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83 Cards in this Set
- Front
- Back
Mech of action of naproxen, ibuprofen
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Competitive, reversible inhibitor of COX 1 and 2
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Celecoxib is (more/less) selective for COX 2 than tNSAIDS
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more (10x)
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Aspirin is (reversible/irreversible) and inhibits the function of ___ and blocks the synthesis of
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irreversible, platelets, PG
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What NSAID is contraindicated in kids?
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Aspirin
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What NSAID acts ONLY in the CNS?
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APAP
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T or F, Cox 2 selective drugs (celexocib) cause MORE GI distress
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False, less
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(acute/chronic) pain is important for survival and (somatic/visceral) pain is hard to locate
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acute, visceral
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Which 2 of these cause pain in ascending pathways and which 2 stop pain in descending pathways?
-5-HT -Glu -Substance P -NE |
Pain = Glu, Sub P
Stop pain = 5-HT, NE |
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What is the term for when you feel pain from something that should NOT produce pain at all?
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allodynia
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An increase in Na conductance in a cell will lead to (hypo/hyper) excitability
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hyper
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APAP effects (POX/COX) reaction the most
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POX
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True or False, celecoxib is safe in patients with CV or renal issues
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False
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Where is ibuprofen and naproxen metabolized?
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liver
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Morphine is good for (sharp/dull) pain
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dull
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What % of morphine is converted to M6g, the active opioid?
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10
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Which opioid is a prodrug?
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codeine
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True or False, codeine has NO anti-inflammatory properties
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T
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Morphine effects (mu/kappa/delta) most
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mu
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Codeine is (more/less/the same) efficacious than morphine
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less
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Tylenol + codeine is a schedule (#) drug
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3
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What are three ways opioids effect pain?
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alter neurotransmitter release, block GABA inhibitory pathway, alter perception of pain
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What drug is known for having both L and D isomers with different actions? Which one is a full mu agonist in this drug?
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Methadone (L isomer is full mu agonist, D is NMDA receptor antagonist)
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What drug is NOT readily reversed with naloxone?
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Meperidine (Demerol)
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How many times more potent than morphine is Fentanyl?
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80-100 (holy crap)
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True or False, Tramadol is a prodrug
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True
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Tapentadol is (more/less) potent than tramadol
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more
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What is the mech of action of Tramadol
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blockes 5-HT and NE reuptake
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Name 2 mixed k agonist/mu antagonists
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butorphanol, nalbuphine
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Naloxone is an opioid (agonist/antagonist) and has a (short/long) duration of action
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antag, short
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non-opioids (do/do not) have a ceiling effect
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do
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For step 1 pain, there is no need to include an anti-inflammatory, just step 2 and 3
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False, all steps!!!
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Aspirin is a (common/uncommon) pain manager that inhibits synthesis of ___ and should not be used in (adults/kids)
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uncommon, PG, kids
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T or F, APAP is the drug of choice bc of its low side effects and strong anti-inflammatory effect
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False, does NOT have strong anti-infl effect
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What is the max 24 dose of APAP?
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4gm
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NSAIDs have (reversible/irreversible) action on platelets
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reversible
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How does celexocib effect platelets?
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Has NO anti-platelet effect
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A patient comes in that has had GI problems in the past and said that ibuprofen made it worse. What type of drug should you use for his pain?
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COX 2 selective (like celecoxib)
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T or F, tramadol should never be used in patients with morphine addiction
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F, it is a good alternative to those at risk for drug abuse!
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You should not use Tramadol with (SSRIs/SNRIs/TCAs)
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SSRIs
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Tapentadol binds to what receptors in the CNS?
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mu opiate receptors
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For NSAIDs, you should start with the (lowest/max) dose, but with opioids, you should start with the (lowest/max) dose
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max, lowest
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T or F, both NSAIDs and opioids have a ceiling effect
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False, opioids do NOT!
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T or F, never schedule opioids around the clock, only as needed
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F, should schedule long-acting opioids ATC
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A patient has a short bout of pain, they should take __% of their normal opioid dose every __ hours as needed
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15-20, 4
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The "gold standard" for severe pain is ___
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morphine
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What step 3 drug (strong opioid) is used in an ORAL form renal dysfxn patients?
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oxycodone
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What drug is known as the "champagne of opioids" and is best for patients with renal problems?
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hydromorphone
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Fentanyl is usually reserved for (acute/chronic) pain
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acute
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Methadone has a (short/long) and unpredictable half life
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long (thus, hard to titrate)
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suboxone (is/is not) safe in pregnant patients
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is
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What two broad drug categories can sometimes be used for patients with neuropathic pain?
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Antidepressants, anticonvulsants
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Corticosteroids are good for pain in what area of the body?
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bone pain
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T or F, caffeine has good analgesic properties
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False, only used to increase NSAID efficacy
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What is the MOA of caffeine that allows it to assist NSAIDS?
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increase NE release
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What sedative increases duration of GABA receptor Cl- channel opening?
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fiorinal (butalbitol)
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Equagesic (meprobamate) is a ___ agonist and may produce dependence
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GABA receptor
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What is the drug of choice for facial and neuropathic pain? What are this drugs big adverse effects as it pertains to dentists?
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amitriptyline (it's a TCA), stomatitis, glossitis and dry mouth
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What drug is the gold standard for trigeminal neuralgia and what is its MOA?
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carbamazopine (an anticonvulsant), block Na channels
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Gabapentin (enhances/inhibits) GABA and (enhances/inhibits) Ca channels
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enhances, inhibits
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Pregabalin (Lyrica) is a schedule (#) drug, meaning it has a (high/low) abuse potential
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5, high
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What is a common injectable treatment for TMJ problems?
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corticosteroids
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What are the two big AEs with corticosteroids?
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poor wound healing, decreases infection resistance
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Capsaicin is a (injectable/topical) agent that acts on ____ receptors
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topical, TRPV1
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Clonidine is a ___ receptor agonist, with what main AE?
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alpha 2, hypOtension
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Ketamine is a ___ receptor ANtagonist
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NMDA
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Sodium Hyaluronate stimulates the production of ____ to augment joint fluidity
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hyaluronic acid
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What is the DMARD of choice? (DMARD = disease modifying anti-rheumatic drug)
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methotrexate
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Cyclosporine has an AE of nephrotoxicity and what other dental related AE?
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gingival hyperplasia
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Name 1 gold compound used in RA
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Auranofin (Ridaura)
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What is the drug of choice for pain in PUD?
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APAP
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PPIs have 2 BIG adverse effects and 2 BIG drug interactions... what are they?
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AE: osteoporosis, C. diff infections due to decrease in stomach acid
DI: warfarin, benzodiazepine |
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Antacids such as Mg and Al salts, and CaCO3 can intact with what to main drugs?
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fluoroquinolones and tetracycline (bc of metal ions)
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If someone has an NSAID induced ulcer, they should stop the NSAIDS and start taking a ___
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PPI
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Sucralfate decreases absorption of what two drugs?
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fluoroquinolones and tetracycline
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What GERD/PUD drug is considered pregnancy category X?
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Misoprostol (Cytotec)
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Antisialagogues can cause (increase/decrease) in salivation by (opening/blocking) ACh on muscarenic receptors
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decrease (that's what they're for!), blocking
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Sialagogues are good for (decreasing/increasing) salivation
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increasing
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What are the three main targets of antiemetics?
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The GI, CTZ, and vestibular apparatus (CN VIII)
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What two antiemetics can cause EPS?
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prochlorperazine and Metoclopramide
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Which antiemetic is also a D2 receptor antagonist?
prochlorperazine metoclopramide dimetnhydrinate |
Meto...
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1st generation H1 receptor antagonists can cause CNS (excitation/depression) and xerostomia (among other things)
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depression
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What types of laxatives are preferred for opioid induced constipation?
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stimulants (bisacodyl, senna)
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Polycarbophil Calcium and Bismuth Subsalicylate have what common drug interactions? (they both contain what??? hint!)
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fluoroquinolones and tetracycline (both contain a metal)
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