Pharmacology 5334, Module 3 Questions And Answers

Pharmacology 5334, Module 3 Questions And Answers Maximum amount of Sumatriptan that can be taken in 1 day - ANSWER- 200 mg The ability of the anesthetic to penetrate the axon membrane is determined by what 3 properties? - ANSWER- Lipid solubility, degree of ionization at tissue pH, molecular size Why is epinephrine given with local anesthetics? - ANSWER- Decreases local blood flow; delays systemic absorption of the anesthetic; prolongs anesthesia; reduces the risk of toxicity Most widely used local anesthetic - ANSWER- Lidocaine What is a possible fatal reaction to benzocaine? - ANSWER- Methemoglobinemia What is included in application guidelines for topical anesthetics? - ANSWER- Avoid wrapping the site and heating the site; avoid application to open skin; use to smallest amount to the smallest site What is the best option for menstrual migraine? - ANSWER- Low dose estrogen about 3 days prior to menses What are the 3 main classes of opiod receptors? - ANSWER- Mu, alpha, and delta Which medication will reverse the effects caused by opioid agonists? - ANSWERNaloxone (Narcan) What medications are used to treat opioid induced constipation (OIC)? - ANSWERNaloxegol, methylinaltrexone, and lubiprostone Tolerance is defined as: - ANSWER- increased doses of a medication needed to obtain the same response Physical dependence is defined as: - ANSWER- abstinence syndrome with abrupt discontinuation Abuse is defined as: - ANSWER- drug use that is inconsistent with medical or social norms Addiction is defined as: - ANSWER- behavior pattern characterized by continued use of a psychoactive substance despite physical, psychologic, or social harm What medication is used for opioid abuse? - ANSWER- Naltrexone Euphoria induced by morphine: - ANSWER- an exaggerated sense of well-being caused by the activation of mu receptors What medication is given nasally for migraines? - ANSWER- Butorphanol Describe the mechanism of NSAIDs - ANSWER- Inhibition of the cyclo-oxygenase enzyme Second generation Cox 2 inhibitors: - ANSWER- suppress inflammation and cause less risk for GI ulceration than Cox 1; increase the risk for heart disease What medication should NOT be given with aspirin? - ANSWER- Glucocorticoids What medication is given for acetaminophen overdose? - ANSWER- Acetylcysteine What are non-endocrine therapeutic uses for glucocorticoids? - ANSWER- RA, SLE, IBS, bursitis, OA, gout, disorders of the eye What is the danger of prolonged use of glucocorticoids? - ANSWER- Adrenal insufficiency Methotrexate can cause fatal toxicities of: - ANSWER- bone marrow, liver, kidneys, lungs; hemorrhagic enteritis and GI perforation What must be checked yearly while taking etanercept? - ANSWER- TB What is the mechanism of action of etanercept? - ANSWER- Suppresses the immune system First line treatment of gout - ANSWER- Indomethacin When would you initiate a uricosuric medication? - ANSWER- more than 3 gout attacks per year Moderate-strong opioid agonists - ANSWER- codeine, oxycodone, hydrocodone, tapentadol Opioid agonist-antagonist - ANSWER- Pentazocine, nalbuphine, butorphanol, buprenorpine (prolongs QT) Non-opioid centrally acting analgesics - ANSWER- Tramadol (suicide and seizure risk), clonidine, Ziconotide, dexmetomidine (used for patients on mechanical ventilation) Non-Aspirin First Generation NSAIDs - ANSWER- Ibuprofen, naproxen. SAFETY ALERT: all first-generation NSAIDs are associated with an increased risk of GI blessing that can lead to hospitalization or death 2nd generation NSAIDs - ANSWER- Celecoxib, meloxican Risks for NSAIDs - ANSWER- Heart disease, renal function, and GI bleeding. Cox-2 poses less risk for GI bleeding Rheumatoid arthritis (RA) - ANSWER- Chronic systemic inflammation including the synovial membranes of multiple joints; shortens lifespan and increases risk of cardiovascular events and stroke; goal of treatment is to reduce inflammation and pain while preserving function and preventing deformity First line treatment for RA - ANSWER- NSAIDs with DMARD Traditional DMARDs - ANSWER- Methotrexate, leflunomide, sulfasalazine, hydroxychloroquine, minocycline, penicillamine, azathioprine, cyclosporine Biological response modifiers DMARDs (non-TNF) - ANSWER- Abatacept, rituximib, anakinra, tocilizumab Biological response modifiers DMARDs (anti-TNF) - ANSWER- Infliximab, adalimubab, etanercept, certolizumab, golimubab Gout treatment - ANSWER- < 3 times per year - NSAIDs first line, glucocorticoids second line or if intolerant to NSAIDs