Meds for chronic pain Flashcards
What does acetaminophen do and max per day
- inhibit prostaglandin synthesis in peripheral tissues (anti pyretic)
- no effect on inflammation
Max 4g adults, 3g seniors
What do NSAIDs do
- inhibit cox enzymes
- reduce inlammation and platelet aggregation
- used for tx of mild to mod pain where inflammation is present
what are the benefits/risks of selective cox 2 NSAIDs
reduce gastro side effects
may be associated w increased CV effects thooo
adverse effects of NSAIDs
GI: indigestion, IBS, peptic ulcer, stomach bleeding
Kidney disease
CV effects (2x-10x higher)
what do anti-spasticity agents work on
- work on the spinal cord or directly on skeletal mm to improve hypertonicity and involuntary spasms
- used to tx conditions such as MS, cerebral palsy, spinal cord injury, post stroke etc
what do antispasmodics do and how long should they be rx for
-decrease mm spasms thru alterations in CNS conduction (inhibit post synaptic trans of GABA)
rx for short term (max 3w) for acute conditions
what are opiod meds rx ofr
1st line in severe acute/ cancer pain
2nd line for neuropathic pain
-limited indication for chronic non cancer pain
what is opiod induced hyperalgesia
paradoxical state of nociceptive sensitizations caused by exposure to opiods
-@ high doses
What is anticonvulsants used for and how do they work
Used to tx epilepsy
-reduce high frequency firing of neurons thru interaction w cal and sod channels
clinical considerations w anticonvulsants
- only really works for neuropathic pain
- have to be built up over time to have pos effetc
what are antidepressants rx for
- neuropathic pain
- migrane priphylaxis
- efficacy for fibromyalgia
What is cymbalta and what is it approved for
Serotonin moradrenaline reuptake inhibitir
-Neuropathic pain, fibro, depression, anxiety
What are the major receptors for cannabinoids and where are they located
CB1- primary CNS
CB2- peripheral tissues
CBD doesnt bind to these but THC does
