Pharmacotherapy of Pain and Altered Musculoskeletal Function

Comprehensive vocabulary flashcards covering pharmacotherapy for pain, inflammation, and musculoskeletal disorders including NSAIDs, opioids, muscle relaxants, and bone health medications.

Nociceptors

Sensory receptors for pain located in peripheral tissues activated by various stimuli.

Neuropathic pain

Sensory disturbance caused by injury or disease of the CNS or PNS, characterized by burning, tingling, or electric shock symptoms.

Endorphins

Neurohormones produced in the CNS that naturally suppress pain conduction.

Histamines

Chemical mediators responsible for dilation and capillary permeability during inflammation.

Kinins

Chemical mediators responsible for increasing the sensation of pain.

Pain

An unpleasant sensory and emotional experience related to tissue injury that is always subjective.

COX-1

An enzyme that protects the stomach lining and regulates platelets and kidney function.

COX-2

An enzyme that triggers inflammation and pain at the site of injury.

PRICE

A non-pharmacologic treatment for inflammation standing for Protect, Rest, Ice, Compression, and Elevation.

Prednisone

A glucocorticoid medication for inflammation with complications including risk for infection, osteoporosis, fluid retention, hyperglycemia, and hypokalemia.

Aspirin (acetylsalicylic acid)

A first-generation NSAID that inhibits COX-1 and COX-2, used for inflammation suppression, fever reduction, and inhibition of platelet aggregation.

Salicylism

A mild aspirin toxicity characterized by tinnitus, sweating, headache, and dizziness.

Aspirin toxicity

A medical emergency progressing from salicylism to high fever, dehydration, electrolyte imbalances, and coma.

Reye’s Syndrome

A serious condition associated with swelling of the liver and brain that can occur when pediatric patients with viral illnesses (varicella or influenza) take aspirin.

Activated charcoal

A substance administered to decrease the absorption of aspirin in cases of poisoning.

Ketorolac

An NSAID used for short-term (up to 5 days) treatment of moderate to severe pain, often administered parenterally first.

Celecoxib

A second-generation selective COX-2 inhibitor that has a Black Box Warning for increased risk of heart attack and stroke.

Acetaminophen (Tylenol)

A non-opioid analgesic and antipyretic that slows prostaglandin production in the CNS and carries a risk of liver damage if exceeding $4\,grams$ per $24\,hours$.

Acetylcysteine

The antidote for acetaminophen toxicity, often administered through a duodenal tube.

Opioid Agonists

Medications like morphine and fentanyl that attach to mu and kappa receptors in the CNS to alter the response to pain.

Opioid toxicity triad

The three classic signs of opioid overdose: Coma, Pinpoint pupils, and Respiratory depression.

Naloxone (Narcan)

A short-acting opioid antagonist used to reverse opioid effects and respiratory depression; half-life is $60$ to $90\,min$.

Butorphanol

An opioid agonist-antagonist that acts as an antagonist on mu receptors and an agonist on kappa receptors, resulting in low potential for abuse.

Abstinence Syndrome

A condition precipitated when opioid agonist-antagonists are given to physically dependent clients, causing symptoms like fever, hypertension, and vomiting.

Naltrexone

A long-acting opioid antagonist used for the control of cravings as part of a treatment plan.

Sumatriptan

A serotonin receptor agonist used as abortive therapy to stop a migraine by causing vasoconstriction of cranial arteries.

Cyclobenzaprine (Flexeril)

A centrally acting skeletal muscle relaxant used for the relief of muscle spasms related to muscle injury.

Baclofen

A centrally acting muscle relaxant used for spasticity related to cerebral palsy, spinal cord injury, and multiple sclerosis.

Dantrolene

A direct-acting skeletal muscle relaxant that inhibits calcium release in muscles; used to treat malignant hyperthermia.

Alendronate

A bisphosphonate used for osteoporosis that must be taken in the morning on an empty stomach, followed by sitting or ambulating for $30\,minutes$.

Raloxifene

A Selective Estrogen Receptor Modulator (SERM) that treats postmenopausal osteoporosis but increases the risk for deep vein thrombosis (DVT).

Methotrexate

A non-biologic DMARD used for rheumatoid arthritis that causes bone marrow suppression and is Pregnancy Risk Category X.

Allopurinol

An antigout medication that inhibits uric acid production to treat chronic gout or secondary hyperuricemia.