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pharm 2 > analgesics table > Flashcards

analgesics table Flashcards

1
Q

Acetaminophen- APAP (Tylenol) - OTC dosing

A

325-1000 mg q 4-6 hours (maximum 3 gm/day OTC use, max 4 gm/day under
supervision of healthcare provider))

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2
Q

APAP anti-inflam properties

A

none

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3
Q

recomended APAP dose for older adults

A

2-3g/day

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4
Q

child dosing APAP

A

see package

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5
Q

who should we avoid APAP use in

A

Avoid use in patients with severe hepatic disease and
alcohol abuse/dependence

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6
Q

what rx’s should be avoided when taking APAP

A

any others containing APAP

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7
Q

NSAIDS anti inflam properties

A

Anti-inflammatory (at prescription strength/higher doses)

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8
Q

NSAIDS general concerns:
May worsen?
increases?
causes?
decrease function of?

A

May worsen heart failure, increase BP, cause edema,
decrease kidney function

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9
Q

Celecoxib (Celebrex) - RX dosing

A

Celecoxib (Celebrex) - RX 100- 200 mg BID

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10
Q

celecoxib moa

A

selective cox 2 inhibitor

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11
Q

celecoxib:
* GI?
* Caution/Contraindications in?

A
  • Lower risk of GI toxicities than non-selective NSAIDs.
  • Caution/Contraindications in CV disease, renal impairment, and high-risk GI bleed.
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12
Q

Ibuprofen (Motrin) doses
OTC adult dose:
RX:

A

OTC adult dose: 200mg
RX: 400 mg, 600 mg, 800 mg

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13
Q

Ibuprofen (Motrin) dosing

A

200 to 800 mg 3 to 4 times daily; usual dose: 400 mg;
usual daily dose: 1,200 to 2,400 mg/day

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14
Q

ibuprofen moa

A

cox 1 and 2 inhibitor

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15
Q

ibuprofen:
* increases risk of?
* Caution/Contraindications in?
* children dosing

A
  • increases risk of bruising and bleeding
  • Caution/Contraindications in CV disease, renal impairment and high-risk GI bleed.
  • See dosing/package information for children’s weight- based dosing
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16
Q

Meloxicam (Mobic)- RX dosing

A

7.5- 15 mg daily

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17
Q

meloxicam:
* increases risk of?
* Caution/Contraindications in?
* children dosing

A
  • increases risk of bruising and bleeding
  • Caution/Contraindications in CV disease, renal impairment and high-risk GI bleed.
  • See dosing/package information for children’s weight- based dosing
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18
Q

Nabumetone (Relafen) - RX dosing

A

500 – 2000 mg daily

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19
Q

Nabumetone:
* increases risk of?
* Caution/Contraindications in?
* children dosing

A
  • increases risk of bruising and bleeding
  • Caution/Contraindications in CV disease, renal impairment and high-risk GI bleed.
  • See dosing/package information for children’s weight- based dosing
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20
Q

Naproxen/Naproxen Sodium
OTC adult dose:
RX:

A

OTC adult dose: 220 mg, as naproxen sodium
RX: 250mg, 500 mg

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21
Q

Naproxen/Naproxen Sodium:
* increases risk of?
* Caution/Contraindications in?
* children dosing

A
  • increases risk of bruising and bleeding
  • Caution/Contraindications in CV disease, renal impairment and high-risk GI bleed.
  • See dosing/package information for children’s weight- based dosing
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22
Q

non-selective NSAIDS

A

IBU
meloxicam
nabumetone
naproxen

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23
Q

selective nsaids

A

celecoxib

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24
Q

COMMON OPIOIDS AND OPIOID-LIKE AGENTS

A
  • Acetaminophen and codeine (Tylenol #3/Tylenol#4)
  • Hydrocodone and acetaminophen
  • Oxycodone and acetaminophen
  • Oxycodone
  • Morphine Sulfate
  • Tapentadol (opioid like)
  • Tramadol and acetaminophen (opioid like)
  • tramadol (opioid like)
25
Q

COMMON OPIOIDS AND OPIOID-LIKE AGENTS:
Start with what doses?

A

Start with lower dose in opioid naïve patients (higher doses may be required in opioid tolerant patients).

26
Q

opioids/opioid like:
Common ADRs:
May cause?

A

Common ADRs: sedation, constipation.
May cause respiratory depression.

27
Q

opioid/opioid like:
Avoid use with>?

A

Avoid use with benzodiazepines, sedative-hypnotics, anxiolytics and other CNS depressants

28
Q

forms of Acetaminophen and codeine

A

Tylenol #3: 300mg APAP, 30 mg codeine,
Tylenol #4, 300 mg APAP, 60 mg codeine) C-III

29
Q

Acetaminophen and codeine dosing

A

Acetaminophen (300 to 600 mg/dose)/codeine (15 to 60 mg/dose) every 4 hours as needed; adjust dose according to severity of pain and response of patient
(maximum: acetaminophen 4,000 mg/codeine 360 mg per 24 hours

30
Q

Acetaminophen and
codeine high rate of what ADEs?

A

High rate of GI ADEs (especially constipation)

31
Q

Acetaminophen and
codeine analgesic effects?

A

limited

32
Q

Acetaminophen and codeine and age precautions

A

Codeine is contraindicated in children younger than 12 yrs of age due to variability in metabolism. Caution in patients 12-18 years, especially those with potential for breathing
problems such as those with obstructive sleep apnea or severe lung disease

33
Q

Hydrocodone and acetaminophen formulations

A
  • Hydrocodone 2.5 mg/APAP 335 mg,
  • Hydrocodone 5 mg/APAP 325 mg,
  • Hydrocodone 7.5 mg/APAP 325 mg,
  • Hydrocodone 10 mg/APAP 325
    (others, somecontain 300 mg APAP)
    C-II
34
Q

Hydrocodone and acetaminophen dosing

A

Hydrocodone 2.5 to 10 mg every 4 to 6 hours
(maximum dose may be limited by the acetaminophen content of
product)

35
Q

what limits Hydrocodone and acetaminophen dosing

A

APAP content

36
Q

Oxycodone and acetaminophen formulations

A
  • oxycodone 2.5 mg/APAP 335 mg,
  • oxycodone 5 mg/APAP 325mg,
  • oxycodone 7.5 mg/APAP 325 mg,
  • oxycodone 10 mg/APAP 325
    C-II
37
Q

Oxycodone and acetaminophen dosing

A

2.5 to 10 mg every 4-6 hours as needed. Titrate according to pain severity and individual response.
Maximum dose of limited by the acetaminophen content of product

38
Q

what limits Oxycodone and acetaminophen dosing

A

APAP content

39
Q

Oxycodone tablet doses

A

tablet - 5 mg, 15 mg, 30 mg
C-II

40
Q

Oxycodone tablet dosing

A

5 to 15 mg every 4 to 6 hours as needed

41
Q

oxycodone tablets can be dosed with?

A

Able to dose with separate NSAID and/or acetaminophen

42
Q

Morphine Sulfate tablet doses

A

15 mg, 30 mg
C-II

43
Q

Morphine Sulfate tablet dosing

A

15 to 30 mg every 4 hours as
needed

44
Q

how are opioids often measured

A

Opioids often compared by Mg Morphine Equivalents
(MMEs)

45
Q

Tapentadol (Nucynta) tablet doses

A

50 mg, 75 mg, 100 mg
C-II

46
Q

Tapentadol (Nucynta) tablet dosing

A

50-100 mg q 4-6 hrs

47
Q

Tapentadol ADEs

A
  • Opioid-like ADEs.
  • Decreases seizure threshold.
48
Q

Tapentadol with adolescents

A

Safety and efficacy not established in patients < 18 years of age

49
Q

Tramadol and acetaminophen formula

A

Tramadol 37.5 mg/APAP 325 mg
C-IV

50
Q

Tramadol and acetaminophen dosing

A

Two tablets q 4 -6 hours as needed for pain relief
(maximum: 8 tablets/day)

51
Q

Tramadol and acetaminophen ADEs

A
  • Opioid-like ADEs.
  • Decreases seizure threshold.
52
Q

Tramadol and acetaminophen caution use with?

A
  • Caution when combined with other serotonergic medications. May precipitate serotonin syndrome
  • other products with APAP
53
Q

Tramadol and acetaminophen dose limited by?

A

APAP content

54
Q

Tramadol and acetaminophen use in kids/adolescents

A

Contraindicated in children younger than 12 yrs of age due to variability in metabolism. Caution in patients 12-18 years, especially those with potential for breathing problems such as those with obstructive sleep apnea or severe lung disease

55
Q

Tramadol (Ultram) dose

A

50 mg
C-IV

56
Q

Tramadol (Ultram) dosing

A

50-100 mg q 4-6 hrs

57
Q

Tramadol ADEs

A
  • Opioid-like ADEs.
  • Decreases seizure threshold.
58
Q

Tramadol caution use with:

A

Caution when combined with other serotonergic medications. May precipitate serotonin syndrome

59
Q

tramadol use contraindicated in:

A

Contraindicated in children younger than 12 yrs of age due to variability in metabolism. Caution in patients 12-18 years, especially those with potential for breathing problems such as those with obstructive sleep apnea or severe lung disease

pharm 2 (20 decks)

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