Portage Pharmacology Module 8
What is pain in the context of this module? - correct answer-It is basic protective mechanism
of the body. The sensation of pain serves as a warning of imminent danger, or that there is
something wrong in the body.
What kinds of meds are used for pain and how do we define them? - correct
answer-Analgesics, they are defined as meds that relieve pain without causing loss of
consciousness.
What is acute pain? - correct answer-It is sudden in onset and usually subsides when
treated. Acute pain last 6 weeks or less in duration.
What is chronic pain? - correct answer-It is persistent or recurring and often much more
difficult to treat. It is classified as any pain lasting 3- 6 months or pain lasting longer than one
month after healing of an acute injury.
What is tolerance, withdrawal, physical dependence? - correct answer-Tolerance is when the
body gets used to the meds, withdrawal is when physical or mental side effects result, this is
known as physical dependence.
What is addiction? - correct answer-Chronic neurobiological disease in which genetic,
psychosocial and environmental factors induce changes in the individuals behavior to
compulsively use drugs despite the harm they may cause.
What is neuropathic pain? - correct answer-It is a unique classification of pain and is defined
as pain resulting from a damaged nervous system or nerve cells. Due to its unique origin,
neuropathic pain does not typically respond to traditional pain medications including opioids
and NSAIDs
How is neuropathic pain treated? - correct answer-It is treated with a variety of medications
such as antileisure meds, antidepressants, and new classes of pain meds meant to treat
neuropathic pain.
Define opioid analgesics? - correct answer-They are synthetic drugs that bind to the opiate
receptors in the brain and relieve pain. Opioids are strong and can alleviate pain of any
origin, but should be used with caution as they are highly addictive.
Define nonopioid analgesics? - correct answer-Painkillers that do not work on opioid
receptors; NSAIDs, which are large chemically diverse group of drug that are analgesics and
also possess anti-inflammatory and antipyretic activity.
What is fibromyalgia? - correct answer-A disorder characterized by widespread
musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It is
believed that fibromyalgia amplifies painful sensations by affecting the way your brain
processes pain signals.
, What are opioids and what are some examples of them? - correct answer-They analgesics
originating from the opium poppy plant. The three classes are morphine-like drugs
(Phenanthrenes, most common), meperidine-like drugs (Phenylpiperidines), and
methadone-like drugs (Phenylheptanes).
Why is it important to know the different classes? - correct answer-Some patients respond
better to some rather than others.
What is the mechanism of action for opioids? - correct answer-They bind to opioid receptors
in the brain causing an analgesic response. Most opioids used for their analgesic properties
are classified as opioid agonists, meaning they stimulate the receptors. They work on mu,
kappa, and delta receptors.
What is the system devised so that all opioids have a relative potency? - correct answer-The
system of morphine equivalents. This system is one whereby morphine is the opioid that all
other opioids are compared to in terms of potency. Proper knowledge of potency is critical
when these meds are being used clinically. In order to transition between opioids safely and
use the correct dose, a clinician can use the system of morphine equivalents.
What are the adverse effects of opioids? - correct answer-Addiction, histamine release
leading to itching, rash, and hemodynamic changes such as flushing and orthostatic
hypotension, respiratory depression, nausea, vomiting, and constipation (opioid receptors in
the GI tract cause slow peristalsis and can cause nausea and vomiting.
Which opioid classes caused the most and the least histamine release? - correct
answer-Morphine-like drugs cause the most, and meperidine-like opioids release the least
amount of histamines.
How are opioid overdoses counteracted?? - correct answer-With Naloxone or Naltrexone, By
the use of Narcan (nasal spray) or Evzio (auto-injector). They are opioid antagonists and can
reverse respiratory depression.
What two common opioids that are less potent than morphine? - correct answer-Codeine (II)
(Schedule III when combined with other drugs such as acetaminophen to make Tylenol with
codeine or cough syrup) and Hydrocodone (only available in combination with other drugs)
aka Lorcet when combined with acetaminophen.
What drugs that has the same potency level as morphine? - correct answer-Oxycodone (Oxy
IR / Oxycontin), available as IR and 24hr Xr | Methadone (Dolophine), used to treat addiction
| Meperidine (Demerol) (not recommended for long term use due to accumulation of toxic
metabolites that can cause seizure
What kinds of morphine are available? - correct answer-The MSIR version (morphine sulfate
immediate release); MS Contin is an extended release formulation.
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