Management of Acute Postoperative Pain part 2

Question 1

why are chronic opioid users hard to manage?

Answer 1

have to manage post-op pain in addition to baseline pain

Question 2

T/F: tolerance of chronic opioid users may require what?

Answer 2

temporary increase in opioid dosage

Question 3

signs and symptoms of allergic rxn

Answer 3

1. skin rash/hives
2. wheezing
3. swelling of body parts
4. anaphylaxis

Question 4

tx of allergic rxn to drug that is not anaphylaxis

Answer 4

1. discontinue drug
2. antihistamines
3. corticosteroids

Question 5

examples of adverse rxn of NSAIDs

Answer 5

1. heartburn

2. bronchospams

Question 6

opioid adverse rxns

Answer 6

1. nausea
2. pruritis
3. sedation/decreased cognition
4. respiratory depression
5. constipation

Question 7

what are some strategies to avoid adverse rxns with opioids

Answer 7

1. dose reduction
2. opioid rotation
3. manage the adverse effects

Question 8

enteral (po) corticosteroids are used for what in dentistry?

Answer 8

trismus/edema

Question 9

when are corticosteroids indicated?

Answer 9

non-anaphylactic allergic rxn that doesn’t respond to antihistamines

Question 10

contraindications of corticosteroids

Answer 10

1. hx of chronic infection
2. peptic ulcer disease
3. diabetes mellitus
4. poor wound healers

Question 11

patients should be cautious about using corticosteroids simultaneous with what drug?

Answer 11

NSAID

Question 12

effect of exogenous steroids on HPA (hypothalamus-pituitary-adrenal) axis can cause extreme stress leading to what?

Answer 12

acute adrenal insufficiency which is medical emergency

Question 13

rule of two’s

Answer 13

consider stress dose of steroid if 20 mg prednisone per day for

1. more than 2 weeks
2. in past 2 months

Question 14

corticosteroids have limited use in dentistry and chronic use of it can impact what?

Answer 14

wound healing