Analgesics and Types of Pain

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Questions and Answers

Which medication selectively inhibits COX-2?

Nabumeton

Tiaprofenat

Nimesulide

Meloxicam (correct)

What is the primary clinical use of Celecoxib?

To lower cholesterol levels

To relieve asthma symptoms

To increase platelet aggregation

For rheumatoid arthritis and osteoarthritis (correct)

Which statement is true regarding Nabumeton?

It is primarily used for acute gout management.

It is an acidic medication.

It is a pro-drug that becomes active in the body. (correct)

It effectively inhibits prostacyclin.

What is the mechanism of action of colchicine in treating gout?

Inhibits inflammation and pain in joints. Signup and view all the answers

Which of the following is NOT a method to lower uric acid levels in the blood?

Promoting uric acid production. Signup and view all the answers

What is a potential systemic effect of decreased PGE2 and PGI2 synthesis?

Hemostatic disturbances in the kidneys Signup and view all the answers

What is the primary route of excretion for salicylates?

Urine Signup and view all the answers

What is one major contraindication for the use of certain analgesics like aspirin?

Peptic ulcer disease Signup and view all the answers

Which of the following is NOT a potential side effect of analgesic medications mentioned?

Skin rash Signup and view all the answers

How does acetaminophen primarily exert its effects?

By inhibiting prostaglandin synthesis in the central nervous system Signup and view all the answers

What is the primary function of analgesics?

Inhibit the perception of pain Signup and view all the answers

Which of the following is an example of a non-causal peripheral analgesic?

Local anesthetics Signup and view all the answers

Which analgesic is classified as a narcotic?

Heroin Signup and view all the answers

What type of pain is characterized by a fast response from stimulation of skin and mucous membranes?

Superficial pain Signup and view all the answers

Which of the following is NOT classified as a type of non-narcotic analgesic?

Morphine Signup and view all the answers

What is the effect of central analgesics on pain?

Act on the cortex and thalamus Signup and view all the answers

What distinguishes mild analgesics from strong analgesics?

The extent of pain relief provided Signup and view all the answers

Which of the following is an endogenous opiate?

Endorphins Signup and view all the answers

Which strong analgesic is known for being 10 times stronger than Morphine?

Heroin Signup and view all the answers

What is the primary concern associated with the use of Morphine?

It is highly addictive. Signup and view all the answers

Which type of strong analgesic is used to alleviate withdrawal symptoms in Heroin addicts?

Methadone Signup and view all the answers

What differentiates Codeine from Morphine?

Codeine contains a different chemical group. Signup and view all the answers

Which synthetic strong analgesic is a combination of acetaminophen and hydrocodone?

Vicodin Signup and view all the answers

Which of the following is NOT a type of strong analgesic discussed?

Topical Signup and view all the answers

What characteristic makes Heroin particularly dangerous compared to other strong analgesics?

It is incredibly addictive. Signup and view all the answers

What is one of the main reasons why strong analgesics like Demerol are used?

To stop muscle spasms. Signup and view all the answers

What is one reason Spanish settlers initially banned cocaine?

It led to a decline in productivity among slaves. Signup and view all the answers

What year did cocaine become classified as a narcotic in the United States?

1914 Signup and view all the answers

Which of the following is a primary use of Procaine (Novacaine)?

For temporary numbing in dentistry. Signup and view all the answers

Which component of cocaine's action allows it to function as a local anesthetic?

Sodium channel blockage. Signup and view all the answers

What percentage of alkaloidal cocaine is typically found in the coca plant leaves?

0.6% - 1.8% Signup and view all the answers

What method is used to extract cocaine from coca leaves?

Soaking in kerosene and sulfuric acid. Signup and view all the answers

What physiological effect is NOT commonly associated with cocaine use?

Decreased respiration rate. Signup and view all the answers

Which derivative of cocaine is known for being the first injectable man-made local anesthetic?

Procaine (Novacaine). Signup and view all the answers

Study Notes

Analgesics

Analgesics are drugs that decrease the sensation of pain
Peripheral analgesics can be classified as causal and non-causal
- Causal analgesics treat the cause of pain, such as atropine for antispasmodic effects
- Non-causal analgesics do not treat the cause of pain
  - Examples include local anesthetics for superficial pain and counter-irritants like acupuncture
Central analgesics are further categorized as narcotics and non-narcotics
- Narcotics include opioids like morphine and its derivatives, offering potent pain relief but with high addictive potential
- Non-narcotics include NSAIDs, providing milder pain relief and anti-inflammatory properties

Types of Pain

Superficial pain arises from stimulation of the skin and mucous membranes, providing a fast response
Deep pain originates from muscles, joints, tendons, and internal organs, resulting in a slower response

Classification of Analgesics

Analgesics can be categorized as mild or strong, based on their pain-relieving capabilities
- Mild analgesics include aspirin, ibuprofen, acetaminophen
- Strong analgesics include opium, heroin, codeine

Aspirin

Aspirin is a common analgesic with antipyretic (fever-reducing) and anti-inflammatory properties
It inhibits the synthesis of prostaglandins (PGs), crucial for pain, fever, and inflammation
Commonly used for headaches, muscle aches, and fever
Side effects include gastric irritation, allergic reactions, and potential bleeding complications

Acetaminophen (Paracetamol)

Acetaminophen is another common analgesic with antipyretic properties
Similar to aspirin, it acts centrally to inhibit PG synthesis, but with less anti-inflammatory effect
Commonly used for mild to moderate pain and fever

Central Analgesics

Narcotics, like opioids, act on the cortex and thalamus, affecting the perception of pain
They have potent pain-relieving effects but come with high addictive potential
Naloxone, nalorphine, and levallorphan are antagonists for opioids, reversing their effects
Non-narcotics, like NSAIDs, primarily act on subcortical regions, like the thalamus
They exhibit weaker analgesic effects but often provide anti-inflammatory benefits
Examples include aspirin, paracetamol, diclofenac, piroxicam, ibuprofen, ketoprofen

Gout

Gout is a condition characterized by the accumulation of uric acid in joints, kidneys, and other tissues
It causes painful inflammation and stiffness in the affected joints

Management of Gout

Gout management involves two primary approaches:
- Addressing acute gout attacks with medications like colchicine, NSAIDs, or corticosteroids
- Reducing uric acid levels in the blood
  - Medications like probenecid and sulfinpirazon increase uric acid excretion
  - Medications like allopurinol inhibit the synthesis of uric acid

Strong Analgesics

Strong analgesics are primarily used for severe pain associated with injuries, heart attacks, or chronic conditions like cancer
They are typically derived from the opium poppy or manufactured synthetically
Strong analgesics can be categorized as natural, semi-synthetic, or synthetic
They are often addictive and require a prescription

Morphine

Morphine is a naturally occurring analgesic found in the opium poppy
Recognized for its potent pain-relieving properties but also its high addiction potential
Commonly used in hospitals for managing severe pain
Available in various forms (injectable, smoked, sniffed, swallowed)
Highly addictive and often misused

Codeine

A commonly used strong analgesic
Similar to morphine with a slightly modified chemical structure
Offers pain relief comparable to Tylenol but is less potent and addictive than morphine
Often combined with Tylenol for milder pain relief

Heroin

Synthesized from morphine using an esterification reaction
Highly addictive and much stronger than morphine
Rapidly absorbed into the brain, delivering a potent "high"
Associated with various social problems like addiction, prostitution, and AIDS

Other Synthetic Strong Analgesics

Vicodin combines acetaminophen and hydrocodone, providing stronger pain relief than codeine but weaker than morphine
Hydrocodone is addictive and can cause euphoria
Demerol (meperidine) is used for moderate to severe pain relief, and to reduce muscle spasms
Methadone is a synthetic opioid weaker than most other strong analgesics, designed to reduce euphoric effects and withdrawal symptoms
It is often used to manage heroin addiction

Cocaine

Cocaine is extracted from the coca plant and is highly addictive
Widely used recreationally due to its potent euphoric effects
Used clinically as a local anesthetic, especially for eye surgery
Modifies synthetic forms are used in dentistry (novocaine) and for sore throats (benzocaine)

Clinical Action of Cocaine

Acts as a reuptake inhibitor for dopamine, norepinephrine, and serotonin, impacting these neurotransmitters in the brain
Interacts with serotonin and muscarinic acetylcholine receptors, affecting cognitive function and mood
Influences sodium channels, contributing to its local anesthetic proprieties

Effects of Cocaine

Subjective effects include euphoria, increased sociability, heightened energy, and hypervigilance
Physiological effects include increased heart rate, increased respiration, body temperature, and blood pressure, as well as pupil dilation

Derivatives of Cocaine

Procaine (Novacaine) is a derivative of cocaine primarily used in dentistry for numbing the mouth
Lidocaine is a potent sodium channel blocker used as an anesthetic for various procedures, including heart arrhythmias, minor surgeries, and topical pain relief

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Description

This quiz covers the classification and types of analgesics, focusing on their role in pain management. It delves into peripheral and central analgesics, exploring the differences between narcotics and non-narcotics. Additionally, you'll learn about superficial and deep pain types.