EXAM 1 ALL CONTENT

What is the prototype NSAID drug (brand name Bayer)?

Aspirin

What is the prototype NSAID drug (brand names Motrin, Advil)?

Ibuprofen

What is the prototype non-opioid analgesic (brand name Tylenol)?

Acetaminophen

What is the antidote for acetaminophen overdose?

N-acetylcysteine

What is the prototype antacid (brand name Tums)?

Calcium carbonate

What is the prototype proton pump inhibitor (brand name Prilosec)?

Omeprazole

What are two prototype laxatives (brand names Miralax, Citroma)?

Polyethylene glycol, Magnesium citrate

What are the prototype antidiarrheal drugs (brand names Imodium A-D, Pepto Bismol)?

Loperamide, Bismuth subsalicylate

Which prototype antihistamines are included?

Diphenhydramine (Benadryl), Cetirizine (Zyrtec), Famotidine (Pepcid)

What are the prototype corticosteroids for PHARM BASICS?

Fluticasone propionate (Flonase), Hydrocortisone (Cortaid)

What is the prototype antitussive (brand names Robitussin, Delsym, Vicks Cough)?

Dextromethorphan

What is the prototype expectorant (brand name Mucinex)?

Guaifenesin

What is the prototype occlusive moisturizer (brand name Aquaphor)?

Petrolatum

What is the prototype vitamin A?

Retinol, beta-carotene

What is the prototype vitamin B1?

Thiamin

What is the prototype vitamin B2?

Riboflavin

What is the prototype vitamin B3?

Niacin

What is the prototype vitamin B5?

Pantothenic acid

What is the prototype vitamin B6?

Pyridoxine

What is the prototype vitamin B7?

Biotin

What is the prototype vitamin B9?

Folic acid

What is the prototype vitamin B12?

Cyanocobalamin

What is the prototype vitamin C?

Ascorbic acid

What is the prototype vitamin D?

Cholecalciferol

What is the prototype vitamin E?

Tocopherols

What is the prototype vitamin K?

Phylloquinone, Phytonadione

What is the prototype calcium supplement?

Calcium carbonate, calcium citrate

What is the prototype phosphorus supplement?

Dipotassium phosphate, disodium phosphate

What is the prototype magnesium supplement?

Magnesium aspartate, citrate, chloride

What is the prototype sodium supplement?

Sodium

What is the prototype potassium supplement?

Potassium chloride, citrate, phosphate

What is the prototype chloride supplement?

Chloride

What is the prototype iron supplement?

Ferrous sulfate, ferrous gluconate

What is the prototype zinc supplement?

Zinc sulfate, acetate, gluconate

What is the prototype copper supplement?

Cupric oxide, cupric sulfate

What is the prototype selenium supplement?

Selenomethionine, sodium selenate

What is the prototype iodine supplement?

Potassium iodide, sodium iodide

What is the prototype manganese supplement?

Manganese sulfate, manganese aspartate

What is the prototype fluoride supplement?

Liquid fluoride drops

What is the prototype chromium supplement?

Chromium picolinate, chromium chloride

What is the prototype adrenergic agonist for the immune system?

Epinephrine (Epi-pen, Neffy)

What are the prototype live vaccines?

MMR, Varicella, Rotavirus

What is the prototype mTOR inhibitor?

Sirolimus (Rapamune)

What is the prototype purine analog antimetabolite?

Azathioprine (Imuran)

What is the prototype corticosteroid for immune modulation?

Dexamethasone (Decadron, DexPak)

What is the prototype glucocorticoid (corticosteroid)?

Prednisone (Deltasone, Prednicot, Rayos, Sterapred)

What are the prototype calcineurin inhibitors?

Cyclosporine (Sandimmune, Gengraf, Neoral)

What is the prototype monoclonal antibody?

Trastuzumab (Herceptin, etc.)

What is the prototype biologic agent?

Abatacept (Orencia)

What are the prototype conventional synthetic DMARDs?

Methotrexate, Hydroxychloroquine, Tofacitinib

What is the prototype biologic DMARD?

Adalimumab

What are the prototype NSAIDs for inflammation?

Aspirin, Ibuprofen, Celecoxib

What is the prototype nonopioid analgesic for inflammation?

Capsaicin (Capzasin, Zostrix)

What is the prototype antigout/antihyperuricemic drug?

Allopurinol (Zyloprim, Aloprim)

What is the prototype opioid agonist?

Morphine (Duramorph, MS Contin)

What is the prototype opioid agonist-antagonist?

Butorphanol tartrate (Stadol)

What is the prototype opioid antidote?

Naloxone (Narcan)

What is the prototype SNRI used for pain?

Venlafaxine (Effexor XR)

What is the prototype GABA analog for pain?

Gabapentin (Neurontin)

What are the FDA-approved cannabis receptor agonist analogs?

Dronabinol, Nabilone, Nabiximols

What is the prototype nonopioid analgesic for headaches?

Acetaminophen (Tylenol)

What is the prototype beta-lactam antimicrobial for headaches?

Amoxicillin (Amoxil)

What are the prototype antiseizure drugs for headaches?

Divalproex (Depakote), Topiramate (Topamax)

What is the prototype tricyclic antidepressant for headaches?

Amitriptyline (Elavil)

What are the prototype serotonin receptor agonists for headaches?

Sumatriptan, Zolmitriptan

What are the prototype sedative-hypnotics for anesthesia?

Propofol, Etomidate, Ketamine

What is the prototype synthetic opioid for anesthesia?

Fentanyl (Actiq, Duragesic, Sublimaze)

What is the prototype benzodiazepine for anesthesia?

Lorazepam (Ativan)

What is the antidote for benzodiazepines?

Flumazenil

What is the prototype depolarizing muscle relaxant?

Succinylcholine (Anectine)

What is the prototype nondepolarizing muscle relaxant?

Rocuronium (Zemuron, Esmeron)

What is the prototype local anesthetic?

Lidocaine (Xylocaine)

TYPES OF PAIN

• Acute pain

• Chronic pain

• Neuropathic pain

• Nociceptive pain

• Radicular pain

Opioid agonists:

• Morphine, fentanyl, meperidine, hydromorphone, and methadone

Opioid agonistsantagonists:

Butorphanol

DUAL-MECHANISM ANALGESIC AGENTS Ex

Tramadol

DUAL-MECHANISM ANALGESIC AGENTS MOA

•Binds with low affinity to mu receptors in the CNS

•Prevents the reuptake of norepinephrine and serotonin

DUAL-MECHANISM ANALGESIC AGENTS CI

•Manage moderate to moderately severe pain, both acute and chronic

DUAL-MECHANISM ANALGESIC AGENTS SE

•Sedation, dizziness, headache, nausea, and constipation

DUAL-MECHANISM ANALGESIC AGENTS ADR

•Seizures, urinary retention, serotonin syndrome, mania (w/SSRIs), respiratory depression, addiction, and toxicity

DUAL-MECHANISM ANALGESIC AGENTS Ed

•Basics

•Constipation – increase their fluid and fiber intake, as well as activity and exercise

•Monitor respiratory rate

•Avoid abrupt cessation (serotonin effect)

OPIOID ANTAGONISTS Ex

Naloxone

OPIOID ANTAGONISTS MOA

• Competitively binds to the opioid receptors in the central and peripheral nervous systems

• Prevent opioid agonists from exerting their effects

OPIOID ANTAGONISTS CI

• Reverses opioid toxicity (very short acting/redose q20 mins)

• Prevention of EtOH/opioid relapse

• Opioid induced constipation

OPIOID ANTAGONISTS SE

• Acute withdrawal (nausea, vomiting, diarrhea, abdominal pain, anxiety, aggression, and runny nose)

OPIOID ANTAGONISTS ADR

• V-tach

• Pulmonary edema

OPIOID ANTAGONISTS Ed

• Basics

• Watch for withdrawal manifestations

NONOPIOID ANALGESICS Ex

Acetaminophen

NONOPIOID ANALGESICS MOA Acetaminophen

• Interferes with COX mechanism in the CNS w/o effective peripheral tissues

• Interrupts PG production in the CNS while stimulating serotonin pathway

NONOPIOID ANALGESICS CI Acetaminophen

• Reduces mild to moderate pain and fever

NONOPIOID ANALGESICS SE Acetaminophen

• GI upset and itching may occur

NONOPIOID ANALGESICS ADR Acetaminophen

• Liver damage

• Nephrotoxicity, acute generalized exanthematous pustulosis, necrolysis, and Stevens-Johnson syndrome

NONOPIOID ANALGESICS Ed Acetaminophen

• Basics

• Avoid EtOH consumption before, during or after taking acetaminophen

NONOPIOID ANALGESICS Ex

Asprin/Ibuprofen

NONOPIOID ANALGESICS MOA Asprin/Ibuprofen

•Blocks COX1 & COX2

NONOPIOID ANALGESICS CI Asprin/Ibuprofen

• Reduces inflammation, pain and fever

NONOPIOID ANALGESICS SE Asprin/Ibuprofen

•Ibuprofen:

•Common side effects are heartburn, dyspepsia, nausea, and vomiting. Long-term use at high doses can significantly increase the risk of developing stomach ulcers.

•Aspirin:

•Common side effects include nausea, epigastric upset, and dyspepsia.

NONOPIOID ANALGESICS ADR Asprin/Ibuprofen

•GI bleeding, kidney problems, increased blood pressure, allergic reactions, tinnitus, and dermatological reactions

NONOPIOID ANALGESICS Ed Asprin/Ibuprofen

•Basics

•Instruct clients to tell the provider about a history of allergies to NSAIDs, GI bleeding or ulcerations, kidney problems, asthma, heart failure, heart attack, and pregnancy or possible pregnancy.

•Instruct clients to report manifestations of an allergic reaction, bleeding, increase in blood pressure, difficulty breathing, decreased urine output, swelling, or weight gain.

NONOPIOID ANALGESICS Ex

Lidocaine