Pharmacology of Pain Management
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Questions and Answers

Match the following drug classes with their mechanisms of action:

Nonsteroidal Anti-Inflammatory Drugs (NSAID) = Inhibit prostaglandin formation Opioid Antagonist = Antagonizes opioid receptors Local Anesthetic = Inhibits sodium ion channels Anti-epileptic = Exact mechanism unknown; blocks voltage-dependent calcium channels

Which of the following is a Non-benzodiazepine hypnotic?

  • Zolpidem (Ambien) (correct)
  • Lorazepam (Ativan)
  • Alprazolam (Xanax)
  • Fentanyl (Duragesic)
  • What is the drug class for naloxone?

    Opioid Antagonist

    All anti-epileptics have a known exact mechanism.

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

    The ADE of celecoxib (Celebrex) includes _____ and GI bleeding.

    <p>CV thrombotic event</p> Signup and view all the answers

    What are some adverse effects of lithium (Lithobid)?

    <p>Toxicity and coma</p> Signup and view all the answers

    Which opioid analgesic binds to opioid receptors?

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

    Which drug class is known for increasing dopamine synthesis?

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

    The ADE of tramadol (Ultram) includes profound _____ and respiratory depression.

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

    What is the mechanism of action for SSRIs?

    <p>Selectively inhibit presynaptic serotonin reuptake</p> Signup and view all the answers

    Study Notes

    Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

    • Inhibit prostaglandin formation, providing anti-inflammatory effects.
    • Examples: ibuprofen (Motrin, Aleve, Naproxen), meloxicam (Mobic), celecoxib (Celebrex), aspirin (Ecotrin).
    • Aspirin offers additional anti-platelet properties.

    Opioid Analgesics

    • Bind to opioid receptors, leading to pain relief.
    • Common opioids include morphine (Kadian, MS Contin), fentanyl (Duragesic, Sublimaze), and hydrocodone with acetaminophen (Vicodin).

    Local Anesthetics

    • Inhibit sodium ion channels, stabilizing neuronal membranes to prevent pain signal propagation.
    • Notable examples: benzocaine (Anbesol), lidocaine (Xylocaine, Duocaine).

    Anti-Epileptics

    • Modulate neurotransmitter release and stabilize neuronal activity through various mechanisms.
    • Include carbamazepine (Tegretol), phenytoin (Dilantin), gabapentin (Neurontin), and others.

    Opioid Antagonists

    • Antagonize opioid receptors to reverse effects of opioid agonists.
    • Naloxone (Narcan) is a critical medication for opioid overdose situations.

    Non-Benzodiazepine Hypnotics

    • Interact with GABA-benzodiazepine receptor complexes to induce sleep with less dependency risk.
    • Examples: eszopiclone (Lunesta), zolpidem (Ambien).

    Melatonin Receptor Agonists

    • Bind to melatonin receptors to regulate sleep-wake cycles.
    • Ramelteon (Rozerem) is a primary drug in this class.

    Selective Serotonin Reuptake Inhibitors (SSRIs)

    • Selectively inhibit serotonin reuptake, enhancing mood.
    • Common SSRIs include citalopram (Celexa), escitalopram (Lexapro), sertraline (Zoloft), fluoxetine (Prozac), and paroxetine (Paxil).

    Tricyclic Antidepressants (TCAs)

    • Nonselectively inhibit the reuptake of norepinephrine and serotonin, affecting various receptor types.
    • Amitriptyline (Elavil) is a notable example.

    Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)

    • Inhibit reuptake of both norepinephrine and serotonin to treat depression.
    • Include duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq).

    Monoamine Oxidase Inhibitors (MAOIs)

    • Irreversibly inhibit monoamine oxidase, boosting neurotransmitter activity.
    • Isocarboxazid (Marplan) is included in this class.

    Dopaminergics

    • Increase dopamine synthesis, mainly used in Parkinson's treatment.
    • Examples are levodopa/carbidopa (Parcopa, Duopa) and selegiline (Zelapar, Eldepryl).

    Acetylcholinesterase Inhibitors

    • Reversibly inhibit acetylcholinesterase to elevate acetylcholine levels.
    • Memantine (Namenda XR) and donepezil (Aricept) are key drugs in this category.

    Norepinephrine-Dopamine Reuptake Inhibitors (NDRIs)

    • Inhibit the uptake of norepinephrine and dopamine.
    • Bupropion (Wellbutrin) is a prominent NDRI.

    Benzodiazepines

    • Enhance GABA neurotransmission, leading to anxiolytic and sedative effects.
    • Examples: alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), diazepam (Valium).

    Mood Stabilizers

    • Primarily used for bipolar disorder, lithium (Lithobid) is a main treatment option.

    Antipsychotics

    • Block dopamine receptors in brain regions affecting mood and perception.
    • Includes aripiprazole (Ability), haloperidol (Haldol), risperidone (Risperdal), and quetiapine (Seroquel).

    Adverse Drug Events (ADE)

    • Celecoxib (Celebrex): Increased cardiovascular thrombotic events & gastrointestinal bleeding.
    • Aspirin (Ecotrin): Bronchospasms, thrombocytopenia, angioedema.
    • Lithium (Lithobid): Toxicity leading to coma.
    • Acetaminophen (Tylenol): Hepatotoxicity, acute kidney injury, thrombocytopenia.
    • Tramadol (Ultram): Risk of profound sedation, respiratory depression, and coma.
    • Gabapentin (Neurontin): Associated with suicidality and angioedema.
    • Zolpidem (Ambien): Can cause sleepwalking, impaired mental alertness.
    • Bupropion (Wellbutrin): High risk of seizures and severe hypertension.
    • Other ADEs: Various drugs such as carbamazepine, fluoxetine, and amitriptyline may lead to serious reactions like arrhythmias, QT prolongation, or hypertensive crises.

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    Description

    This quiz explores the pharmacological agents used in pain management, including NSAIDs, opioid analgesics, local anesthetics, anti-epileptics, and opioid antagonists. Understand their mechanisms of action, examples, and clinical applications. Test your knowledge on how these medications affect pain relief and inflammation.

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