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INTERNSHIP > Analgesics > Flashcards

Analgesics Flashcards

1
Q

Name 2 classes of pain relief

A
  1. Non-opioid analgesics
  2. Opioid analgesics
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2
Q

Name 2 classes of non-opioid analgesics

A
  1. NSAIDs
  2. Paracetamol
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3
Q

Name the 2 classes of NSAIDs

A
  1. Nonselective NSAIDs (COX-1 and COX-2 inhibitors)
  2. Selective NSAIDs (COX-2 inhibitors)
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4
Q

Name 9 nonselective NSAIDs (COX-1 inhibitors)

A
  1. Aspirin
  2. Diclofenac
  3. Ibuprofen
  4. Indometacin
  5. Ketoprofen
  6. ketOROLAC
  7. Mefenamic acid
  8. Naproxen
  9. Piroxicam
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5
Q

Name 4 selective NSAIDs (COX-2 inhibitors)

A
  1. Celecoxib
  2. Etoricoxib
  3. Meloxicam
  4. Parecoxib
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6
Q

Name 15 opioid analgesics

A
  1. buprenorphine
  2. codeine
  3. aspirin with codeine
  4. ibuprofen with codeine
  5. paracetamol with codeine
  6. fentanyl
  7. hydromorphone
  8. methADONe
  9. morphine
  10. oxycodone
  11. oxycodone with naloxone
  12. pethidine
  13. tAPENTadol
  14. tRAMadol
  15. tRAMadol with paracetamol
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7
Q

List the NSAIDs in order from most COX-1 selectivity to most COX-2 selectivity.

A
  1. Ketoprofen (Most COX-1 Selective)
  2. Aspirin
  3. Indometacin
  4. Ibuprofen
  5. Naproxen
  6. Piroxicam
  7. ketOROLAC
  8. Mefenamic acid
  9. Diclofenac (Most COX-2 Selective)
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8
Q

Name 12 opioid analgesics

A
  1. Alfentanil
  2. Buprenorphine
  3. Codeine
  4. Fentanyl
  5. Hydromorphone
  6. Methadone
  7. Morphine
  8. Oxycodone ± Naloxone
  9. Pethidine
  10. Remifentanil
  11. Tapentadol
  12. Tramadol
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9
Q

What is the opioid of choice in surgery?

A

Morphine

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10
Q

Why is morphine the opioid of choice for surgery?

A

As it has the best retention in the cerebrospinal fluid.

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11
Q

What must you always consider (besides age) when determining the dose when initiating an opioid?

A

Renal function

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12
Q

Why must you consider renal function when initiating an opioid?

A

As renally-cleared opioids will accumulate in poor renal function.

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13
Q

What should you consider if you see oxycodone and tramadol concurrently charted?

A

Check if there has been APS involvement.

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14
Q

What is the common approach to pain management by the Acute Pain Service?

A

They will commonly start a patient on paracetamol and oxycodone, then add tramadol if pain is still not sufficiently controlled

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15
Q

What is the rationale for the Acute Pain Service adding tramadol to a patient already on Oxycodone?

A

Tramadol has a slightly different mechanism to oxycodone.

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16
Q

What should you do if you see IV opioids charted on the ward?

A

Chase this with the team to have it removed (IV opioids can’t be given on the wards) and check to see if anything else should be charted in its place.

17
Q

What is generally a requirement for a patient to be charted opioids as an inpatient?

A

They must be on regular paracetamol.

18
Q

How must Targin be ordered by a ward?

A

A ward can send a distribution form for Targin but they must specify the patient details as they must have past history for pharmacy to be able to supply it.

19
Q

Name 13 NSAIDs

A
  1. Aspirin (analgesic)
  2. Diclofenac
  3. Ibuprofen
  4. Indometacin
  5. Ketoprofen
  6. KetOROLAC
  7. Mefenamic acid
  8. Naproxen
  9. Piroxicam
  10. Celecoxib
  11. Etoricoxib
  12. Meloxicam
  13. Parecoxib
20
Q

Name 9 Nonselective NSAIDs (COX‑1 and COX‑2 inhibitors)

A
  1. Aspirin (analgesic)
  2. Diclofenac
  3. Ibuprofen
  4. Indometacin
  5. Ketoprofen
  6. Ketorolac
  7. Mefenamic acid
  8. Naproxen
  9. Piroxicam
21
Q

Name 4 Selective NSAIDs (COX‑2 inhibitors)

A
  1. Celecoxib
  2. Etoricoxib
  3. Meloxicam
  4. Parecoxib
22
Q

Which NSAID tends to be most effective for headaches?

A

Aspirin

23
Q

What is a practical benefit of aspirin over other NSAIDs in the setting of headache?

A

It tends to work faster.

24
Q

What is an effective method of using aspirin to treat a sore throat?

A

Gargling soluble aspirin solution (even without swallowing)

25
Q

What is ketOROLAC?

A

ketOROLAC is an intramuscular NSAID.

26
Q

What is a risk of ketOROLAC?

A

People commonly go into renal dysfunction if it is overused.

27
Q

What is an alternative to intramuscular dosing of ketOROLAC?

A

It can be given intravenously over 15 minutes (injection not infusion).

28
Q

Describe the role of parecoxib

A

Parecoxib is often used intra-operatively

29
Q

How should parecoxib be used in relation to other NSAIDs?

A

No other NSAIDs should be used 12 hours either said of parecoxib.

30
Q

What is the indication of paracetamol modified release caplets 665mg as per Medication Profiler?

A

For the treatment of mild to moderate pain

31
Q

What does the “other important information” section on MedProfiler say about paracetamol modified release caplets 665mg?

A

There are many brands of paracetamol. Do not exceed a total daily dose of 4 grams of paracetamol. Do not take more than 6 Panadol Osteo tablets per day.

32
Q

What does the “generic subheading” section on MedProfiler say about paracetamol modified release caplets 665mg?

A

Swallow whole and do not crush or chew

INTERNSHIP (189 decks)

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