Non-opioid pain meds Flashcards

1
Q

The governing principle of the WHO ladder for chronic pain treatment is…

A

use the drug with the least addictive potential at the lowest concentration needed to achieve effective pain management

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2
Q

any drug with indications other than pain that may be an analgesic

A

adjuvant

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3
Q

What is a common antidepressant added to tx chronic back pain after failing acetaminophen treatment and has a hx of cardiovascular problems

A

duloxitine

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4
Q

Gabapentin treats pain by reducing…

A

glutamate release from primary nociceptors

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5
Q

Which adjuvant drug is known for its fast onset of action?

A

pregabalin

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6
Q

In the dorsal horn, NE produces analgesia by inhibiting presynaptic …

A

Cav channels

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7
Q

What antidepressant drugs have been shown to not have any analgesic properties?

A

SSRIs

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8
Q

What is a first line tx for neuropathic pain?

A

SNRIs

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9
Q

What is duloxetine metabolized by?

A

CYP2D6 and CYP1A2

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10
Q

Venlafaxine is a weak inhibitor of NE re uptake, but it is metabolized in the liver by CYP2D6 to

A

active metabolite desvenlafaxine

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11
Q

What line of TCAs are preferred to tx neuropathic pain?

What are two drug names of these?

A

secondary amine TCAs because AEs better tolerated

Nortriptyline

Desipramine

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12
Q

What antidepressant adjuvant drug has the fewest potential pharmacokinetic interactions?

A

milnacipran

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13
Q

What is the only Nav channel targeted AED that is FADA approved to tx a chronic pain condition - trigeminal neuralgia?

A

carbamazepine

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14
Q

What does carbamazepine induce?

A

CYP3A4

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15
Q

Carbamazepine enhances the production of…

which can impact the plasma levels of other drugs

A

multiple microsomal enzymes and p-glycoprotein,

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16
Q

What are major AE of carbamazepine?

A

blurred vision, diplopia, and ataxia

Steven Johnsons and blood disorders

17
Q

What drugs target the Cav channel alpha2delta subunit?

A

gabapentin and pregabalin

18
Q

The dose-limitation of gabapentin is by-passed by a pro-drug form of gabapentin -

A

gabapentin enacarbil

19
Q

A chronic pain pt is taking a drug that produces severe orthostatic hypotension. What is the pt taking?

A

clonidine

20
Q

Ketamine txs pain by blocking…

A

NMDA receptors