Chemistry

Homework 4

Pain

Define:

What are the strategies for the Treatment of cancer pain

Define Opioids –

Opioid Receptors

What are the opioid receptors in pain management?

What happens when an opioid agonist is administered?

Opioid Antagonists

Act by –

Used to

What is the mechanism of action of Subutex?

What is the mechanism of action of Suboxone?

Morphine

Mechanism of action-

Usage-

Adverse effects-

Narcan (naloxone)

Mechanism of action-

Usage-

Adverse effects-

Cycolooxygenase (COX)

What do COX1 and COX2 do in the body?

Why were selective COX2 inhibitors desirable? Why were they developed?

Why is their use now limited?

Aspirin

Mechanism of action-

Usage-

Adverse effects-

Why must aspirin be discontinued 2 weeks prior to a procedure?

NSAIDS include:

Mechanism of action-

Usage-

Adverse effects-

Selective COX-2 Inhibitors include:

Mechanism of action-

Usage-

Adverse effects-

Acetominophen

Mechanism of action-

Usage-

Adverse effects-

Does acetaminophen and anti-inflammatory activity?

Migraine

Triptans

Prototype drug

Mechanism of action-

Usage-

Adverse effects-

Ergot Alkaloids (ergotamine, dihydroergotamine)

Mechanism of action-

Usage-

Adverse effects-

ANESTHESIA

Local anesthetics

5 techniques:

Esters

Prototype drug

Mechanism of action-

Usage-

Adverse effects-

Amides

Prototype drug

Mechanism of action-

Usage-

Adverse effects-

General Anesthesia

Stages of General Anesthesia

Stage I

StageII

Stage III

Stage IV

Inhalation Anesthesia

Prototype drugs

Volatile liquids –

Gases –

Mechanism of action-

Usage-

Adverse effects-

Invtravenous Agents

Barbituates & Barbituate-like

Prototype drug

Mechanism of action-

Usage-

Adverse effects-

Benzodiazepines

Prototype drug

Mechanism of action-

Usage-

Adverse effects-

Opioids used for General Anesthesia

Prototype drug – fentanyl

Mechanism of action-

Usage-

Adverse effects-

Inflammation

What is the purpose of inflammation?

What are the signs of inflammation?

Chemical Mediators

1. Histamine

2. Prostaglandins

3. Leukotrienes

4. Bradykinin

5. Complement

1. Histamine

What does histamine do?

What do the 2 Histamine Receptors do?

H1:

H2:

2. Prostaglandins

Cyclooxygenase Inhibitors

NSAIDS

Aspirin

Mechanism of action

How is aspirin different than other NSAIDS?

Ibuprofen

Mechanism of action

COX-2 Inhibitors Rofecoxib

Mechanism of action

Adverse effects:

Systemic Glucocorticoids – hydrocortisone, prednisone

Mechanism of action

What are the serious adverse effects of glucocorticoids?

What precautions are taken when glucocorticoids are used for long-term treatment?

Define Antipyretics:

Prototype drug: acetaminophen

****Acetominophen treats pain and fever, but not inflammation***

Allergy and upper respiratory

Anti-Histamines (see above)

Prototype drug for allergies, 1st generation: diphenhydramine

Adverse effects:

Prototype drug for allergies, 2nd generation: fexofenadine (Allegra)

Adverse effects:

Why is drowsiness less than with 1st generation?

Intranasal Glucocorticoids (fluticasone (Flonase))

What is the mechanism of action

Why are these desirable drugs?

Cough

Non-opioid – dextromorphan

Mechanism of action:

Decongestants – (oxymetazoline)

Mechanism of action:

Asthma

Why are beta agonists used to treat asthma – how do they work?

Why must these drugs be given locally?

Prototype drug for short-acting beta agonists?

Prototype drug for long-acting beta agonists?

Side effects for beta agonists?

How are corticosteroids used to treat asthma?

What is the prototype drug for corticosteroids used to treat asthma?

What are the side effects?

Which drugs is used to terminate an allergy attack?

Which drugs are used to prevent asthma attacks?

What is the first step in treatment for asthma?

COPD

List COPD key indicators

List risk factors

What is the first step in treatment for COPD?

While the drugs are similar, what is different between treatment for Asthma and COPD?

Make sure you know the prototype drugs for COPD:

β2 – agonists

Short-acting

Salbutamol (albuterol)

Long-acting

Salmeterol

Anticholinergics

Short-acting

Ipratropium bromide

Long-acting

Tiotropium

Combination short acting β2 – agonists & anticholinergics

Salbutamol/

Ipratropium

Inhaled Glucocorticosteroids

Beclomethasone

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