Analgesics for Oral Surgery Flashcards
What are the ideal analgesics family to use for inflammatory pain and name some
NSAIDs e.g.:
- Ibuprofen
- Naproxen
- Diclofenac
What can inflammatory pain arise from in oral surgery
- Pulpitis/Periapical periodontitis
- Extraction (post op)
Why is paracetamol not one of the preferred analgesics for inflammatory pain
- It is analgesic and antipyretic but it doesnt have anti-inflammatory properties
What other analgesic should paracetamol not be used with
Co-codamol
What properties does paracetamol have
Analgesic and Antipyretic
What is paracetamol often recommended to be taken in combination with and why
NSAIDs due to its lack of anti-inflammatory properties
What is the mechanism of action of NSAIDs
- NSAIDs inhibit the activity of cyclooxyrgenase enzymes (COX-1 and/or COX-2)
What do the cyclooxyrgenase enzymes do (COX-1 and 2)
These enzymes are involved in the synthesis of prostaglandins and thromboxanes
What are prostaglandins involved in
The inflammatory response (this is therefore inhibited by NSAIDs)
What are thromboxanes involved in
In blood clotting (also inhibited by NSAIDs)
What are the main adverse effects of NSAIDs
- GI bleeds
- Selective COX-2 NSAIDs promote thrombosis and increase risk of CVA
- Contraindicated in patients with CV and GI problems and asthma
- Could induce Raye’s syndrome
Do NSAIDs inhibit COX-1 and 2 selectively or non-selectively
Most NSAIDs are non-selective but there is a subgroup that is a selective COX-2 inhibitor
When can opioids be prescribed
- When NSAIDs can’t be prescribed and/or pain levels are expected to be moderate to severe
Name some opioid analgesics
- Codeine phosphate
- Dihydrocodeine
What are some of the potential side fx of opioids
- Constipation
- Tolerance
- Physical dependence and addiction (rare in short courses)
- Nausea and vomiting
- Respiratory depression
- Interactions with other depressant drugs such as benzodiazepines
