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Chap - 19
PharmacologyHSC1149
| Question | Answer |
|---|---|
| experienced or perceived only by the individual | subjective |
| observation of patient's reaction to pain in terms of vital signs, position, & emotional response | objective |
| pain has both psychological and __ components | physiological |
| analgesics produced within the brain as a reaction to severe pain or intense exercise | endorphins |
| produced within the brain | endogenous |
| endorphins __ the transmission of pain | block |
| relief from pain as the result of suggestion without administration of an analgesic | placebo effect |
| classified as opioid, nonopioid, & adjuvant | analgesics |
| classified as full or pure agonist, partial agonist, or mixes agonist-antagonists depending on specific receptors they bind to & their activity at the receptor | opioids |
| commonly used because action similar to that of opium in altering the perception of pain | full agonists |
| medication level at which there is no enhanced analgesia is said to have no | ceiling to analgesic effects |
| morphine, hydromorphone, meperidine, oxycodone, & fentanyl will not __ __ like other classes | reverse analgesia |
| listed under controlled substance schedule and include both the natural alkaloids and synthetics | opioid |
| opioids tend to cause | tolerance |
| with chronic use opioids can also cause | dependence |
| addiction or psychological dependence is not a problem for patient's who require opioids for | pain management |
| dependence is irrelevant for __ __ and should not be a consideration | dying patients |
| more effective pain control can be achieved by combining opioids with nonopioid & __ drugs | adjuvant |
| around-the-clock dosing, for terminally ill patients, prevents | pain from developing |
| sometimes in the management of chronic pain therapy there is the addition to the analgesic regimen of | tricyclic antidepressants or anticonvulsants |
| adjuvant analgesics __ the analgesic effects | enhance |
| sedation, confusion, euphoria, restlessness/agitation, headache/dizziness, hypotension/bradycardia, urinary retention, nausea/vomiting, constipation, resp. distress, blurred vision, flushing, rash, pruritis are all | side effects of opioids |
| in large doses of opioids a side effect can be | seizures |
| head injuries, cardiac disease, hypotension, CNS depression, hepatic/renal/thyroid disease, COPD, asthma, pregnancy, lactation, pediatrics, elderly suicidal, alcoholic are all | contraindications/extreme caution for opioids |
| higher doses of opioids are ___ for opioid-naïve patients | contraindicated |
| psychotropics, alcohol, sedatives/hypnotics, muscle relaxants, antihistamines, antiemetics, antiarrhythmics, antihypertensives are all CNS depressants that are interactions for opioids because of | potentiation of effect of opioids |
| perioperatively an opioid is frequently combined in a syringe with __ to reduce # of injections given concurrently | anticholinergics |
| preoperative meds are usually administered ___ 30-60 min. before start of anesthesia | intramuscularly |
| Meperidine is frequently combined with Phenergan postoperatively to__ analgesic effect | potentiate |
| available in various strengths, as concentrated oral solutions & in combination products | opioid antagonists |
| combination of morphine, for potentiation of analgesic effect, postoperatively is better for | older adults |
| used to treat opioid overdoses & in delivery room & newborn nursery for opiate-induced respiratory depression | opioid antagonists |
| Trade name Narcan; used to treat opioid overdoses & in delivery room & newborn nursery for opiate-induced respiratory depression | naloxone |
| Trade name ReVia; used to treat alcohol & opiate dependence; acts by robbing the drugs pleasurable effects | naltrexone |
| naltrexone is only used after withdrawal from opiates, such as __ & __, to help avoid relapses | morphine; heroin |
| if ReVia is given to someone currently dependent on opiates, it can send them into | instant severe life-threatening withdrawal |
| given for purpose of mild to moderate pain, fever, & anti-inflammatory conditions | nonopioids |
| nonopioids are also used as __ in severe acute or chronic pain requiring opioids | coanalgesics |
| aspirin, salsalate, & choline magnesium trisalicylate are | salicylates |
| salicylates are most commonly used for analgesic, __ & __ properties | antipyretic; anti-inflammatory |
| used for analgesic & antipyretic properties, but little effect on inflammation | acetaminophen |
| patient should be instructed to check the ingredients of all __ __ because of potentially serious side effects | combination products |
| salicylate analgesic & anti-inflammatory actions are associated primarily with preventing the formation of | prostaglandins |
| prolonged bleeding time, bleeding/frequent bruising, gastric distress, ulceration, & bleeding; tinnitus & hearing loss w/overdose; coma, resp. failure, or anaphylaxis; GI symptoms are all | side effects of salicylates & NSAIDs |
| GI ulcer & bleeding, bleeding disorders in patients taking anticoagulants, asthma, pregnancy, lactation, Vit.K deficiency are all | contraindications of salicylates & NSAIDs |
| anemia, hepatic disease, renal disease, Hodgkin's disease, pre/postoperatively are all | cautions of salicylates & NSAIDs |
| alcohol, anticoagulants, corticosteroids, antacids in high doses, insulin/oral antidiabetic agents, methotrexate, Probenecid, antihypertensives are all listed for | interactions with of salicylates & NSAIDs |
| severe liver toxicity, renal insufficiency, rash/uticaria, blood dyscrasias are rare, but all | side effects of acetaminophen |
| caution must be used with frequent acetaminophen use & alcohol ingestion because of potential | liver damage |
| centrally acting synthetic analgesic compound similar in effect to opioids, but chemically unrelated | tramadol (Ultram) |
| dizziness, somnolence, malaise, headache, nausea, constipation, sweating & pruritus, orthostatic hypotension, anxiety, confusion, rash, allergic reaction are all | side effects of tramadol |
| increased intracranial pressure/head injury, renal/hepatic disease, seizure disorders, pregnant/nursing, under 16 yr, abrupt discontinuation, opiate agonist hypersensitivity are all | contraindications of tramadol |
| may impair mental/physical abilities, & in older adults or anyone operating machinery | cautions of tramadol |
| MAOIs/neuroleptics (increase seizure risk), carbamazepine (antagonizes action), SSRIs (increase serotonin syndrome) are all | interactions for tramadol |
| originally intended for treatment of conditions other than pain | adjuvant analgesics |
| used in treatment of nerve pain associated w/herpes, arthritis, diabetes & cancer, migraines or tension headaches, insomnia, & depression | tricyclic antidepressants |
| tricyclic antidepressants actions are associated w/increasing available __ & __, which block pain transmission | norepinephrine; serotonin |
| Elavil, Pamelor, & Tofranil are common tricyclic antidepressants used for treating | pain |
| dry mouth, urinary retention, delirium, constipation, sedation, orthostatic hypotension, tachyarrhythmias, heart block in cardiac patients are all | side effects of tricyclic antidepressants |
| is used w/prostatic hypertrophy, urinary retention, increased intraocular pressure & glaucoma | cautions for tricyclic antidepressants |
| commonly used for nerve pain associated w/neuralgia, shingles, & cancer; implemented when patient described the pain as sharp, shooting, shock-like, or lightening-like | anticonvulsants |
| generally considered a first-line anticonvulsant or neuropathic pain therapy | Neurontin |
| Neurontin, Tegretol & Lamictal are all | anticonvulsant drugs |
| sedation, dizziness, & confusion; nausea, vomiting, constipation, & anorexia; hypotension & unsteadiness; bone marrow suppression; and hepatitis are all | side effects of anticonvulsant drugs |
| if used w/allergies, hepatitis, cardiac disease, & renal disease | cautions of anticonvulsant drugs |
| hypersensitivity, psychiatric conditions, pregnancy, SA & AV block, hemolytic disorders, & abrupt discontinuation are all | cautions for anticonvulsant drugs |
| alcohol, antacids, antineoplastics, CNS depressants, folic acid, Dilantin w/ any drug in solution, antiretrovirals can cause | interactions with anticonvulsant drugs |
| brand name for hydromorphone | Dilaudid |
| brand name for SR oxycodone | Oxycontin |
| brand name for hydrocodone w/acetaminophen | Lortab, Vicodin, & Lorcet |
| brand name for oxycodone w/aspirin | Percodan or Endodan |
| acetaminophen w/codeine 15mg | Tylenol #2 |
| acetaminophen w/codeine 30mg | Tylenol #3 |
| acetaminophen w/codeine 60mg | Tylenol #4 |
| Percodan is an opioid analgesic that contains | aspirin |
| used only infrequently as sedative-hypnotics because they have many serious, potentially dangerous side effects | barbiturates |
| adjuvant analgesic used in management of nerve pain associated w/neuralgia & other conditions | carbamazepine (Tegretol) |
| tricyclic antidepressant used to treat nerve pain associated w/migraine or tension headaches | amitripytyline (Elavil) |
| local anesthetic used for management of pain from postherpetic neuralgia | Lidoderm |
| Imitrex (sumatriptan) is prescribed in order to treat __ migraine headaches in adults | acute |
| abrupt withdrawal of hypnotics may results in rebound | insomnia |
| most common neurovascular headache & may cause nausea, vomiting, & sensitivity to light/noise | migraine |
| developed based on observation that serotonin levels decrease while vasodilation & inflammation of vessels in brain increase as migraine symptoms worsen | Serotonin Receptor Agonists (SRAs) |
| Phenobarbital is still used in the treatment of | seizure disorders |
| hypnotic benzodiazepine temazepam | Restoril |
| nonbenzodiazepine hypnotics zolpidem & zaleplon | Ambien, Sonata |
| daytime sedation, confusion & headache-hangover effect are side effects of | benzodiazepines |
| when a patient is applying a lidocaine patch, it must only be applied to __ skin | intact |
| drugs administered to calm, soothe, or produce sedation are called | sedatives |
| benzodiazepines & non-benzodiazepines are classified as | non-barbiturates |
| Benadryl is not desirable as sedative-hypnotics for use by older patients because it may have an extended half-life leaving the slower metabolism and impaired circulatory system of these patient | particularly susceptible to the side effects |
| sedative-hypnotic agents should prescribed for | short-term use only |
| codeine is considered ___ because it suppresses coughs | antitussive |
Created by:
lfrancois
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