15 - Acute Pain

Question 1

Non-pharms for acute pain?

Answer 1

• immobilize fracture
• dress burns
• cold or heat therapy
• relaxation
• yoga for muscle pain

Question 2

ASA _____ inhibits platelet function

Answer 2

irreversibly

Question 3

ASA and NSAIDs can precipitate _____ in ASA-sensitive patients and all NSAIDs have a risk of MI

Answer 3

asthma

Question 4

What are 2 options for GI protection from NSAIDs?

Answer 4

• PPI

- misoprostol

Question 5

Advantage of COX-2 selective inhibitors?

Answer 5

GI protection

Question 6

s/e of opioids

Answer 6

constipation, nausea, sedation, respiratory depression, tolerance, withdrawal symptoms, opioid use disorder

Question 7

____ should not be used for pain that is expected to last for more than 3 hours

Answer 7

meperidine

Question 8

age limit for codeine?

Answer 8

only use in those > 12 or those > 18 if it’s to treat pain after surgery to remove tonsils or adenoids

Question 9

MOA of tramadol?

Answer 9

• has opioid and nonopioid mechanisms, structurally related to morphine and codeine, inhibits serotonin and NE re-uptake
• causes more nausea and may be less effective

Question 10

How long should you limit Ketorolac use to?

Answer 10

5 days

Question 11

____ is gold standard in which we compare all other opioids to

Answer 11

morphine

Question 12

morphine is not affected by ____ disease

Answer 12

liver

Question 13

Fentanyl does not induce _____ release, unlike morphine and meperidine

Answer 13

histamine

Question 14

fentanyl is a ____ opioid

Answer 14

synthetic

Question 15

Why do we limit use of meperidine to pain less than 3 hours duration?

Answer 15

accumulation of the neurotoxic metabolic, normeperidine, can occur and cause seizures and other CNS effects

Question 16

Who should you avoid meperidine in ?

Answer 16

• those with kidney or liver dysfunction

- those who have had MAOis in the past 14 days

Question 17

What drug can you inhale for pain?

Answer 17

nitrous oxide

Question 18

DOC in pregnancy?

Answer 18

acetaminophen

Question 19

When can you use NSAIDs in pregnancy?

Answer 19

1st or 2nd trimester

Question 20

Are opioids safe in pregnancy?

Answer 20

yes but monitor newborn for signs of withdrawal or other s/e if mom still breastfeeding

Question 21

DOC in breastfeeding?

Answer 21

acetaminophen

Question 22

Are NSAIDs safe in breastfeeding?

Answer 22

yes

Question 23

What pain meds should you avoid in breastfeeding mothers?

Answer 23

• avoid codeine

- avoid meperidine

Question 24

If mom is using opioids, how long should they wait to breastfeed after taking the medication?

Answer 24

at least 2 hours to breast feed and continuously monitor baby