Non opioids

Question 1

Epidural and intrat used for pain management for cancer and non cancer pain and post op

Answer 1

Clonidine

Question 2

Used as IV sedation short period for intubates/mechanically ventilated patients (less than 24 hrs)

Answer 2

Dexmedetomidine does not depress respiratory

Question 3

If discontinued cause withdrawal effect

Answer 3

Clonidine and dexmedetomidine

Question 4

Used as adjunct in labor anesthesia

Answer 4

Clonidine

Question 5

Enhances and prolongs sensory block and motor blockage, anesthetic action and analgesia action of LA epidural
Synergism effect on LA epidural, prolongs duration

Answer 5

Clonidine

Dexmedetomidine

Question 6

Reduce dosage liver AND kidney impairment

Answer 6

Dexmedetomidine

Question 7

Side effects: Bradycardia, heart block, hypotension, nausea

Answer 7

Dexmedetomidine

Question 8

Withdrawal causes rebound hypertension, agitation and sympathetic overactivity

Answer 8

Clonidine

Dexmedetomidine also causes withdrawal

Question 9

Increases Nausea and vomiting

Answer 9

Neostigmine, Baclofen & Dexmedetomidine

Question 10

Intrathecal Increases effects of LA, Opioids and other alfa 2 agonists drugs like clonidine

Answer 10

Neostigmine

Question 11

Epidural does not affect motor blockage

Answer 11

Nesotigmine

Question 12

Does not cause respiratory depression or pruritus alone or with opioids

Answer 12

Neostigmine

Question 13

Alfa 2 receptors need to be inhibited or activated by agonist

Answer 13

Activated to cause inhibitory effect

Question 14

Spinal used in pediatric lower abdominal & urological cases

Answer 14

Neostigmine

Question 15

Nociceptive stimulation release which excitatory NT

Answer 15

Glutamate, asparate & neuropeptides

Substance P

Question 16

Epidural administration must be administered preservative free

Answer 16

Ketamine, preservative causes neurotoxicity

Question 17

May be used as a sole agent or with opioids in post op pain

Answer 17

Ketamine

Question 18

Prolongs onset and duration of LA

Answer 18

Ketamine

Question 19

Intrathecal reduces N/V

Answer 19

Versed

Question 20

MOA of versed

Answer 20

Binds to GABA A receptor, increases GABA A ,allowing Cl influx
Also binds to d opioid receptors

Question 21

2 meds risk of neurotoxicity

Answer 21

Ketamine & Versed

ketamine due to metabolite

Question 22

Epidural & intrathecal antiemetic

Answer 22

Droperidol

Question 23

Increases suicidal instincts

Answer 23

Ziconotide

Question 24

Only nonopioid approved for FDA for neuropathic pain

Answer 24

Zicotidine Spinal

Question 25

Reduces pruritus and post op N/V

Answer 25

Dropiderol

Question 26

N type Calcium channel receptors

Answer 26

Zicotidine, decreases NE

Question 27

Gabapentin and preabalin uses (3)

Answer 27

neuropathic pain, anticonvulsant (oral), fibromyalgia

Question 28

Baclofen unique MOA

Answer 28

Activates GABA B receptors, increases K, causes hyperpolarization, also presynaptically inhibits Glutamate and Substance P

Question 29

Uses for Baclofen

Answer 29

MS, Cerebral Palsy, spasticity, dystonia, low pain pain with root compression

Question 30

Side effects of Baclofen

Answer 30

sedation, drowsiness, headache, nausea, weakness rhabdomyolysis and multiple organ faillure

Question 31

One of the side effects is rhabdomyolyisis and multiple organ failure

Answer 31

Baclofen

Question 32

COX Pathway leads to the production of what mediators?

Answer 32

Prostaglandyns, Prostacyclins and thromboxanes

Question 33

What 2 reactions catalyzed COX

Answer 33

1: Cyclization of AA acid to PGG2 2: PGG2 reduction to PGH2

Question 34

Meds contraindication for Ketotolac

Answer 34

Decreases protein binding, increases drug

Question 35

Highly bound to plasma albumin

Answer 35

COX inhibitors, (Aspirin reduces plasma binding od Ketorolac and increases drug)

Question 36

Does not have antiinflammatory effects

Answer 36

Acetaminophen

Question 37

NSAIDS recommended for cardiovascular complications

Answer 37

Naproxen

Question 38

Result on ductus arteriousus

Answer 38

Closes ductus arteriosus in neonates, Prostaglandins maintain open

Question 39

Which COX inhibitors cause GI bleeding & GI bleeding?

Answer 39

COX 1 also Ibuprofen and

Question 40

Respiratory effects

Answer 40

Risk of anaphylaxis: Nasal polyps, sllergic rhinitis & asthma

Question 41

IV NSAID

Answer 41

Ketorolac

Question 42

NSAID does not cross BBB

Answer 42

Ketorolac

Question 43

Coxibs do not affect

Answer 43

Platelet inhibition

Question 44

Responsible for pain COX 1, 2

Answer 44

COX 2

Question 45

NSAID limited for 5 days due to renal toxicity (papillary necrosis) and GI ulceration

Answer 45

Ketorolac

Question 46

Aspirin OD

Answer 46

acid/base imbalaces & RESPIRATION

Question 47

Acetaminophen Overuse

Answer 47

Fulminant Renal Failure

Question 48

Adverse effects of COX 1 inhibitors (graph)

Answer 48

Platelet dysfunction, Hypersensitivity & GI ulceration

Question 49

Selective COX 2

Answer 49

Acetaminophen and Coxib

Question 50

MOA of TCA

Answer 50

Block Na channels and increase antinociceptive noradrenergic an serotonergic projections descending from the brain to the spinal cord

Question 51

Beneficial for post op resp depression or emesis

Answer 51

Ketorolac

Question 52

Short management of pain (Less than 5 days ) causes renal toxicity and GI ulceration (increases Aspirin effects)

Answer 52

Ketorolac

Question 53

Cox 2 selective inhibitor with little anti inflammatory effects

Answer 53

Acetaminophen

Question 54

Has low therapeutic index, overdose can result in liver failure

Answer 54

Acetaminophen

Question 55

COX 2 Selective Inhibitors that are antiinflammatories, analgesica and antipyretic actions as conventional NSAIDS but without antiplatelet action.

Answer 55

COXIBS, Celecoxib

Question 56

DIffernece between COX 1 AND 2 Inhibitors

Answer 56

COX 1 GI upset and bleeeding more than CO@ COX 2 no antiplatelet action COX 1 Hypersensitivity

Question 57

Drug used primarily to treat trigeminal neuralgia

Answer 57

Antiarrthymic Drugs, treats chronic pain

Question 58

MOA of Carbamazepine (antiarrthmic drug)

Answer 58

Blocks Na channels

Question 59

Antidepressants are also used for

Answer 59

Chronic pain

Question 60

MOA for antidepressants TCA manage of chronic pain

Answer 60

Blocks sodium channels

Question 61

MOA for Venlafaxine and Duloxetine for management of chronic pain

Answer 61

Block NE and serotonin reuptake (Reuptake inhibitors)