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Flashcards in Analgesics Deck (9)
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1
Q

What are the pharmacological actions of Non-steroidal anti-inflammatory drugs?

A

Antipyretic - reduce body temperate during fever
Analgesic - relief of pain associated with increased production of PGs eg. arthritic, muscular, dental pain, post-partum, bone cancer pain
Anti-inflammatory - reduce oedema, sensitisation of nociceptors

2
Q

Side effects of NSAIDS and how to reduce

A

Indigestion, diarrhoea, nausea, vomiting, gastric bleeding, ulceration
Reduce side effects by developing drugs that only inhibit cox2 enzyme, have enteric coating of tablets, administer pro-drugs eg. sulindac

3
Q

Aspirin

NSAID

A
Effective against mild pain and fever 
Non-selective cox inhibitor 
Should not be given to:
- children under 16
- history of peptic ulcers
- haemophilia/ other bleeding disorders
- patients taking anti-coagulant drugs
- liver disease
4
Q

Ibuprofen

NSAID

A

Non-selective cox inhibitor
1st choice drug as has less risk of side effects compared to aspirin however can cause indigestion/peptic ulcers
eg. Naproxen - more potent, longer lasting so fewer doses
eg. Dexibuprofen, Fenbufen, Ketoprofen

5
Q

Paracetomol

NSAID

A
Antipyretic
Analgesic
Limited anti-inflammatory action
Used to treat children
Toxic to the liver 2/3 times the normal therapeutic dose
6
Q

NSAIDs and opioid analgesics

A

Eg. Co-codamol (aspirin and codeine phosphate)
Eg. Co-codaprin (Paracetomol and codeine phosphate)
Increased number of side effects

7
Q

Opioid analgesics

A

Enkephalins, endorphins and dynorphins
Bind to opioid receptors
Used for pain of visceral origins eg. surgery, terminal illness
Action:
- encephalin released
- binds to opioid receptors on AO/C fibres
- substance P release inhibited (inhibits Ca+ influx)
- signal not transmitted to thalamus
Examples:
- Mild/moderate pain = codeine, dihydrocodeine, meptazinol
- Moderate/severe pain = MORPHINE, diamorphine (heroin), tramadol
- Intraoperative analgesia = fentanyl, alfentanil
- Postoperative analgesia = morphine
-Overdose = naloxone

8
Q

Morphine

A

Acute/chronic pain (palliative care)
State of euphoria/mental detachment
Slowly absorbed by the mouth to give a sustained release
IV/IM/subcutaneous/rectal administration also
Side effects: constipation, nausea/vomiting, sedation, confusion, hallucinations, dependency, respiratory depression

9
Q

Local anaesthetics

A

Can be applied topically to skin or mucosal surfaces or by subcutaneous injection to act on nerve endings
Nerve block: anaesthetic infiltrated around a nerve
Intravenous regional anaesthesia
Examples: lidocaine, bupivicaine, prilocaine, tetracaine