Opioid and Non-Opioid Analgesics Overview
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Questions and Answers

What is the mechanism of action of Tramadol?

  • Agonizes the Mu opioid receptor while inhibiting reuptake of serotonin and norepinephrine (correct)
  • Blocks NMDA receptors
  • Acts only as a Kappa agonist
  • Inhibits reuptake of dopamine and norepinephrine
  • Which side effect is associated with Tramadol use?

  • Bradypnea (correct)
  • Hypotension
  • Constipation
  • Tachycardia
  • What is a contraindication for using Tramadol?

  • Concurrent use with SSRIs (correct)
  • Controlled substance regulation
  • Chronic pain over 6 months
  • Opioid dependence
  • What is indicated use of Buprenorphine?

    <p>Treatment of opioid dependence</p> Signup and view all the answers

    How should the dosage of a new opioid be adjusted when switching medications?

    <p>Decrease the dose by 25% to 50% to manage overdose risk</p> Signup and view all the answers

    Which of the following is a potential risk when using Tramadol?

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

    In which circumstance is Buprenorphine not recommended?

    <p>For chronic pain management</p> Signup and view all the answers

    What is the recommended percentage of total daily Morphine milligram equivalents (MME) reserved for PRN dosing?

    <p>10-15%</p> Signup and view all the answers

    What interaction concern exists with Tramadol?

    <p>Risk of serotonin syndrome with SSRIs</p> Signup and view all the answers

    What is the therapeutic ceiling effect in the context of Buprenorphine?

    <p>Signifying a limit to its analgesic effect</p> Signup and view all the answers

    What is the primary mechanism of action of aspirin in relation to platelet aggregation?

    <p>It acetylates cyclooxygenase, preventing thromboxane A(2) synthesis.</p> Signup and view all the answers

    Which of the following is a potential side effect of overdose with acetaminophen?

    <p>Oxidative damage to hepatocytes due to NAPQI production.</p> Signup and view all the answers

    In what scenario is acetaminophen recommended as a first-line treatment?

    <p>For pregnant patients.</p> Signup and view all the answers

    What is the recommended maximum daily dose of acetaminophen?

    <p>4 grams</p> Signup and view all the answers

    Which of the following statements about NSAIDs is true?

    <p>Consideration is necessary in patients with excessive alcohol consumption.</p> Signup and view all the answers

    What is a contraindication for the use of aspirin?

    <p>History of gastrointestinal bleeding.</p> Signup and view all the answers

    Which of the following parameters may require renal dosing adjustments when using acetaminophen?

    <p>Creatinine clearance less than 30</p> Signup and view all the answers

    What is the reason for aspirin's irreversible effect on platelet aggregation?

    <p>Acetylation of cyclooxygenase prevents new cyclooxygenase formation in nuclear-free thrombocytes.</p> Signup and view all the answers

    What is the primary mechanism of action of acetaminophen?

    <p>Antipyretic and analgesic properties</p> Signup and view all the answers

    Which of the following is an important adverse effect of acetaminophen?

    <p>Liver toxicity at high doses</p> Signup and view all the answers

    What is a primary therapeutic use for acetaminophen?

    <p>Relief of fever</p> Signup and view all the answers

    What consideration should be made regarding the dosing of acetaminophen?

    <p>Dosage may need adjustment in individuals with liver impairment</p> Signup and view all the answers

    Which of the following conditions should contraindicate the use of acetaminophen?

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

    In terms of side effects, which of the following is NOT typically associated with acetaminophen?

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

    What is a distinguishing feature of acetaminophen compared to NSAIDs?

    <p>Primarily acts as an analgesic and antipyretic</p> Signup and view all the answers

    Which patient population requires careful monitoring when administering acetaminophen?

    <p>Individuals with chronic alcohol use</p> Signup and view all the answers

    Which mechanism of action does NOT apply to acetaminophen?

    <p>Anti-inflammatory pathway activation</p> Signup and view all the answers

    In cases of overdose, which intervention is crucial for patients who have taken excessive acetaminophen?

    <p>N-acetylcysteine (NAC) therapy</p> Signup and view all the answers

    Study Notes

    Opioid Analgesics

    • Morphine is a strong opioid agonist with a high risk of overdose.
    • Converting to a different opioid should be done with a 25% to 50% dose reduction to avoid overdose due to incomplete cross-tolerance and individual variability in opioid pharmacokinetics.
    • 10-15% of total daily MME (Morphine milligram equivalents) should be reserved for PRN (as needed) dosing.
    • Tramadol binds to the Mu opioid receptor and inhibits serotonin and NE reuptake.
    • Tramadol should be avoided in patients taking SSRIs due to the risk of serotonin syndrome.
    • Tramadol is not approved for use in children and XR products should be avoided in patients with CrCL < 30 or severe hepatic impairment.
    • Buprenorphine is a partial opioid agonist/antagonist with a ceiling effect.
    • Buprenorphine is not appropriate for chronic pain control.

    Non-Opioid Analgesics

    • Acetaminophen has antipyretic and analgesic properties, but no anti-inflammatory effects.
    • Acetaminophen is thought to inhibit COX-3 in the CNS, reducing prostaglandins and increasing pain threshold.
    • Acetaminophen overdose can lead to hepatic injury and the antidote is N-acetylcysteine.
    • Aspirin is a potent inhibitor of both prostaglandin synthesis and platelet aggregation.
    • Aspirin irreversibly inactivates cyclooxygenase via acetylation.
    • Aspirin inhibits platelet aggregation for the life of the platelet, which is 7 to 10 days.
    • Aspirin inhibits the synthesis of thromboxane A(2) irreversibly.

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    Description

    This quiz covers critical information about opioid and non-opioid analgesics, including their mechanisms, risks associated with use, and dosing guidelines. Learn about the importance of pharmacokinetics and individual patient considerations when using these medications.

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