MOD 2 Orthopedic Pharmacology Acute Pain Management

Question 1

What type of pain is acute pain typically>

Answer 1

nociceptive

Question 2

What medication is used for mild pain (1-3)?

Answer 2

non opioids (NSAID or acetaminophen

+/- adjuvant analgesics

Question 3

What medication is used for moderate pain (4-6)?

Answer 3

immediate release short acting opioids with slow titration

+ non opioid (NAIDs) +/- adjuvant analgesics

Question 4

What type of medication is used for severe pain (7-10)?

Answer 4

immediate release, short acting opioids with rapid titration

+ non opioid +/- adjuvant analgesics

Question 5

What do opioids do?

Answer 5

decrease transmission and perception of pain

decrease reaction to pain

Question 6

What do non opioids do?

Answer 6

decrease sensitization to pain

Question 7

What is opioid sparing?

Answer 7

using non opioids to decrease the use of opioids

Question 8

What do non-opioid analgesics do?

Answer 8

effective in treatment of inflammation

Question 9

What is an example of a non-opioid analgesic?

Answer 9

acetaminophen, NSAIDs

Question 10

What are side effects of non-opioid analgesics?

Answer 10

dyspepsia and gastric ulceration

Question 11

What are examples of nonselective COX inhibitors?

Answer 11

ibuprofen and naproxen

Question 12

What are examples of selective COX-2 inhibitors?

Answer 12

celecoxib and acetaminophen

Question 13

What do tNSAIDs do?

Answer 13

block platelet aggregation by inhibition of COX-1 TXA synthesis which promotes bleeding

Question 14

What drugs are anti platelet?

Answer 14

low dose aspirin and clopidogrel (plavix)

Question 15

What drugs are antithrombotic?

Answer 15

warfarin, apixaban, and dabigatran

Question 16

Does celecoxib alter platelet function or increase bleeding risk?

Answer 16

no

Question 17

What are the clinical uses of acetaminophen?

Answer 17

• mild to moderate pain
• at max doses, less effective than tNSAIDs
• no inflammatory response

Question 18

What are the side effects of acetaminophen?

Answer 18

little risk of side effects on GI tract, platelets, kidneys

hepatotoxicity risk

Question 19

What are opioids used for?

Answer 19

• acute pain from trauma or surgery
• chronic cancer or acute exacerbations

more effective for mod to severe pain

Question 20

What do combination agents do?

Answer 20

permit increase in pain control with minimal increase in side effects

Question 21

What are adverse effects of opioids?

Answer 21

sedation: which can be troublesome in PT sessions

constipation: could be troublesome in patients with spinal cord injury

nausea and vomiting

orthostatic hypotension

insensitivity to CO2

withdrawal

Question 22

What do anti-inflammatory corticosteroids do?

Answer 22

adjuvant analgesics: treat concurrent symptoms that exacerbate pain

provide independent analgesic activity for some specific pain

Question 23

What are the benefits of anti-inflammatory corticosteroids?

Answer 23

• anti inflammatory
• helps work with arthritis patients

Question 24

What are the most common used anti-inflammatory corticosteroid agents?

Answer 24

• prednisone
• methylpednisolone
• dexamethasone