Adjuvant Meds for pain

Question 1

Tricyclic antidepressant prototype

Answer 1

Amitriptyline

Question 2

Anticonvulsant prototype

Answer 2

Carbamazepine, gabapentin

Question 3

CNS stimulant prototype

Answer 3

Methylphenidate

Question 4

Antihistamine prototype

Answer 4

Hydroxyzine

Question 5

Glucocorticoid prototype

Answer 5

Dexamethasone

Question 6

Biphosphonate prototype

Answer 6

Etidronate

Question 7

NSAID prototype

Answer 7

Ibuprofen

Question 8

What do adjuvant meds for pain do?

Answer 8

Enhance effects of opioids while allowing a reduced dose of opioid to improve adverse effects

Question 9

Therapeutic use of tricyclic depressants

Answer 9

Depression, fibromyalgia, neuropathic pain

Question 10

Therapeutic use of anticonvulsants

Answer 10

Relieve neuropathic pain and neuralgia

Question 11

Therapeutic use of CNS stimulants

Answer 11

Augment analgesia and decrease sedation

Question 12

Therapeutic use of antihistamines

Answer 12

Decrease anxiety, prevent insomnia, and relieve nausea/vomiting

Question 13

Therapeutic use of glucocorticoids

Answer 13

Improve appetite and decrease painf orm intracranial pressure, spinal cord compression, and rheumatic arthritis

Question 14

Therapeutic use of bisphosphonates

Answer 14

reduce hypercalcemia and bone pain

Question 15

Therapeutic use of NSAIDS

Answer 15

reduce inflammation, fever, and mild to moderate pain

Question 16

Complications of tycylic antidepressants

Answer 16

• Orthostatic hypotension
• Sedation
• Anticholinergic effects (dry mouth, urinary retention, constipation, blurred vision)
  *

Question 17

Complications of anticonvulsants

Answer 17

• Decreased effectiveness of oral contraception
• bone marrow suppression
• GI distress (not peptic ulcers)
• Drowiness
• Rash

Question 18

Complications of CNS stimulants

Answer 18

• Weight loss
• Insomnia

Question 19

Complications of antihistamines

Answer 19

• Sedation
• Dry mouth

Question 20

Complications of glucocorticoids

Answer 20

• Adrenal insufficiency
• Osteoporosis
• Hypokalemia
• Sodium and water retention
• Hyperglycemia
• Peptic ulcer disease
• Frequent infections

Question 21

Complications of bisphosphonates

Answer 21

• Transient flu-like symptoms
• Abdominal cramps, nausea, diarrhea, esophagitis
• Venous irritation at injection site
• Hypocalcemia

Question 22

Complications of NSAIDS

Answer 22

• Bone marrow suppression
• GI distress including ulceration
• MI
• Stroke

Question 23

Contraindications of trycylic antidepressants

Answer 23

• If recovering from MI
• Within 14 days of taking an MAOI
• Caution with pregnancy and lactation, seizures, hyperthyroidism, liver and kidney disease, BPH

Question 24

Contraindications of anticonvulsants

Answer 24

• bone marrow suppression
• within 14 days of taking MAOI
• Lactation
• Pregnancy is a precaution

Question 25

Contraindications of CNS stimulants

Answer 25

• Within 14 days of taking MAOI
• Precaution with hypertension, tics, substance abuse history
• Pregnancy not established but lactation is ok.

Question 26

Contraindications of antihistamines

Answer 26

• Asthma
• 1st trimester pregnancy
• lactation
• caution in older adults and 2nd-3rd trimester

Question 27

Contraindications of glucocorticoids

Answer 27

• fungal infection
• Seizure disorder
• Ulcerative colitis
• Coagulopathy
• Caution with hypertension, hypothyroidism, diabetes, osteoporosis, liver disease
• Prenancy and lactation not established

Question 28

Contraindications of bisphosphonate

Answer 28

• Preganncy
• Lactation
• Achalasia
• Esophageal stricture
• Osteomalacia
• Caution with kidney disease

Question 29

Contraindications of NSAIDs

Answer 29

• Avoid after 30 weeks gestation
  *Bronchospasms with aspirin
  Severe kidney or liver disease
  Caution in lactation, GI disorder, cardiac disorder, and elderly