Analgesics and Pain meds Flashcards
MOA of Acetaminophen
COX inhibitor in CNS only
Fever reducer
No anti-inflammatory effects
Most potent to least potent opioids in combination with acetaminophen
Oxycodone
Hydrocodone
Codeine
Tramadol
Effects of NSAIDs
Anti-inflammatory
Analgesic
Antipyretic
4 NSAIDs to know
Ibuprofen
Naproxen
Piroxicam
Celecoxib
Med that IRREVERSIBLY binds/inhibits COX enzyme
Aspirin
Which COX enzyme induces inflammation?
Cox-2
Which med is the most selective for COX 2 and therefore the best if pt has gastric ulcer issues?
Celecoxib
Which med is preferred if pt has cardiac issues?
Naproxen (least selective for cox 1/2 aside from aspirin)
6 oral opioids in order from most potent to least potent
Hydromorphone Oxycodone Morphine Hydrocodone Codeine Meperidine
ADRs of opioids
Respiratory depression Nasea/vomiting Sedation Dizziness Confusion Pruritus Constipation
MOA of Tramadol
Binds to CNS receptors and interrupts w/ nociceptive transmission.
Inhibits the reuptake of serotonin and norepinephrine (anti-depressant like)
What are the 4 classes of treatment options for Neuropathic pain?
TCAs (Tricyclic antidepressants)
SNRIs (Seretonin Norepinephrine Reuptake Inhibitors
SSRIs (Seretonin Selective Reuptake Inhibitors
(and some anticonvulsant meds)
MOA of TCAs
Inhibition of nociceptive pathway
- inhibition of NE and seretonin reuptake
- increase the synaptic concentrations of 5HT3 (seretonin) and NE
- Potentiate the analgesic effects of opioids
- Na channel blocking effects
ADRs of TCAs
Anticholinergic effects
- Urinary retention
- Constipation
- Xerostomia
- Orthostatic hypotension
also. .. common ones - orthostatic hypotension
- cognitive dysfunction
- sedation
- weight gain
5 TCAs
Desipramine Nortriptyline Amitriptyline Doxepin Imipramine
TCAs with less anticholinergic and sedative effects…
Desipramine
Nortriptyline
Anticonvulsants used to treat neuropathic pain
Gabapentin
Pregabalin
Carbamazapine
Oxcarbasepine
SNRI examples
Duloxetine
Venlafaxine
Desvenlafaxine
ADRs of SNRIs
Xerostomia
Bruxism
Increase in BP
8 prophylactic meds for Migraine HAs
Metoprolol Propranolol Valproic acid Topiramate Timolol Amitriptyline Atenolol Venlafaxine
Acute treatment meds for Migraine HAs
Triptans
- Sumatriptan
- Zolmitriptan
- Rizatriptan
- Frovatriptan
- Naratriptan
- Almotriptan
When are triptans contraindicated?
Uncontrolled hypertension
Pregnancy
Ischemic bowel disease
PVD peripheral vascular dz
Prophylaxis meds for Tension HAs
TCAs
Botulinum toxin
Acute meds for Tension HAs
Acetaminophen
NSAIDs
