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Principles of Anesthesia II - Fall 2024 > Acute Pain - More Drugs - Exam 2 > Flashcards

Acute Pain - More Drugs - Exam 2 Flashcards

1
Q

Ibuprofen starting dose:

ceiling effect dose:

A
  • 200mg TID
  • 400mg = ceiling effect
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2
Q

Celecoxib Starting dose:

A

100mg daily

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3
Q

Tylenol starting dose:

A

500-1000mg q 4-6h

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4
Q

Naproxen starting dose:

A

220mg BID

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5
Q

Diclofenac starting dose

A
  • 50mg BID
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6
Q

MOA anti-depressants (TCAs) for pain:

What type of pain are they used for?

A
  • MOA: increase transmission in spinal cord to reduce pain signals
  • nerve pain: DM/chronic
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7
Q
A
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8
Q

How long do TCA/anti-depressants take to have effect?

A

5-10 days

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9
Q

TCA/anti-depressant

SE:

A
  • dizziness
  • drowsiness
  • decreased appetite
  • dry mouth
  • strung out
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10
Q

What types of pain are anti-convulsants used for?

A
  • acute surgical pain
  • nerve pain
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11
Q

What are 4 examples of anticonvulsants used for pain?

A
  1. Gabapentin (Neurontin)
  2. Phenytoin (Dilantin)
  3. Carbamazepine (Tegretol)
  4. Topiramate (Topamax)
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12
Q

Gabapentin dose:

A
  • 100mg - 300mg BID/TID
  • pre-op dosing
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13
Q

SE of anticonvulsants for pain:

A
  • dizziness, drowsiness
  • HA
  • wt gain
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14
Q

What are the indications for skeletal muscle relaxants in pain control?

A
  1. muscle pain
  2. tension HA
  3. lower back pain
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15
Q

What are 5 skel. muscle relaxants available for pain

A
  1. Baclofen (Lioresal)
  2. Carisoprodol (Soma)
  3. Cyclobenzaprine (Flexeril)
  4. Methocarbamol (Robaxin)
  5. Tizanidine (Zanaflex)
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16
Q

what is there a high incidence of w/ Soma?

A
  • OD
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17
Q

What are SE associated w/ skel. muscle relaxants?

A
  • dizziness
  • drowsiness
  • dry mouth
  • constipation
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18
Q

What are available OTC topicals?

A
  • capsaicin cream
  • menthol - methyl salicylate cream (Bengay)
  • lidoderm 5% patch
  • compounded (ibuprofen & ketamine) (ketamine, precedex, ibuprofen)
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19
Q

What are the 3 types of dosing for opioids?

A
  • initial: opioid naive for acute pain
  • up-titration: need more in PACU
  • max dose: not really a max (acute, persistent, cancer, end of life pain)
20
Q

Opioid conversion

Morphine IV:PO

A
  • IV: 10mg
  • PO: 30mg
21
Q

Opioid conversion

Dilaudid IV:PO

A
  • IV: 1.5mg
  • PO: 7.5mg
22
Q

Opioid conversion

oxycodone IV:PO

A
  • IV: —
  • PO: 20-30mg
23
Q

opioid conversion

codeine IV:PO

A
  • IV: 130mg
  • PO: 200mg
24
Q

opioid conversion

hydrocodone IV:PO

A
  • IV: —
  • PO: 30mg
25
Q

opioid conversion

methadone IV:PO

A
  • IV: 1.5-2.5mg
  • PO: 3-5mg
26
Q

opioid conversion

fentanyl IV:PO

A
  • IV: 0.1mg
  • PO: —
27
Q

PCA dosing:

Morphine (1mg/mL)
bolus:
lockout:
cont:

A
  • bolus: 0.5-2.5mg
  • lockout 6-10min
  • cont: 1-2mg/hr
28
Q

PCA dosing

Fentanyl (0.01mg/mL)
bolus dose:
lockout:
cont:

A
  • bolus: 20-50mcg
  • lockout: 5-10min
  • cont: 10-100mcg/hr
29
Q

PCA dosing

Hydromorphone (0.2mg/mL)
bolus dose:
lockout:
cont:

A
  • bolus: 0.05-0.25mg
  • lockout: 10-20min
  • cont: 0.2-0.4mg/hr
30
Q

PCA dosing

Alfentanil (0.1mg/mL)
bolus:
lockout:

A
  • bolus: 0.1-0.2mg
  • lockout: 5-10min
31
Q

PCA dosing

Methadone (1mg/mL)
bolus:
lockout:

A
  • bolus: 0.5-1.5mg
  • lockout: 10-30min
32
Q

PCA dosing

Oxymorphone (0.25mg/mL)
bolus:
lockout:

A
  • bolus: 0.2-0.4mg
  • lockout: 8-10min
33
Q

PCA dosing

Sufentanil (0.002mg/mL)
bolus:
lockout:
cont:

A
  • bolus: 2-5mcg
  • lockout: 4-10min
  • cont: 2-8mcg/hr
34
Q

PCA dosing (agonist/antagonist)

Buprenorphine (0.03mg/mL)
bolus:
lockout:

A
  • bolus: 0.03-0.1mg
  • lockout: 8-20min
35
Q

PCA dosing (agonist/antagonist)

Nalbuphine (1mg/mL)
bolus:
lockout:

A
  • bolus: 1-5mg
  • lockout: 5-15min
36
Q

PCA dosing (agonist/antagonist)

Pentazocine (10mg/mL)
bolus:
lockout;

A
  • bolus: 5-30mg
  • lockout: 5-15min
37
Q

Neuraxial Doses

Fentanyl (2mcg/mL)
intrathecal:
epidural single:
epidural infusion:

A
  • intrathecal: 5-25mcg
  • epidural single: 50-100mcg
  • infusion: 25-100mcg/h
38
Q

Neuraxial doses

Sufentanil
SA:
epi single:
epi infusion:

A
  • SA: 2-10mcg
  • epi single: 10-50mcg
  • infusion: 10-20mcg/h
39
Q

Neuraxial Doses

Alfentanil
SA:
epi single:
epi infusion:

A
  • SA: —
  • epi single: 0.5-1mg
  • infusion: 0.2mg/h
40
Q

Neuraxial Doses

Morphine
SA:
epi single:
epi infusion:

A
  • SA: 0.1-0.3mg
  • epi single: 1-5mg
  • infusion: 0.1-1mg/h
41
Q

Neuraxial Doses

Hydromorphone
SA:
epi single:
epi infusion:

A
  • SA: —
  • epi single: 0.5-1mg
  • 0.1-0.2mg/h
42
Q

Neuraxial Doses

ER morphine
SA:
epi single:
epi infusion:

A
  • SA: not recommended
  • epi single: 5-15mg
  • infusion: not recommended
43
Q

Neuraxial doses - LA

Bupivacaine
SA:
epi single:
epi infusion:

A

SA: 5-15mg
epi single: 25-150mg
infusion: 1-25mg/h

44
Q

Nueraxial Doses - LA

Ropivacaine
SA:
epi single:
epi infusion:

A
  • SA: not recommended
  • epi single: 25-200mg
  • infusion: 6-20mg/h
45
Q

Neuraxial Doses - Adjuvant

Clonidine
SA:
epi single:
epi infusion:

A
  • SA: not recommended
  • epi single: 100-900mcg
  • infusion: 10-50mcg/h

Principles of Anesthesia II - Fall 2024 (10 decks)

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