritis)Celecoxib is the generic name |
| why are some COX 2 inhibitors are off the market? | causes heart attack |
| What are adverse reactions for NSAIDS | GI Irritationulcerspain/bleedingif you have kidney disease, may cause failureif allergic to aspirin do not take NSAID |
| Drug interactions | |
| Lithium | NSAIDS reduce clearance of lithium & could lead to toxicity |
| antihypersensitive | NSAIDS reduce effectiveness |
| MethotrexateDigoxin | increase toxicity levels |
| contraindications | asthma - causes bronchoconstriction in aspirin sensitive asthmaticscardiovascular & renal disease when there is fluid retentionPoor clotting - acts to add to the problemliver failurePregnancy- consult with OB |
| acetaminophen | |
| State the trade (brand) name for acetaminophenpharmacologic effects?state the normal adult dose | tylenolantipyretic, analgesic325-650mg |
| pharmacokinetics | absorbs by GI tract |
| No GI irritation or effect on platelets | |
| adverse reactions | At high doses can lead to liver damage If extended toxic doses remain can cause brain damage, coma, and deathSingle lg dose causes anorexia, nausea, vomiting, abdominal pain |
| Identify 2 major contraindications/precautions for using acetaminophen. | People with liver damage should NOT take acetaminophenSteven Johnson |
| List limits of acetaminophen dosages for different types of drinkers | Max dose non-drinker= 3000mgMax dose moderate drinker (<3)= 1500mg Max dose heavy drinker(>=3)=none |
| Gout | |
| Define the term, uricosuric. | Uricosuric refers to medications or substances that increase the excretion of uric acid in the urine |
| how is gout treated | NSAIDSPrescription Colchicine |
| State why patients with gout who take probenecid should not take aspirin | because aspirin decreases the excretion of urisic acid |
| Recognize the following as types of drugs used in the treatment of migraines | a. Antidepressantsb. Blood pressure medicationsc. Anticonvulsantsd. NSAIDSe. Botulinum Toxin Type A |
| (tylenol) + Codeine = | Tylenol # 1,2, 3 or 4 |
| Acetaminophen +oxycodone = | Percocet |
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