Analgesics COPY Flashcards by VANESSA LANTIGUA

postaglandins

sensitize neurons to painful stimuli

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endorphins

(endogenous morphine)
blocks painful stimuli
stimulate pleasure centers in the brain

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GABA

calms down nerves- (but unsure as to why it calms them down. reduces neuronal hyper excitability related to epilepsy and neuropathic pain)

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Types of nociceptive pain

Somatic (skin bone joint muscle or connective tissue

Visceral pain- internal organs

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___ often results in a phenomenon known as “referred pain”

visceral pain which is nociceptive pain

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role of NSAIDS

reduces inflammation

reduces pain

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neuropathic pain

comes from the nerves itself

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“burning, shooting, stinging pain”

neuropathic pain

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which type of pain does not involve stimuli

neuropathic pain

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diseases invoving neuropathic pain

diabetic neuropathy

postherpetic neuralgia

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___ pain is the result of neurophysiological problems

neuropathic pain

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___ pain is phamton limb pain

neuropathic

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aka learned pain

phantom limb pain

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____ used for minor aches and pains

pain relief topical agents

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What type of local anesthetic causes vasoconstriction and less bleeding

lidocaine w/ epinephrine

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cant use lidocaine with epi where

fingers toes nose penis

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treats mild to moderate severe pain

NSAIDS

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Examples of NSAIDS

ibuprofen 
naproxen 
meloxicam
asprin
toradol
celebrex
diplofenac- topically

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ibuprofen works for

4-6 hours

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naproxen works for

12 hours

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meloxicam works for

24 hours

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celebrex works for

24 hours

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Asprin precaution

avoid use in children can cause reye’s syndrome

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pain number for mild to moderate pain is anything between

1-4

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NSAIDS MOA

``` inhibits formation of prostaglandins and thromboxanes (cause inflammation) ```

how are NSAIDS excreted?

renally.

Precations for NSAIDS

use with caution in elderly (they have decreased kidney function) Worsens HF

Do not prescribe NSAIDS to patients with which disorders

``` stomach ulcers (can cause this) stomach ache (can cause a stomach ache) HF (worsens- causes fluid overload) ```

Which NSAID has Less stomach irritation

Celebrex | meloxicam

IV NSAID

Toradol

Topically applied NSAID

Diclofenac

kidney stones (renal colic) can be treated w/ works well with

Torodol

kidney infection is MORE likely if i combine an NSAID w/

ACE ARB diuretic

NSAIDS can reduce effects of

hypertensives | Worsens Hypertension

What areas in older adults is toxicity seen with NSAIDS

GI tract | kidneys

Acetaminophen used for | MOA

mild to moderate pain but NOT to treat inflammation | inhibits prostaglandins but not thromboxanes

has antipyretic properties

NSAIDs tylenol

GI problems, caused by NSAIDS or tylenol

NSAIDS

max dose of acetaminophen

4g/day | 3kg/lifetime

motrin max dose

3200 mg/day

Antidote for acetaminophen

mucomyst IV | charcoal

Opiods all have short durations (how long) except for

4 hours | methadone

when first taking methadone the duration of action is __ hrs, after repeated doses the duration is ___

4 hours, 24 hours

provides a safe opioid as a substitute for heroin

methadone

___ is the weakest opioid

tramadol

middle strength of opioids

hydrocodone | codeine

Used for moderate to severe neuropathic or nociceptive pain

opioids

If you are allergic to opioids which opioids can you take?

methadone, fentanyl, meperidine | since structure is dissimilar

effects of opioids on pupils/eyes

constricts pupils

epidural route

into spine

intrathecal route

into meanings of spinal cord

contraindications of opioids

``` liver disease kidney disease premature infants - avoid increased intracranial pressure prostatic hypertrophy ```

transdermal opioids which for short term PCA?

Ionsys

when do we look for fentanyl patches

when assessing patient AMS respiratory depression applying another patch

if someone has AMS what else can you do for them?******** she repeats this one twice

``` check: ABC's blood glucose EtOh CT scan of head (brain bleed) brain injury give them ******Narcand**** ```

post hemetic neuralgia aka | causes what type of pain

shingles | neuropathic pain

Dirty Drug"

meperidine | b/c metabolizes inot things that are harmful to patients

meperidine used for

restricted to patients with pancreatic diseases

used for severe pain, example cancer

methadone

very difficult to resusitate patient in OD of ____

methadone

____ opiod with least risk of respiratory depression

tramadol

opioid antidote

narcane | naloxone/enzio- home antidote

how must naloxone be taken to block euphoria

crushed snorted injected

When naloxone is taken orally will it deter abuse

Diseases that would cause bone pain

pagets dx- (malformation of the bone caused by osteoarthiris) bone cancer osteoarthritis

treatment for bone pain

bisphosphonates- used to treat osteroprosis steriods (sometimes need opioids)

lyrica and gabapentrin is used for which dx

diabetic peripheral neuropathy fibromyalgia postherpatic neuralgia epilepsy

lyrica function

calm nerves down

lyrica SE

diziness headache drowsiness more youtake more SE u experience