1- Choosing analgesic
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Questions and Answers

What is a significant reason why many people avoid seeking dental care?

  • Lack of awareness about dental hygiene
  • Fear of pain (correct)
  • Fear of needles
  • Lack of insurance

    • Which type of pain usually has identifiable tissue damage and a predictable endpoint?

  • Acute pain (correct)
  • Neuropathic pain
  • Somatic pain
  • Chronic pain

    • How long must pain be present in order to be classified as chronic pain?

  • Greater than 3 months duration (correct)
  • Greater than 2 years duration
  • Greater than 6 months duration
  • Greater than 1 year duration

    • What physiological arousal is not usually seen in chronic pain compared to acute pain?

    <p>Increased pulse and respiratory rate</p> Signup and view all the answers

    According to the text, what is the most accurate and reliable indicator of the existence and intensity of pain?

    <p>Patient's report</p> Signup and view all the answers

    What is one misconception mentioned in the text?

    <p>Wait as long as possible before taking medication</p> Signup and view all the answers

    Which nociceptive process can pharmacologic control of pain be directed at, according to the text?

    <p>Initiation of impulses</p> Signup and view all the answers

    Which of the following is considered one of the most important and useful nonopioid analgesics in dentistry?

    <p>Acetaminophen</p> Signup and view all the answers

    Where do NSAIDs primarily act to prevent the synthesis and release of inflammatory mediators?

    <p>At the peripheral nervous system</p> Signup and view all the answers

    What substance do aspirin-like drugs prevent platelet production of?

    <p>Thromboxanes and Prostaglandins</p> Signup and view all the answers

    Which opioid analgesic is commonly used in dentistry?

    <p>all of the above</p> Signup and view all the answers

    What is a potential indication for aspirin-like drugs?

    <p>Reducing fever</p> Signup and view all the answers

    Which condition would be a contraindication for aspirin-like drugs?

    <p>Gastric ulcers</p> Signup and view all the answers

    What is a potential side effect of aspirin-like drugs mentioned in the text?

    <p>Nausea and vomiting</p> Signup and view all the answers

    For which medical condition might aspirin-like drugs be prescribed?

    <p>Thromboembolic disorders</p> Signup and view all the answers

    What is the most significant association with Reye’s syndrome as mentioned in the text?

    <p>Aspirin therapy</p> Signup and view all the answers

    When does Reye’s syndrome usually occur in infants and young children as per the text?

    <p>During a respiratory viral infection</p> Signup and view all the answers

    What has consistently demonstrated to be more effective than placebo or codeine for post-extraction pain as per the text?

    <p>650mg of aspirin</p> Signup and view all the answers

    What is the usual cause of acute encephalopathic symptoms and liver issues in infants and young children?

    <p>Reye’s Syndrome</p> Signup and view all the answers

    What is the maximum daily dosage of ibuprofen for adults?

    <p>3.2g</p> Signup and view all the answers

    What is the recommended dosage of ibuprofen for children aged 2-11 years?

    <p>7.5mg/kg qid</p> Signup and view all the answers

    Which medication is most frequently recommended for treating acute pain after 3rd molar surgery?

    <p>Ibuprofen</p> Signup and view all the answers

    What is the maximum daily dosage of Naproxen Sodium for adults as per the text?

    <p>1375mg</p> Signup and view all the answers

    How often should an adult take Naproxen Sodium after the loading dose according to the text?

    <p>q 6-8 h</p> Signup and view all the answers

    What is the half-life of Naproxen as mentioned in the text?

    <p>3-3.5 hours</p> Signup and view all the answers

    In what way is Naproxen Sodium similar to ibuprofen in providing relief of acute clinical pain?

    <p>Slower onset time</p> Signup and view all the answers

    What is the primary mechanism responsible for the gastrointestinal side effects of NSAIDs?

    <p>Inhibition of prostaglandin responsible for protecting the gastric lining</p> Signup and view all the answers

    Which NSAID has an irreversible effect on platelet cyclooxygenases?

    <p>Aspirin</p> Signup and view all the answers

    What is the most common side effect of NSAIDs according to the text?

    <p>Dyspepsia</p> Signup and view all the answers

    Which prostaglandin-related effect is unique to aspirin among NSAIDs?

    <p>Significantly prolongs bleeding</p> Signup and view all the answers

    What is the potential advantage of selective COX-2 inhibitors over other NSAIDs?

    <p>Selective inhibition of COX-2 enzymes, sparing COX-1 constitutive enzymes associated with maintaining gastrointestinal health</p> Signup and view all the answers

    What is the result of the selective inhibition of COX-2 enzymes by selective COX-2 inhibitors?

    <p>Limitation of gastrointestinal erosions, ulcers, and bleeding</p> Signup and view all the answers

    What adverse effect has been associated with rofecoxib and valdecoxib among selective COX-2 inhibitors?

    <p>Increase in myocardial infarctions and strokes</p> Signup and view all the answers

    What is the recommended choice for managing acute pain during late pregnancy?

    <p>APAP</p> Signup and view all the answers

    What potential risk is associated with the use of aspirin and NSAIDs in the third trimester of pregnancy?

    <p>Pulmonary hypertension of the newborn</p> Signup and view all the answers

    What is a potential complication of using non-opioid analgesics late in pregnancy?

    <p>Postpartum hemorrhage</p> Signup and view all the answers

    What is the mechanism through which aspirin and NSAIDs can affect labor?

    <p>Inhibiting contractions</p> Signup and view all the answers

    Which medication is generally thought to be equipotent to aspirin but with fewer side effects, and has an unclear mechanism of action?

    <p>Acetaminophen (Tylenol)</p> Signup and view all the answers

    What did the USFDA alert practitioners and consumers about regarding a specific medication?

    <p>Acetaminophen (Tylenol)</p> Signup and view all the answers

    What has resulted in the voluntary reduction of the maximum daily dose recommendation of a specific medication from 4000 mg to 3000 mg?

    <p>Acetaminophen (Tylenol)</p> Signup and view all the answers

    What is a known contraindication for APAP?

    <p>Hypersensitivity</p> Signup and view all the answers

    What is the primary risk associated with the combination of NSAIDs and Alcohol?

    <p>Gastrointestinal bleeding</p> Signup and view all the answers

    What is the maximum daily dosage of acetaminophen for adults according to the text?

    <p>3 gm/day</p> Signup and view all the answers

    What is the recommended dosage of acetaminophen for children over 12 years old?

    <p>325-650mg q4h</p> Signup and view all the answers

    What is a common side effect of centrally-acting analgesics mentioned in the text?

    <p>Nausea and vomiting</p> Signup and view all the answers

    How do centrally-acting analgesics relieve pain, according to the text?

    <p>By reducing the perception of pain in the CNS</p> Signup and view all the answers

    What is the first-pass effect of centrally-acting analgesics as mentioned in the text?

    <p>Only a small fraction of the absorbed drug reaches the analgesic receptors in the brain</p> Signup and view all the answers

    What is a significant contraindication for the use of centrally-acting analgesics?

    <p>Head injuries</p> Signup and view all the answers

    What physiological response is associated with increasing doses of centrally-acting analgesics?

    <p>Increased noxious side effects</p> Signup and view all the answers

    What area in the central nervous system is considered important to the perception of pain?

    <p>Medulla oblongata</p> Signup and view all the answers

    What is the primary difference between complete agonist and partial agonist-antagonist centrally-acting analgesics?

    <p>The mechanism of action</p> Signup and view all the answers

    Which is a Partial Agonist-Antagonist opioid

    <p>Pentazocine (Talwin)</p> Signup and view all the answers

    What is a significant difference between nonopioid analgesics and opioid analgesics?

    <p>Non Opioid analgesics have a ceiling effect on their analgesic response</p> Signup and view all the answers

    What is the potential risk associated with taking more than the prescribed dose of an acetaminophen-containing product in a 24 hr period?

    <p>Severe liver injury</p> Signup and view all the answers

    What is a common characteristic of combination analgesics with opioid and nonopioid components?

    <p>The nonopioid component limits the dose of the opioid</p> Signup and view all the answers

    What is the primary rationale for selecting a full agonist with minimal first-pass metabolism in managing acute pain in dentistry?

    <p>To improve the analgesic response</p> Signup and view all the answers

    What is a characteristic of long-acting local anesthetics used in perioperative pain management?

    <p>They can delay the onset of post procedural pain</p> Signup and view all the answers

    What distinguishes Opioid Analgesics from Nonopioid Analgesics?

    <p>Non Opioids have a ceiling effect on their analgesic response</p> Signup and view all the answers

    What is the FDA's recommendation regarding acetaminophen prescription combination drug products with more than 325 mg?

    <p>To discontinue prescribing and dispensing them</p> Signup and view all the answers

    In which scenario have cases of severe liver injury with acetaminophen occurred, according to the FDA statement?

    <p>When taken with alcohol</p> Signup and view all the answers

    What action does the FDA recommend for pharmacists who receive a prescription for a combination product with more than 325 mg of acetaminophen per dosage unit?

    <p>Contact the prescriber to discuss a lower dose of acetaminophen</p> Signup and view all the answers

    What is the consequence of taking more than 325 mg of acetaminophen per dosage unit, according to the FDA statement?

    <p>Added risk of severe liver injury from inadvertent overdose</p> Signup and view all the answers

    What is the recommended dosage of Ibuprofen for mild postoperative dental pain?

    <p>200-400mg every 4-6 hours as needed</p> Signup and view all the answers

    What is the maximum daily dosage of Advil Dual Action for individuals aged 12 years and older?

    <p>6 caplets in 24 hours</p> Signup and view all the answers

    Which combination of medications is recommended for severe postoperative dental pain after the initial fixed interval period?

    <p>Ibuprofen (400-600mg) with Acetaminophen (650mg) with hydrocodone (10 mg) q 6hrs: Fixed interval for 24-48 hrs, then ibuprofen (400-600mg) with Acetaminophen (500 mg) q 6 hrs prn pain</p> Signup and view all the answers

    What is the primary action of Codeine in the CNS?

    <p>Alters perception and emotional response to pain</p> Signup and view all the answers

    What drug interaction should be considered when prescribing Codeine?

    <p>CNS depressants</p> Signup and view all the answers

    How often should acetaminophen be taken for mild pain or fever?

    <p>Every 4 to 6 hours</p> Signup and view all the answers

    What is the maximum daily dose of acetaminophen recommended for adults?

    <p>3 grams</p> Signup and view all the answers

    How does acetaminophen relieve fever?

    <p>By central action in the hypothalamic heat regulating center</p> Signup and view all the answers

    What is the maximum daily dose of Motrin for adults?

    <p>3.2 grams</p> Signup and view all the answers

    Which adverse reaction is associated with the respiratory system when taking Motrin?

    <p>Bronchospasm</p> Signup and view all the answers

    Which medication interaction may decrease the effectiveness of antihypertensives?

    <p>Motrin</p> Signup and view all the answers

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