Homework 4
Pain
Define:
What are the strategies for the Treatment of cancer pain
–
–
–
–
Define Opioids –
Opioid Receptors
What are the opioid receptors in pain management?
What happens when an opioid agonist is administered?
Opioid Antagonists
Act by –
Used to
–
–
What is the mechanism of action of Subutex?
What is the mechanism of action of Suboxone?
Morphine
Mechanism of action-
Usage-
Adverse effects-
Narcan (naloxone)
Mechanism of action-
Usage-
Adverse effects-
Cycolooxygenase (COX)
What do COX1 and COX2 do in the body?
Why were selective COX2 inhibitors desirable? Why were they developed?
Why is their use now limited?
Aspirin
Mechanism of action-
Usage-
Adverse effects-
Why must aspirin be discontinued 2 weeks prior to a procedure?
NSAIDS include:
Mechanism of action-
Usage-
Adverse effects-
Selective COX-2 Inhibitors include:
Mechanism of action-
Usage-
Adverse effects-
Acetominophen
Mechanism of action-
Usage-
Adverse effects-
Does acetaminophen and anti-inflammatory activity?
Migraine
Triptans
Prototype drug
Mechanism of action-
Usage-
Adverse effects-
Ergot Alkaloids (ergotamine, dihydroergotamine)
Mechanism of action-
Usage-
Adverse effects-
ANESTHESIA
Local anesthetics
5 techniques:
Esters
Prototype drug
Mechanism of action-
Usage-
Adverse effects-
Amides
Prototype drug
Mechanism of action-
Usage-
Adverse effects-
General Anesthesia
Stages of General Anesthesia
Stage I
StageII
Stage III
Stage IV
Inhalation Anesthesia
Prototype drugs
Volatile liquids –
Gases –
Mechanism of action-
Usage-
Adverse effects-
Invtravenous Agents
Barbituates & Barbituate-like
Prototype drug
Mechanism of action-
Usage-
Adverse effects-
Benzodiazepines
Prototype drug
Mechanism of action-
Usage-
Adverse effects-
Opioids used for General Anesthesia
Prototype drug – fentanyl
Mechanism of action-
Usage-
Adverse effects-
Inflammation
What is the purpose of inflammation?
What are the signs of inflammation?
Chemical Mediators
What does histamine do?
What do the 2 Histamine Receptors do?
H1:
H2:
Cyclooxygenase Inhibitors
NSAIDS
Aspirin
Mechanism of action
How is aspirin different than other NSAIDS?
Ibuprofen
Mechanism of action
COX-2 Inhibitors Rofecoxib
Mechanism of action
Adverse effects:
Systemic Glucocorticoids – hydrocortisone, prednisone
Mechanism of action
What are the serious adverse effects of glucocorticoids?
What precautions are taken when glucocorticoids are used for long-term treatment?
Define Antipyretics:
Prototype drug: acetaminophen
****Acetominophen treats pain and fever, but not inflammation***
Allergy and upper respiratory
Anti-Histamines (see above)
Prototype drug for allergies, 1st generation: diphenhydramine
Adverse effects:
Prototype drug for allergies, 2nd generation: fexofenadine (Allegra)
Adverse effects:
Why is drowsiness less than with 1st generation?
Intranasal Glucocorticoids (fluticasone (Flonase))
What is the mechanism of action
Why are these desirable drugs?
Cough
Non-opioid – dextromorphan
Mechanism of action:
Decongestants – (oxymetazoline)
Mechanism of action:
Asthma
Why are beta agonists used to treat asthma – how do they work?
Why must these drugs be given locally?
Prototype drug for short-acting beta agonists?
Prototype drug for long-acting beta agonists?
Side effects for beta agonists?
How are corticosteroids used to treat asthma?
What is the prototype drug for corticosteroids used to treat asthma?
What are the side effects?
Which drugs is used to terminate an allergy attack?
Which drugs are used to prevent asthma attacks?
What is the first step in treatment for asthma?
COPD
List COPD key indicators
List risk factors
What is the first step in treatment for COPD?
While the drugs are similar, what is different between treatment for Asthma and COPD?
Make sure you know the prototype drugs for COPD:
β2 – agonists
Short-acting
Salbutamol (albuterol)
Long-acting
Salmeterol
Anticholinergics
Short-acting
Ipratropium bromide
Long-acting
Tiotropium
Combination short acting β2 – agonists & anticholinergics
Salbutamol/
Ipratropium
Inhaled Glucocorticosteroids
Beclomethasone