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Board Study Topics > 00 Pain Management > Flashcards

00 Pain Management Flashcards

1
Q

What is the MOA of Salicylates?

A

IRREVERSIBLY inhibit COX-1 and COX-2, prevent prostaglandin formation, inhibit platelet aggregation

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2
Q

What is the generic name of Cystex?

A

Sodium Salicylate (nonacetylated salicylate)

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3
Q

When should Cystex be avoided?

A

(Sodium Salicylate): avoid in sodium-restricted patients, cardiovascular disease

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4
Q

What is the generic name of Doan’s?

A

Magnesium Salicylate

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5
Q

When should Doan’s be avoided?

A

(Magnesium Salicylate): Avoid in renal insufficiency

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6
Q

What medications fall under the Enolic Acids (NSAIDs)?

A

Meloxicam, Piroxicam

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7
Q

What medications fall under the Acetic Acids (NSAIDs)?

A

Diclofenac, Etodolac, Sulindac, Ketorolac

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8
Q

What medications fall under the Propionic Acids (NSAIDs)?

A

Ibuprofen, Naproxen, Ketoprofen

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9
Q

What medication falls under the COX-2 Inhibitor (NSAID)?

A

Celecoxib (only one left on the market)

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10
Q

What is important to know about the length of use for Ketorolac?

A

More GI toxicity than other NSAIDs, not to exceed more than 5 days of use

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11
Q

Which NSAIDs have once daily dosing?

A

Meloxicam, Piroxicam, Nabumetone, Oxaprozin

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12
Q

Which NSAID is commonly used for gout exacerbations?

A

Indomethacin

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13
Q

What is NSAID use like in pregnancy?

A

Generally avoid. Category B 1st & 2nd trimester, Category D in 3rd

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14
Q

What are the opiate side effects?

A

SPEND: Sedation, Postural hypotension, Euphoria, Nausea, Derm rashes. SCRAM: Sex hormone drugs needed, Constipation, Respiratory depression, Addiction, Miosis

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15
Q

What is the drug of choice for pain associated with myocardial infarction?

A

Morphine

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16
Q

What impairment is morphine not a good choice with?

A

Renal impairment

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17
Q

What is the generic name of Roxanol?

A

IR Morphine (Q4h)

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18
Q

What is the generic name of Kadian?

A

CR Morphine (Q12h)

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19
Q

What is the generic name of MS Contin?

A

CR Morphine (Q12h)

20
Q

What is the generic name of Avinza?

A

ER Morphine (Q24h)

21
Q

What is the generic name of Lorcet?

A

Hydrocodone + APAP

22
Q

What is the generic name of Lortab?

A

Hydrocodone + APAP

23
Q

What is the generic name of Tylenol #3?

A

Codeine + APAP

24
Q

What is the generic name of OxyIR?

A

IR Oxycodone (Q4-6h)

25
Q

What is the generic name of Oxycontin?

A

ER Oxycodone (Q12h)

26
Q

What is the generic name of Dilaudid?

A

IR Hydromorphone (Q4-6h)

27
Q

What is the generic name of Exalgo?

A

ER Hydromorphone (Q24h)

28
Q

What is the generic name of Opana?

A

Oxymorphone

29
Q

What is the generic name of Ultram?

30
Q

What is the MOA of Ultram (Tramadol)?

A

Inhibits reuptake of serotonin and norepinephrine

31
Q

What are the toxicities related to Ultram (Tramadol)?

A

Seizures. Nausea & Dizziness

32
Q

What is the generic name of Butrans?

A

Buprenorphine Patch (Q7 days)

33
Q

What must you do before starting Butrans Patch?

A

Taper the patient’s long-acting opioids for up to 7 days to no more than 30mg of oral morphine or equivalent

34
Q

When might the Butrans Patch not work well?

A

In patients needing > 80mg/day morphine equivalent

35
Q

What is the generic name of Demerol?

A

Meperidine

36
Q

What is a unique indication for Demerol (Meperidine)?

A

Rigors as well as moderate-severe pain

37
Q

What are the ADRs like for Demerol (Meperidine)?

A

Many ADRs, risk of seizures d/t metabolite normeperidine

38
Q

When can Fentanyl be used?

A

Only for opioid-tolerant patients (60mg morphine equivalent/day x at least 7 days)

39
Q

What is the generic name of Duragesic?

A

Fentanyl Transdermal

40
Q

If a patient is on 50mg of morphine equivalent/day, what Fentanyl patch should they be on?

A

25mcg (MICROGRAMS). Common practice is to use a 2:1 ratio

41
Q

What is a risk with Methadone?

A

Risk of QTc prolongation, baseline ECGs

42
Q

If a patient has a true allergy to codeine, morphine, hydrocodone, etc., what may he/she safely take?

A

Methadone. Meperidine. Fentanyl

43
Q

What is the generic name of Narcan?

A

Naloxone (for overdose of opiates)

44
Q

What are some different medication options for Neuropathic Pain?

A

AEDs (Gabapentin, Pregabalin, Topiramate, Carbamazepine, Oxcarbazepine). Anesthetics (Lidocaine). Corticosteroids. SNRIs (Venlafaxine, Duloxetine). TCAs (Amitriptyline, Desipramine, Nortriptyline). Opiates. Topical preps

45
Q

What are the 3 FDA-approved medications for Fibromyalgia Syndrome (FMS)?

A

Lyrica (Pregabalin). Cymbalta (Duloxetine). Savella (Milnacipran - SNRI w/ some NMDA inhibition)

46
Q

How does the analgesic activity of Celecoxib compared to traditional NSAIDs?

A

Less analgesic activity compared to traditional NSAIDs

47
Q

What is sometimes combined with NSAIDs to decrease the incidence of GI bleeding?

A

Misoprostol

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