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Analgesia Flashcards

0
Q

Fentanyl/Sublimaze/Duragesic

P-Dyn

A

Combines with brain receptor sites to produce analgesia
-Decreased pain perception (mu, kappa, delta)
Mostly Mu

Decreased emetic effect

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1
Q

Fentanyl/Sublimaze/Duragesic

Class

A

Opioid analgesic

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2
Q

Fentanyl/Sublimaze/Duragesic

Indications

A

Analgesia

Sedation for airway (combo with other agents)

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3
Q

Fentanyl/Sublimaze/Duragesic

Adverse/Side Effects

A

Triad (MBP)
Brady
Hypotension
N/V, constipation

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4
Q

Fentanyl/Sublimaze/Duragesic

Contraindications

A

Allergy
Head injury/CNS depression/ICP
Myasthenia gravis
MAO inhibitors within 14 days

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5
Q

Fentanyl/Sublimaze/Duragesic

Precautions

A

Old, respiratory, seizures, cardiac

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6
Q

Fentanyl/Sublimaze/Duragesic

Interactions

A

CNS depressants
Potentiated by benzos
MAO inhibitors precipitate HTN crisis

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7
Q

Fentanyl/Sublimaze/Duragesic

Dose

A

May dilute
25-200 mcg slow IV
50-100 mcg IM q 30-60 min PRN

1-2 mcg/kg slow IV/IM q 5-15 min PRN

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8
Q

Fentanyl/Sublimaze/Duragesic

Peds dose

A

1-2 mcg/kg slow IV q 5-15 min PRN

1-2 mcg/kg IM q 15-60 min PRN

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9
Q

Meperidine/Demerol

Class

A

Narcotic analgesic

Opioid

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10
Q

Meperidine/Demerol

P-Dyn

A

Analgesia (pain perception, catecholamine production)
Decreased myocardial O2 demand
Lacks hemodynamic morphine effects

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11
Q

Meperidine/Demerol

Indications

A

CP suggestive of AMI, unresponsive to nitrates

Mod/severe musculoskeletal pain

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12
Q

Meperidine/Demerol

A/S

A

Triad
Hypotension
N/V
Constipation

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13
Q

Meperidine/Demerol

Contraindications

A

MAOIs (Nardil, Parnate)
SSRI (Paxil,Prozac, Zoloft, Luvox)

Allergy
Hypovolemia, hypotension
Head injury, CNS depression, ICP
Abd pain

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14
Q

Meperidine/Demerol

Interactions

A

Increased effects with CNS depressants
Dilantin/Phenytoin blunts effects
Enhanced with lots of meds

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15
Q

Meperidine/Demerol

Dose

A

25-50 mg slow IV q 1 hr PRN

50-100 mg IM q3-4h PRN

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16
Q

Meperidine/Demerol

Peds Dose

A

1-2 mg/kg slow IV/IM

17
Q

Hydromorphone/Dilaudid

Class

A

Opioid analgesic

18
Q

Hydromorphone/Dilaudid

P-Dyn

A

Combines with Mu receptors in brain to produce analgesia

Decreases perception of pain

19
Q

Hydromorphone/Dilaudid

Indications

A

Mod/severe pain

Antitussive

20
Q

Hydromorphone/Dilaudid

A/S

A

Triad
Brady
Hypotension
N/V, constipation

21
Q

Hydromorphone/Dilaudid

Contraindications

A

Allergy
Head injury, CNS depression, ICP
Asthma

22
Q

Hydromorphone/Dilaudid

Precautions

A

7-10 x morphine

Old, resp, seizure disorders

23
Q

Hydromorphone/Dilaudid

Interactions

A

Increased with CNS depressants, TCAs, phenothiazines, benzos

24
Hydromorphone/Dilaudid | Dose
1-2 mg slow q 6-8 hrs
25
Toradol/Ketorolac Tromethamine | Class
NSAID
26
Toradol/Ketorolac Tromethamine | P-Dyn
Non-opiate analgesia - inhibits prostaglandin synthesis - decreases responsiveness of pain receptors in inflamed tissue - peripheral acting
27
Toradol/Ketorolac Tromethamine | Indications
Mod/Severe pain
28
Toradol/Ketorolac Tromethamine | A/S
Bleeding, abd pain, diarrhea, nausea Swelling, anaphylaxis Increased BP Drowsiness
29
Toradol/Ketorolac Tromethamine | Contraindications
Allergy (incl. ASA NSAIDs) Active ulcers/GI bleed Renal failure Head bleed
30
Toradol/Ketorolac Tromethamine | Precautions
IM typical route, single dose Caution in renal/hepatic impairment Reduced dose in above and elderly
31
Toradol/Ketorolac Tromethamine | Interactions
Increased bleeding with anticoagulants Increased lithium levels Reduces Lasix effectiveness
32
Toradol/Ketorolac Tromethamine | Dose
``` IM 60 mg (normal) 30 mg (over 65, renal, less than 50 kg) IV 30 mg (normal) 15 mg (over 65, renal, less than 50 kg) No peds ```
33
Adjuvant analgesic
Enhance efficacy of opioids Treat underlying causes Reduce side effects
34
Nalmefene/Revex | Class
Narcotic/opiate antagonist | Competitive antagonist
35
Nalmefene/Revex | P-Dyn
Competes for narcotic/opiate receptors | Reverses narcotic effects
36
Nalmefene/Revex | Indications
Narcotic OD
37
Nalmefene/Revex | A/S
Withdrawal -HTN, tachycardia, violent behavior, tremors, seizures Arrhythmias N/V
38
Nalmefene/Revex | Contraindications
Allergy
39
Nalmefene/Revex | Interactions
Poss. increased risk of seizures if used with Flumazenil
40
Nalmefene/Revex | Dose
1st 0.5 mg/70 kg 2nd q2-5, 1 mg/70 kg With addicts start with 0.1 mg/70 kg No peds

Pharm (13 decks)

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