Analgesics Flashcards
Explain the Gate Theory of Pain Transmission
A distractive, non-noxious stimulus can block the “gate” (dorsal horn), preventing noxious stimuli from reaching the brain
Explain analgesics vs. anesthetics
Analgesics: pain relief without loss of consciousness
anesthetics: pain relief with loss of consciousness
What are the 3 types of analgesics?
Opiods
Nonopioids
Adjunct meds
What are the 3 examples of Adjunct meds?
Antidepressants
-amitriptyline
Anticonvulsants
-Gabapentin
Corticosteroids
OPIOIDS
-main use?
-contraindication?
-extreme caution?
alleviate moderate-severe pain
severe asthma
respiratory insufficiency
elevated intracranial pressure
morbid obesity/sleep apnea
paralytic ileus
pregnancy
Why do opioids lower BP?
Peripheral vasodilation and CNS depression
What is expected with long-term opioid treatment?
Tolerance and physical dependence
-Not addiction/psychologic dependence
What main class of substances do opioids interact with?
CNS depressants
Explain equinalgesia
Ability to provide equivalent pain relief by calculating dosages of different drugs or routes of admin. that provide comparable analgesia
Which drug is 7x more potent than morphine?
10 mg morphine + 1 mg ___ = 17 mg morphine
Hydromorphone (Dilaudid)
Hydromorphone
All opioids except ____ are schedule II
Codeine w/ tylenol
Which opioid is used for cough suppression?
Codeine
Oxycodone & Hydrocodone
Weaker opioids
often combined w/ tylenol
IR and SR forms
0.1 mg _____ = 10 mg morphine!
Fentanyl
Which opioid is synthetic?
Hydromorphone (Dilaudid)
Methadone Hydrochloride
Used for detox/maintenance therapy for opioid use disorder
-long half life- accidental OD risk
Naloxone
-routes?
-purpose?
-MOA?
-IV/IM/Inhalation
-given as antidote for severe respiratory depression with opioids
-removes opioids from receptor
ACETAMINOPHEN
-properties?
-combo doses?
-MOA?
-antipyretic, analgesic
-not anti-inflammatory
-max 3000 mg/24 hr
-max 2000mg/24hr with older adults/liver disease
-MOA: inhibits prostaglandin synthesis
ACETAMINOPHEN
-AEs?
-contraindications?
-interactions?
-overdose can cause?
-hepatoxicity, hypersensitivity, red/peeling/blistering skin
-liver disfunction, G6PD deficiency
-alcohol, hepatotoxic meds
-Can cause hepatic necrosis-liver failure
What is the antidote to Acetaminophen overdose?
Acetylcysteine
TRAMADOL
-location of action?
-MOA?
-Controlled?
-Caution w/?
-Centrally acting analgesic
-Dual MOA: mu receptor bond, inhibits NE/E reuptake
Not controlled
psych meds
LIDOCAINE (transdermal)
-route?
-indication?
Topical anesthetic
postherpetic neuralgia
12 hours max- systemic absorption risks cardiac events
How does Feverfew react with NSAIDS?
Bleeding risk
