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Intro To Drugs > analgesics > Flashcards

analgesics Flashcards

1
Q

muscul/o, my/o, myos/o

A

bone

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2
Q

fasci/o

A

fascia

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3
Q

ten/o, tend/o, tendin/o

A

tendons

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4
Q

oss/e, oss/i, oste/o, ost/o

A

bone

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5
Q

myel/o

A

bone marrow

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6
Q

chondr/o

A

cartilage

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7
Q

arthr/o

A

joints

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8
Q

ligament/o

A

ligaments

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9
Q

synovi/o, synov/o

A

synovial membrane, synovial fluid

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10
Q

burs/o

A

bursa

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11
Q

NSAID drugs

A

all OTC, Aspirin, diclofenac, etodolac, ibuprofen, indomethacin, meloxicam, nabumetone, naproxen, ketorolac

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12
Q

NSAIDs MOA

A

Inhibition of cyclooxygenase (COX) enzymes 1 and 2  reduction in prostaglandin precursors associated with inflammation and pain
Anti-inflammatory and anti-pyretic

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13
Q

NSAIDs indications

A

Mild to moderate pain, inflammation, and fever

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14
Q

NSAIDs adverse effects

A

** gastrointestinal, cardiovasculat*** renal reye’s syndrome

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15
Q

NSAIDs interactions

A

Anti-hypertensive agents
Diuretics
Anticoagulants

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16
Q

NSAIDs counseling

A

Make aware of signs and symptoms of GI bleeding

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17
Q

Aspirin individual characteristics

A

Also indicated for prevention and treatment of MI and acute ischemic stroke/TIA
Other NSAIDs may diminish cardioprotective effects

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18
Q

Indomethacin, Ibuprofen individual characteristics

A

Also utilized for patent ductus arteriosus in infants

Maximum daily dose IBU – 1200 mg to 3200 mg

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19
Q

Ketorolac (IV, IM, PO) individual characteristics

A

Dose adjustment required for geriatric, renal insufficiency, low body weight
Maximum daily dose
Maximum duration of treatment is 5 days

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20
Q

Selective COX-2 Inhibitors drugs

A

Celecoxib

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21
Q

Celecoxib indications

A

osteoarthritis, rheumatoid arthritis

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22
Q

Celecoxib lower risk?

A

gastrointestinal adverse effects

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23
Q

Celecoxib class

A

Selective COX-2 Inhibitors

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24
Q

Acetaminophen MOA

A

Inhibits CNS prostaglandin synthesis

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25
Q

Acetaminophen indications

A

Mild pain
Severe pain in combination
Fever

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26
Q

Acetaminophen adverse effects

A

Hepatotoxicity

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27
Q

Acetaminophen dosing

A

Usual dose: 500-650 mg PO Q 4-6H prn

Children: 10-15 mg/kg PO Q 4-6H prn

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28
Q

Acetaminophen max daily dose

A

Maximum daily dose: 3 grams

Hepatic dosage adjustment: limit to 2 grams/day

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29
Q

Acetaminophen BB warning

A

Hepatotoxicity

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30
Q

Acetaminophen contraindications

A

Hypersensitivity

Severe hepatic impairment/Severe active liver disease

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31
Q

Acetaminophen interactions

A

Concomitant hepatotoxins

Ethanol

32
Q

Acetaminophen counseling

A

Maximum daily dose
Warn against inadvertent overdose
Report unresolved pain or fevers

33
Q

Butalbital/Caffeine/APAP drugs

34
Q

Fioricet MOA

A

Butalbital – barbiturate – sensory cortex and motor activity depression, sedation/drowsiness
Caffeine – increase in cAMP, vasoconstriction, CNS stimulation

35
Q

Fioricet indications

36
Q

Fioricet dosing

A

50 mg butalbital/40 mg caffeine/325-750 mg APAP

1-2 tabs/caps (15-30 mL soln) Q4H prn

37
Q

Fioricet adverse effects

A

Nausea
CNS depression, drowsiness, depression, respiratory depression,nervousness, insomnia, nightmares, hallucinations, tachycardia
Hepatotoxicity

38
Q

Fioricet interactions

A

CNS depressants

Alcohol

39
Q

Fioricet counseling

A

Contains APAP, avoid inadvertent overdose

40
Q

Tramadol MOA

A

Opioid receptor agonist

Inhibits reuptake of serotonin and norepinephrine

41
Q

Tramadol indications

A

moderate to severe pain

42
Q

Tramadol max daily dose

A

Maximum daily dose 400 mg (300 mg extended-release products)

43
Q

Tramadol adverse effects

A

Nausea, vomiting, constipation
Sedation, somnolence, dizziness, euphoria, dysphoria
Hypotension, seizures, abstinence syndrome with abrupt discontinuation

44
Q

Tramadol interactions

A

CNS depressants

Antidepressants may increase risk of seizures and serotonin syndrome

45
Q

Tramadol counseling

A

May cause drowsiness

Abrupt discontinuation may result in withdrawal symptoms

46
Q

CSA Act of 1970 as Amended

A

Comprehensive Drug Abuse Prevention and Control Act (Controlled Substances Act [CSA]) of 1970 as amended
Replaced Harrison Narcotics Act of 1914
Established the Drug Enforcement Agency (DEA) with enforcement powers
Defined 5 Schedules of controlled substances

47
Q

Schedule I

A

The drug or other substance has a high potential for abuse.
The drug or other substance has no currently accepted medical use in treatment in the United States.
There is a lack of accepted safety for use of the drug or other substance under medical supervision.
Examples of Schedule I substances include heroin, lysergic acid diethylamide (LSD), marijuana, and methaqualone

48
Q

Schedule II

A

The drug or other substance has a high potential for abuse.
The drug or other substance has a currently accepted medical use in treatment in the United States or a currently accepted medical use with severe restrictions.
Abuse of the drug or other substance may lead to severe psychological or physical dependence.
Examples of Schedule II substances include morphine, phencyclidine (PCP), cocaine, methadone, and methamphetamine

49
Q

Schedule III

A

The drug or other substance has less potential for abuse than the drugs or other substances in schedule II.
The drug or other substance has a currently accepted medical use in treatment in the United States.
Abuse of the drug or other substance may lead to moderate or low physical dependence or high psychological dependence.
Anabolic steroids, codeine and hydrocodone with aspirin or Tylenol®, and some barbiturates are examples of Schedule III substances.

50
Q

Schedule IV

A

The drug or other substance has a low potential for abuse relative to the drugs or other substances in Schedule III.
The drug or other substance has a currently accepted medical use in treatment in the United States.
Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in Schedule III.
Examples of drugs included in schedule IV are Darvon®, Talwin®, Equanil®, Valium®, and Xanax

51
Q

Schedule V

A

The drug or other substance has a low potential for abuse relative to the drugs or other substances in Schedule IV.
The drug or other substance has a currently accepted medical use in treatment in the United States.
Abuse of the drug or other substances may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in Schedule IV.
Cough medicines with codeine are examples of Schedule V drugs.

52
Q

Narcotics facts and exaples

A

Opioids
Variety of different routes of administration and formulations
Fentanyl, hydromorphone, methadone, morphine, oxycodone

53
Q

Narcotics MOA

A

µ opioid receptor agonist activity  alteration in perception and response to pain centrally and peripherally

54
Q

Narcotics indications

A

Moderate pain, severe pain

55
Q

Narcotics dosing

A

Titrate to response

56
Q

Narcotics adverse effects

A 
Rash, pruritis
Gastrointestinal
Nausea, vomiting
Constipation 
CNS depression
Sedation , dizziness
Respiratory depression
57
Q

Narcotics BB warnings **

A

High potential for abuse, misuse, and diversion

May cause potentially life-threatening hypoventilation, respiratory depression, and/or death

58
Q

Narcotics contraindications

A

Paralytic ileus

59
Q

Narcotics interactions

A

CNS depressants

Alcohol

60
Q

Narcotics counseling

A

May cause constipation requiring laxatives
May cause drowsiness and impair your ability to operate machinery
Avoid alcohol use
May cause physical or psychological dependence with prolonged use
After prolonged use, abrupt discontinuation may result in abstinence syndrome
A new prescription is required for all C-II refills

61
Q

Morphine dosage forms

A

immediate and sustained-release tablets, injection, oral solution, suppositories

62
Q

Morphine counseling

A

do not crush or chew the controlled-release products

63
Q

Oxycodone dosage forms

A

capsules, oral liquid, oral concentrate, immediate and controlled-release tablets

64
Q

Oxycodone counseling

A

do not crush or chew the controlled-release products

65
Q

Oxycodone adverse effects

A

Deaths due to overdose have been reported due to misuse/abuse after crushing the sustained-release tablets

66
Q

Fentanyl dosage forms

A

transdermal patch, buccal tablets, film, lozenges, injection

67
Q

Fentanyl adverse effects

A

Transdermal patch – skin rash

68
Q

Fentanyl counseling

A

Transdermal patch – rotate application site to reduce skin irritation, may take up to 12 hours for onset of effect, never cut patches, discard properly

69
Q

Hydromorphone dosage forms

A

Dosage forms: oral liquid, immediate-release tablets, injection, suppository

70
Q

Methadone indications

A

Pain – multiple daily doses

Addiction – single daily dose

71
Q

Narcotic/Non-narcotic Combinations

A

Introduction:
Commonly combined with APAP or ibuprofen as coanalgesics
Codeine/APAP, hydrocodone/APAP, hydrocodone/IBU, oxycodone/APAP
Indications: moderate pain

72
Q

Codeine/APAP

A

Also used for cough

C-III

73
Q

Hydrocodone/APAP

A

Dosage forms: tablets, elixir, solution

C-III

74
Q

Hydrocodone/IBU

A

Dosage forms: tablets

C-III

75
Q

Oxycodone/APAP

A

Dosage forms: capsules, tablets, oral liquid
Indicated for moderate or severe pain
C-II

Intro To Drugs (13 decks)

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