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Pharmacology 1 > Non-Opioid Dosages > Flashcards

Non-Opioid Dosages Flashcards

1
Q

Aspirin alternate name:

A

acetylsalicylic acid (ASA)

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2
Q

Aspirin structure:

A

benzene ring with carboxylic acid group

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3
Q

Aspirin MOA:

A
  1. Irreversibly acetylates COX enzymes
  2. Prevents the conversion of arachidonic acid to prostaglandins thus attenuating nociceptive response to endogenous mediators of inflammation
  3. Inhibiting platelet aggregation for the life of the platelet
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4
Q

Aspirin Onset:

A

15 min

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5
Q

Aspirin Duration of action:

A

4-6 hr

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6
Q

Aspirin PB:

A

80-90%

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7
Q

Aspirin metabolism:

A

Active metabolite salicylic acid with half life of 2-3 hours

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8
Q

Aspirin PO dose (daily preventative):

A

81 mg
Max 4 g/day

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9
Q

Aspirin PO dose (analgesia/antipyretic):

A

325-650 mg Q 4-6 hr
Max 4 g/day

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10
Q

Aspirin PO dose (for anti-inflammatory):

A

1000 mg
Max 4 g/day

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11
Q

Aspirin Side Effects:

A

B – Bleeding
A – Allergic Reaction
K – Kidney Failure
E – Edema

G – GI Bleed

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12
Q

Aspirin Contraindications / cautions:

A

C – Constriction (bronchoconstriction)
H – Heart attack (prevention)
I – Increased temperature (fever treatment)
P – Prostaglandin (decreases production)
S – Stroke (prevention)

  1. Inhibits platelet for life (10-14 days)
  2. Do not give children (risk for reyes syndrome)
  3. Salicylate overdose—tinnitus, metabolic acidosis
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13
Q

Toradol alternate name:

A

Ketorolac

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14
Q

Toradol structure:

A

Fenamate
Racemic mixture

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15
Q

Toradol MOA:

A
  1. Inhibits the COX I & II enzymes (most selective COX-1)
  2. Prevents the conversion of arachidonic acid to prostaglandins thus attenuating nociceptive response to endogenous mediators of inflammation
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16
Q

Toradol Onset:

A

10 min

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17
Q

Toradol duration of action:

A

4-6 hr

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18
Q

Toradol PB:

A

99%

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19
Q

Toradol Metabolism:

A

conjugated in the liver, excreted by the kidneys

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20
Q

Toradol IV adult dose:

A

15-30 mg Q 6 hr IV or IM for no more than 5 days

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21
Q

Toradol IV Meds Dose:

A

0.5 mg/kg

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22
Q

Toradol Side Effects:

A

B – Bleeding
A – Allergic Reaction
K – Kidney Failure
E – Edema

G – GI Bleed

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23
Q

Toradol Contraindications / cautions:

A

C – Constriction (bronchoconstriction)
H – Heart attack (increased risk)
I – Increased temperature (fever treatment)
P – Prostaglandins
S – Stroke (increased risk)

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24
Q

Celecoxib alternate name:

A

Celebrex

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25
Q

Celecoxib Structure:

A

Acetic acid derivative

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26
Q

Celecoxib MOA:

A
  1. Inhibit the action of cyclo-oxygenase (COX)
  2. Prevents the conversion of arachidonic acid to prostaglandins thus attenuating nociceptive response to endogenous mediators of inflammation
  3. Treatment of mild to moderate post-op pain
  4. Analgesic, antipyretic, and anti-inflammatory
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27
Q

Celecoxib Onset:

A

2 hr

28
Q

Celecoxib duration of action:

A

4-6 hr

29
Q

Celecoxib PB:

A

97%

30
Q

Celecoxib Metabolism:

A

CYP450 mediated oxidation or glucuronidation

31
Q

Celecoxib PO dose:

A

200 mg pre-op
100-200 mg QD or BID for first 3 days post op

32
Q

Celecoxib Side Effects:

A

B – Bleeding
A – Allergic Reaction
K – Kidney Failure
E – Edema

G – GI Bleed

33
Q

Celecoxib Contraindications / cautions:

A

C – Constriction (bronchoconstriction)
H – Heart attack (increased risk)
I – Increased temperature (fever treatment)
P – Prostaglandins
S – Stroke (increased risk)

34
Q

Acetaminophen alternate name:

A

Tylenol

35
Q

Acetaminophen structure:

A

Fenamate

36
Q

Acetaminophen MOA:

A
  1. Acts on serotonergic pathways
  2. Possible COXIII inhibition
  3. Possible endogenous cannabinoid potentiation
  4. Anti-pyretic effects from direct inhibition of the hypothalamic heat regulating centers by inhibiting actions of endogenous pyrogens
37
Q

Acetaminophen Onset:

A

10 min

38
Q

Acetaminophen duration of action:

A

4-6 hr

39
Q

Acetaminophen PB:

A

20%

40
Q

Acetaminophen Metabolism:

A

90% hepatic, small amount excreted unchanged

41
Q

Acetaminophen IV dose:

A

1000 mg over 15 min (max 4g/day)

42
Q

Acetaminophen Peds dose:

A

10-15 mg/kg (max daily: 75 mg/kg)

43
Q

Acetaminophen Side Effects:

A
  1. Decrease pain
  2. No anti-inflammatory effect
  3. See C/c for additional
44
Q

Acetaminophen Contraindications / cautions:

A
  1. Treat overdose with acetylcysteine within 8 hours

T – Temperature (decreases fever)
Y - Yellowing (jaundice)
L - Liver damage (with overdose)
E – End stage Renal (possible with long term use)
N - Nausea
O - Opioids: may reduce absorption
L - Lush – caution in alcoholics

45
Q

Decadron Alternate name:

A

Dexamethasone

46
Q

Decadron structure:

A

Synthetic corticosteroid / glucocorticoid

47
Q

Decadron MOA:

A
  1. Inhibits Phospholipase A2 thus inhibiting arachidonic acid and the entire pathway
  2. Prostaglandins are inhibited – decreasing pain and inflammation
  3. Leukotrienes are inhibited – ok for brittle asthmatics unlike NSAIDS
48
Q

Decadron Onset:

A

1-2 hr

49
Q

Decadron duration of action:

A

36-48 hr

50
Q

Decadron PB:

A

80%

51
Q

Decadron Metabolism:

A

Liver - CYP3A4
excreted by the kidneys

52
Q

Decadron IV pain dose:

A

8-10 mg

53
Q

Decadron IV PONV dose:

A

4 mg

54
Q

Decadron IV Peds dose:

A

0.15 mg/kg

55
Q

Decadron Side effects:

A
  1. Increased Glucose levels
  2. Weight gain and fluid retention
  3. Mood changes
  4. Insomnia
  5. Increased risk of infections
56
Q

Decadron Contraindications / cautions:

A
  1. Allergy to Decadron
  2. May exacerbate hypertension
  3. Caution in diabetics
  4. Adrenocortical insufficiency or withdrawal if discontinued rapidly
  5. Increased risk of perforation/bleeding in patients with GI issues (peptic ulcers, ulcerative colitis, etc.)
57
Q

Magnesium alternate name:

A

Jokes, there isn’t one (sometimes referred to as its chemical compound, magnesium sulfate, magnesium oxide, etc)

58
Q

Magnesium structure:

A

Elemental

59
Q

Magnesium MOA:

A
  1. Calcium channel and NMDA antagonist
  2. Antagonizes hippocampal presynaptic CA++ channels that regulate aspartate and glutamate, preventing central sensitization, inhibiting hyperalgesia and amplifying the analgesic effects of opioids
  3. NMDA antagonism is related to magnesium plug that sits within the NMDA channel
60
Q

Magnesium Onset:

A

30-60 sec

61
Q

Magnesium Duration of action:

A

30-60 min

62
Q

Magnesium PB:

A

30%

63
Q

Magnesium Metabolism:

A

Not metabolized - renally excreted

64
Q

Magnesium IV bolus dose:

A

30-50 mg/kg (over 30-60 min)

65
Q

Magnesium IV infusion dose:

A

10 mg/kg/hr

66
Q

Magnesium Side effects:

A
  1. Hypotension
  2. Respiratory depression
  3. Decreased DTRs
  4. Muscle weakness
  5. Flushing
67
Q

Magnesium Contraindications / cautions:

A
  1. Caution in patients with respiratory issues
  2. Caution in patients on CCBs
  3. CNS depression
  4. Caution in Renally impaired patients
  5. Caution in patients with Heart block

Pharmacology 1 (12 decks)

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