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PPS 946 > Cancer Pain Management > Flashcards

Cancer Pain Management Flashcards

1
Q

What is the conversion ratio of fentanyl to MSO4?

A

6:1

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2
Q

How long does methadone last with chronic dosing?

A

6-8 hours

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3
Q

Why can’t we give methadone as PRN?

A

There is a problem with respiratory depression.

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4
Q

For oral treatment of pain >4, what is the range of the morphine sulfate dose that the NCCN guidelines say to give?

A

5-10mg

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5
Q

For IV treatment of pain >4, what is the range of the MSO4 dose that the NCCN guidelines say to give?

A

2-5mg

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6
Q

How long should you expect tolerance for sedation from opioids?

A

1-3 days

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7
Q

How do you treat persistent sedation?

A

You optimize the dose and can give Ritalin

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8
Q

How long should you expect tolerance for N/V in patients taking opioids?

A

3-4 days.

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9
Q

What is the most common cause of nausea in patients taking opioids?

A

Constipation

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10
Q

What medications can you give to patients to help with N/V due to opioids?

A

Metoclopramide

Prochlorperazine

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11
Q

What is pruritus?

A

Several opioids cause histamine release which can cause pruritus as a side effect.

It is severe itching.

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12
Q

What dose should you start at for naloxone when reversing respiratory depression?

A

0.4mg/10mL
Give 0.5mL every 2 minutes.

You do this to prevent causing severe rebound pain.

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13
Q

Do sleeping patients need naloxone?

A

No

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14
Q

Why are antidepressants used as an analgesic adjuvant?

A

TCAs are useful for neuropathic pain.

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15
Q

Why are anticonvulsants used as an analgesic adjuvant?

A

Useful for neuorpathic pain

Carbamazepine, Gabapentin

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16
Q

Why are corticosteroids used as an analgesic adjuvant?

A

Useful for pain due to nerve compression or inflammation, lymphedema, bony pain, increased intracranial pressure.

17
Q

Why are benzodiazepines useful as an adjuvant analgestic?

A

Useful for muscle spasms

18
Q

Why are bisphosphonates used as an analgesic adjuvant?

A

May be useful in bone pain, especially for osteolytic lesions

19
Q

How do you treat bone pain?

A

NSAID or NSAID +Opioid

20
Q

How do you treat muscle spasms?

A

BZD or baclofen

21
Q

How do you treat neuropathic pain?

A

Nortriptyline or Carbamazepine +/- narcotic

If unresponsive use gabapentin, corticosteroid, or mexilitene

22
Q

How do you treat increased intracranial pressure?

A

Corticosteroids

PPS 946 (22 decks)

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