non-narcotic pain management

Question 1

aspirin (ASA)

Answer 1

• inhibits platelets
  
  • increase bleeding with surgery or procedures
• dont use in children due to potential Reye’s syndrome
• can antagnoize gout meds

Question 2

ibuprofen

Answer 2

• can decrease effectiveness of ACE inhibitors
• should take with food

Question 3

naproxen

Answer 3

• (trade names = aleve, anaprox, naproxyn)
• may decrease effect of B-blockers, ACE inhibitors and furosemide
• more CV neutral than other NSAIDS but can affect BP

Question 4

Indomethacin

Answer 4

• (indocin)
• used MOSTLY FOR ACUTE GOUT ATTACKS
• high rate of GI problems
  
  • nausea, vomiting, diarrhea

Question 5

ketorolac

Answer 5

• treatment should NOT exceed 5 days
• contraindicated in pt with Renal impairement, volume depletion or peptic ulcer
• USED FOR MODERATE-SEVERE pain
  
  • sometimes used when patients can’t toleract narcotics

Question 6

Meloxicam

Answer 6

• avoid use with cyclosporine –> can lead to kidney disease
• may alter effectiveness of ACE inhibitors and beta-blockers
• More cox-2 selective than other NSAIDS
• thought to have less GI side effects

Question 7

Diclofenac

Answer 7

• can elevate liver enzymes
  
  • check AST/ALT within 4-8 weeks of oral treatment
• CONTRAINDICATED in pregnancy
• helps prevent GI ulcers