Nociceptive Pn Tx

Question 1

NSAIDs

Answer 1

• somatic pn
• can use PPI/H2 blocker if GI upset
• TAKE WF
• effective if prior to pn (not during)
• watch for dark/tarry stool (GI bleeding)

Question 2

How long can we use Ketorolac for?

Answer 2

MAX: 5 days

Question 3

Topical NSAID

Answer 3

Voltaren

• low systemic absorption –> use where PO NSAID not recommended
• healthy skin
• superficial joints ONLY

Question 4

Muscle Relaxants

Answer 4

short-term

• best if used after NSAIDs
• no one better than another (use AE)

antispastic (baclofen)
- prevents or diminishes spasms
antispasmodic (cyclobenzaprine, methocarbamol, carisoprodol)
- relieve spasm of involuntary muscle

Carisoprodol has additive potential

Question 5

Which muscle relaxants are the least sedating?

Answer 5

Methocarbamol
&
metaxalone –> ($$)

Question 6

Which muscle relaxants are the most sedating?

Answer 6

Cyclobenzaprine (anticholinergic effects)
&
Tizanidine (routine hepatic func. test required)