Non-opioid pain meds Flashcards
The governing principle of the WHO ladder for chronic pain treatment is…
use the drug with the least addictive potential at the lowest concentration needed to achieve effective pain management
any drug with indications other than pain that may be an analgesic
adjuvant
What is a common antidepressant added to tx chronic back pain after failing acetaminophen treatment and has a hx of cardiovascular problems
duloxitine
Gabapentin treats pain by reducing…
glutamate release from primary nociceptors
Which adjuvant drug is known for its fast onset of action?
pregabalin
In the dorsal horn, NE produces analgesia by inhibiting presynaptic …
Cav channels
What antidepressant drugs have been shown to not have any analgesic properties?
SSRIs
What is a first line tx for neuropathic pain?
SNRIs
What is duloxetine metabolized by?
CYP2D6 and CYP1A2
Venlafaxine is a weak inhibitor of NE re uptake, but it is metabolized in the liver by CYP2D6 to
active metabolite desvenlafaxine
What line of TCAs are preferred to tx neuropathic pain?
What are two drug names of these?
secondary amine TCAs because AEs better tolerated
Nortriptyline
Desipramine
What antidepressant adjuvant drug has the fewest potential pharmacokinetic interactions?
milnacipran
What is the only Nav channel targeted AED that is FADA approved to tx a chronic pain condition - trigeminal neuralgia?
carbamazepine
What does carbamazepine induce?
CYP3A4
Carbamazepine enhances the production of…
which can impact the plasma levels of other drugs
multiple microsomal enzymes and p-glycoprotein,
