Term
|
Definition
| a sensation that may indicate pathology |
|
|
Term
| Where is the pain stimulus from? |
|
Definition
| the peripheral nervous system |
|
|
Term
| What is pain interpreted by? |
|
Definition
| the central nervous system |
|
|
Term
|
Definition
| no, it may be perceived differently, there are different treatment options for individualized pain relief |
|
|
Term
| What pain is considered a standard that allows for comparison for clinical studies? |
|
Definition
| dental pain from a tooth extraction |
|
|
Term
| What are the two types of orofacial pain? |
|
Definition
| neuropathic and nociceptive |
|
|
Term
| What type of pain is neuropathic? What does it cause? |
|
Definition
-chronic pain
-causes damage to the nerve tissue(in or out of CNS) |
|
|
Term
| Does neuropathic pain occur in or outside of the CNS? |
|
Definition
| can occur in both inside or outside of the CNS |
|
|
Term
| What are some causes of neuropathic pain? |
|
Definition
-diabetic peripheral neuropathy
-trigiminal neuralgia |
|
|
Term
| What types of medications is neuropathic pain treated with? |
|
Definition
-analgesics
-antidepressants
-anticonvulsants |
|
|
Term
| Where do analgesics work? Can they effectively cross the blood brain barrier? |
|
Definition
| Work effectively in the PNS, can't effectively cross the blood brain barrier |
|
|
Term
|
Definition
| sensory receptor for painful stimulus found in the peripheral nervous system |
|
|
Term
| What type of pain is nociceptive? What is it caused from? |
|
Definition
-acute pain
-caused from injury or stimulus |
|
|
Term
| What are some causes of nociceptive pain? |
|
Definition
| toothache, surgery, lesions |
|
|
Term
| What is nociceptive pain treated with? |
|
Definition
-NSAIDs
-acetaminophen
-narcotics(opioids) |
|
|
Term
| What are some big differences between opioids and nonopioids? |
|
Definition
-Different sites of action
-Different mechanisms of action |
|
|
Term
| What are the sites of action for opioids? Nonopioids? |
|
Definition
Opioids- within CNS
Nonopioids- within PNS |
|
|
Term
| What are the mechanisms of action for opioids? Nonopioids? |
|
Definition
Opioids- depresses the CNS
Nonopioids- inhibits prostaglandin synthesis |
|
|
Term
| What can nonopioids be divided into? |
|
Definition
-salicylates
-acetaminophen
-NSAIDs |
|
|
Term
| What does NSAIDs stand for? |
|
Definition
| non-steroidal anti-inflammatory drugs |
|
|
Term
| What is prostaglandin synthesis? |
|
Definition
| phospholipids converted to arachidonic acid by phospholipase A |
|
|
Term
| What is prostaglandin synthesis inhibited by? |
|
Definition
|
|
Term
| What do corticosteroids treat? |
|
Definition
| chronic inflammation(asthma, arthritis |
|
|
Term
| What are two common corticosteroids? |
|
Definition
-Prednisone
-Dexamethasone |
|
|
Term
| What happens in prostaglandin synthesis after arachidonic acid is made? |
|
Definition
| converted by cyclooxygenase enzymes to prostglandins |
|
|
Term
| What is the abbreviation for cyclooxygenase enzymes? |
|
Definition
|
|
Term
|
Definition
| prostaglandins that assist platelets, kidneys, and GI tract |
|
|
Term
|
Definition
|
|
Term
|
Definition
| produces prostaglandins that cause pain, fever, and inflammation |
|
|
Term
| What is COX-2 produced in response to? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is another nae for aspirin? |
|
Definition
| acetylsalicylic acid(ASA) |
|
|
Term
| What type of receptor is aspirin? |
|
Definition
| noncompetitive enzyme inhibitors |
|
|
Term
| What is the mechanism of aspirin? What is the administration of aspirin? |
|
Definition
Mechanism-irreversibly inhibits COX enzymes(binds to and blocks COX 1,2,3 enzymes)
Administration-predominantly oral |
|
|
Term
| How quickly is aspirin absorbed? When are the peak effects seen? |
|
Definition
Absorption- 30 mins after ingestion
**Peak effects seen 2 hours** |
|
|
Term
| What are the pharmacologic effects of salicylates? |
|
Definition
| relieves pain, fever, inflammation, reduced clotting |
|
|
Term
| What are the adverse reactions of salicylates? Why do these occur? |
|
Definition
-GI tract distress
-bleeding problems
-Reye's Syndrome
-hepatic and renal effects
-teratogenicity
-allergies
*Occur because these are related to COX 1 enzyme and aspirin blocks this enzyme* |
|
|
Term
| Does GI tract distress indicate an allergy to salicylates? |
|
Definition
| no, it is a normal side effect |
|
|
Term
| What is Reye's syndrome? Who should not take aspirin? |
|
Definition
| kids under age 6 should not take it due to possible development of Reye's syndrome which is buildup of fluid in the skull related to a virus |
|
|
Term
| Can Reye's syndrome be fatal? |
|
Definition
|
|
Term
| What can frequent use of aspirin in pregnant people result in? |
|
Definition
| can result in still borns, shows teratogenic effects |
|
|
Term
| What are the symptoms of toxicity of aspirin? What causes it? |
|
Definition
-due to overdose
-headache
-dizziness
-nausea
-vision problems |
|
|
Term
| What can the breakdown of liver cause? |
|
Definition
|
|
Term
| What happens when aspirin is taken with warfarin? |
|
Definition
|
|
Term
| What happen when aspirin is taken with alcohol? |
|
Definition
|
|
Term
| What happens when aspirin is taken with probcecid(treats gout)? |
|
Definition
| a decrease in aspirin excretion |
|
|
Term
| What happens when aspirin is taken with methotrexate (taken with cancer and autoimmune diseases)? |
|
Definition
| increased bleeding, and aspirin decreases methotrexate excretion |
|
|
Term
| What happens when aspirin is taken with sulfonylureas(taken for diabetes) ? |
|
Definition
| decreased sulfonylrea excretion |
|
|
Term
| What happens when aspirin is taken with antihypertensives? |
|
Definition
| the aspirin decreases the antihypertensive effectiveness |
|
|
Term
| Why do a majority of these drug to drug interactions occur with aspirin? |
|
Definition
| because of an increased risk of bleeding |
|
|
Term
| What is another name for acetaminophen? |
|
Definition
|
|
Term
| What is the mechanism of acetaminophen? Administration? |
|
Definition
Mechanism- competitive inhibitor of COX enzymes
Administration- predominately oral |
|
|
Term
| When does absorption of acetaminophen occur? What are the pharmacologic effects? |
|
Definition
Absorption- peak effects at 30-60 mins
Pharmacologic effects- relieves pain and fever |
|
|
Term
| Does acetaminophen relieve inflammation? |
|
Definition
|
|
Term
| What are the adverse reactions of acetaminophen? |
|
Definition
| hepatic and renal toxicity, methemoglobinemia |
|
|
Term
| What is methemoglobinemia? What is a sign of this? |
|
Definition
| hemoglobin that cannot bind to oxygen, cynanosis around lips is a sign of this |
|
|
Term
| When does toxicity occur? What are signs of this? |
|
Definition
-occurs after overdose
-nausea, vomiting, anorexia, renal necrosis(kills kidney) |
|
|
Term
| What are the drug interactions of acetaminophen? |
|
Definition
| other than alcohol, essentially none, but some may exacerbate hepatic toxicity |
|
|
Term
| What does alcohol do when taken with acetaminophen? |
|
Definition
| forces/induces acetaminophen to use Phase I metabolism, cytochrome P450 enzyme metabolite produced is toxic to the liver |
|
|
Term
| What type of receptor is acetaminophen? Is it reversible? What type of metabolism does it generally go through? |
|
Definition
| competitive inhibition, reversible, generally goes through phase II metabolism |
|
|
Term
| What is the mechanism of NSAIDS? |
|
Definition
| reversibly inhibits COX-1/3 and COX-2 enzymes |
|
|
Term
| How are NSAIDs administered? |
|
Definition
|
|
Term
| When does absorption of NSAIDs occur? What does it depend on? |
|
Definition
| absorption occurs 1-2 hours after ingestion, depends on food |
|
|
Term
| Are NSAIDs competitive? Reversible? |
|
Definition
| they are competitive and reversible |
|
|
Term
| Are NSAIDs better absorbed in a full or empty stomach? Why? |
|
Definition
| better absorbed on an empty stomach because they are weak acids |
|
|
Term
| What are the pharmacologic effects of NSAIDs? |
|
Definition
-relieves pain
-fever
-inflammation
-reduced clotting |
|
|
Term
| How are NSAIDs compared to acteaminophen? Aspirin? |
|
Definition
| does more then acetaminophen, works as well as aspirin but it is not as harsh |
|
|
Term
| What are some adverse reactions of NSAIDs? |
|
Definition
-ulceration
-CNS depression
-sedation
-convulsions
-renal effects in people with renal disorders
-oral effects
-allergy |
|
|
Term
| If you are allergic to aspirin should you take NSAIDs? |
|
Definition
| no, if you are allergic to aspirin you are likely allergic to NSAIDs |
|
|
Term
| What is the toxicity of NSAIDs? |
|
Definition
| similar to those with salicylates (aspirin) |
|
|
Term
| What happens when NSAIDs are taken with lithium? |
|
Definition
| decreased lithium excretion |
|
|
Term
| What happens when NSAIDs are taken with digoxin(treats cardiovascular conditions)? |
|
Definition
| it increases digoxin effects |
|
|
Term
| What happens when NSAIDs are treated with antihypertensive medications? |
|
Definition
| opposes antihypertensive effects |
|
|
Term
| What happens when NSAIDs are taken with methotrexate? |
|
Definition
| increased bleeding, decreased mehotrexate excretion |
|
|
