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pain consists of
perception and reaction
TERM 2
analgesics are classifed as
DEFINITION 2
nonopiods (nonnarcotics) and opiods (narcotics)
TERM 3
nonopiod site of action
DEFINITION 3
peripheral nerve endings
TERM 4
nonopiods inhibit
DEFINITION 4
cyclooxygenase (COX), which inhibits prostaglandin
synthesis
TERM 5
opiods act on the
DEFINITION 5
CNS
Two groups of nonopiods
salicylates and NSAIDs
TERM 7
salicylates come from
DEFINITION 7
willow bark
TERM 8
ASA stands for
DEFINITION 8
AcetylSalicylic Acid
TERM 9
prostaglandins are
DEFINITION 9
lipids synthesized during the inflammatory response and
makes the pain receptors sensitive bradykinin
TERM 10
aspirin is rapidly absorbed from
DEFINITION 10
the stomach and small intestine
salicylate adverse reactions
dyspepsia, nausea, emesis, gastric bleeding, inhibits
platelets aggregation
TERM 17
how long do salicylates inhibit platelet
aggregation?
DEFINITION 17
4-7 days
TERM 18
how long does it take after taking salicylates
for platelets to BEGIN to return to normal
DEFINITION 18
approx. 1.5 days (when 20% of platelets are replaced)
TERM 19
aspirin's most frequent side effect
DEFINITION 19
gastro intestinal side effects
TERM 20
salicylates adverse effects result from
DEFINITION 20
direct gastric irritation and inhibition of prostaglandins
prostaglandins are responsible for
inhibition of gastric acid secretion and stimulation of the
cytoprotective mucus in the stomach
TERM 22
In high doses, aspirin's stimulation of the _ _ _
in the _ can also produce _ and _
DEFINITION 22
chemoreceptor trigger zone; CNS; nausea; vomiting
TERM 23
salicylate-induced gastric bleeding is
DEFINITION 23
painless and does not usually significantly affect the patient's
health
TERM 24
salicylates may exacerbate
DEFINITION 24
preexisting ulcers, gastritis, or hiatal hernia
TERM 25
don't use aspirin in adolescents with flu or
chicken pox
DEFINITION 25
Reye's syndrome
usual dose of salicylates
650 mg q4h
TERM 32
forms of salicylates
DEFINITION 32
enteric coated, buffered, in combo with other analgesics and
caffine
TERM 33
uses for salicylates
DEFINITION 33
mild to moderate pain, fever, inflammation, prevention of
stroke or heart attack, antiplatelet effects
TERM 34
NSAIDs
DEFINITION 34
Non-Steroidal Anti-Inflammatory Drugs
TERM 35
Types of
NSAIDs
DEFINITION 35
analgesics, antipyretics, antiinflammatory
one of the most useful types of drugs
available to treat dental pain
NSAIDs
TERM 37
NSAIDs work by
DEFINITION 37
inhibiting cyclooxygenase (PG synthesis)
TERM 38
NSAIDs peak effects
DEFINITION 38
1-2 hours
TERM 39
how food affects NSAID
absorption
DEFINITION 39
reduces the rate, but not the extent
TERM 40
NSAIDs Adverse Reactions
DEFINITION 40
GI effects, renal effects, hypersensitivity reactions, CNS
effects (sedation, dizziness, confusion, depression, and
headache), reversable platelet aggregation inhibition
Ibuprofen onset
30 min
TERM 47
Ibuprofen half life
DEFINITION 47
2 hrs
TERM 48
Naproxen
DEFINITION 48
lithium interaction, longer T1/2 (dose at 8-12hr)
TERM 49
Ketorolac
DEFINITION 49
oral use following IV/IM. short term use.
TERM 50
NSAIDs drug interactions
DEFINITION 50
lithium, MTX, diuretics, ACE inhibitors, beta-blockers, digoxin
Acetaminophen effects
analgesic and antipyretic
TERM 52
Acetaminophen (at theraputic doses) does
not effect
DEFINITION 52
GI, cardiovascular, respiratory systems
TERM 53
hepatotoxicity (adverse effect of
acetaminophen)
DEFINITION 53
20-25 g or long term use of theraputic doses. children more
at risk (non-age/weight appropriate). signs include nausea,
vomiting, abdominal pain, anorexia
TERM 54
nephrotoxicity
DEFINITION 54
alcoholics should avoid acetaminophen (they have an
increase in enzymes involved in the metabolism of
acetaminophen)
TERM 55
adverse effects can be potentiated by
DEFINITION 55
drugs that increase microsomal enzymes
acetaminophen is useful for children because
it is not known to cause Reye's syndrome
TERM 62
gout
DEFINITION 62
excess uric acid in body, urate crystals (tophi) in joints
TERM 63
in acute gout attacks
DEFINITION 63
NSAIDs and Colchicine are used
TERM 64
For gout attack prevention
DEFINITION 64
allopurinol (Zyloprim) inhibits synthesis of uric acid or
probenecid (Benemid) increases excretion of uric acid
TERM 65
opiods mechanism of action
DEFINITION 65
bind to receptor sites in CNS and alter perception of reaction
to pain
_ have opiod-like reaction
endorphins (endogenous)
TERM 67
three types of opiod receptors
DEFINITION 67
mu, kappa, delta
TERM 68
opiods
absorption
DEFINITION 68
orally (also thru mucosa and skin)
TERM 69
opiods distribution
DEFINITION 69
variable first-pass metabolism in liver intestines
TERM 70
opiods metabolism
DEFINITION 70
mainly via glucuronidation in liver
opiods adverse reaction
respiratory depression (decreased response to CO2),
increases intracranial pressure (don't use in head injuries),
nausea and emesis, constipation, myosis
TERM 77
opiods adverse reactions
DEFINITION 77
urinary retention, postural hypotension, pregnancy (not
teratogenic, but depressed respiration and withdrawl
symptoms in fetus), drug interactions often cause sedation
TERM 78
myosis of opiods
DEFINITION 78
below 2.9mm
TERM 79
degree of addiction to opiods is proportional
to
DEFINITION 79
analgesic strength
TERM 80
addicts develop tolerance to eveything
except
DEFINITION 80
myosis and constipation
most common type of allergic reaction to
opiods
skin rashes and urticaria
TERM 82
upset stomach is a
DEFINITION 82
"side effect"
TERM 83
drug interactions are _ with other CNS
depressants
DEFINITION 83
additive
TERM 84
true opiod allergies are
DEFINITION 84
uncommon
TERM 85
morphine
DEFINITION 85
not used in dentistry, other opiods compared to 10 mg of
morphine
hydromorphone
(Dilaudid) very strong opiod, limited need in dentistry.
ADDICTS
TERM 92
methadone
DEFINITION 92
used to treat opiod addiction
TERM 93
fentanyl
DEFINITION 93
(Duragesic, Sublimaze) short acting parenterally
administered opiod agonist used in general anesthesia
procedures. also used in combo with droperidol to induce or
supplement general anesthesia
TERM 94
Pentazocine
DEFINITION 94
(Talwin) is a MIXED opiod (agonist-antagonist). adequate
analgesic, but less side effects usually associated with opiods
TERM 95
naloxone
DEFINITION 95
(Narcan) Opiod antagonist. Parenteral use. Alone it has few
pharmacological effects. Will reverse opiod-induced
respiratory depression. Does not have additive effect if the is
NOT the cause for the initial respiratory depression.
