Non opioids Flashcards
Epidural and intrat used for pain management for cancer and non cancer pain and post op
Clonidine
Used as IV sedation short period for intubates/mechanically ventilated patients (less than 24 hrs)
Dexmedetomidine does not depress respiratory
If discontinued cause withdrawal effect
Clonidine and dexmedetomidine
Used as adjunct in labor anesthesia
Clonidine
Enhances and prolongs sensory block and motor blockage, anesthetic action and analgesia action of LA epidural
Synergism effect on LA epidural, prolongs duration
Clonidine
Dexmedetomidine
Reduce dosage liver AND kidney impairment
Dexmedetomidine
Side effects: Bradycardia, heart block, hypotension, nausea
Dexmedetomidine
Withdrawal causes rebound hypertension, agitation and sympathetic overactivity
Clonidine
Dexmedetomidine also causes withdrawal
Increases Nausea and vomiting
Neostigmine, Baclofen & Dexmedetomidine
Intrathecal Increases effects of LA, Opioids and other alfa 2 agonists drugs like clonidine
Neostigmine
Epidural does not affect motor blockage
Nesotigmine
Does not cause respiratory depression or pruritus alone or with opioids
Neostigmine
Alfa 2 receptors need to be inhibited or activated by agonist
Activated to cause inhibitory effect
Spinal used in pediatric lower abdominal & urological cases
Neostigmine
Nociceptive stimulation release which excitatory NT
Glutamate, asparate & neuropeptides
Substance P
Epidural administration must be administered preservative free
Ketamine, preservative causes neurotoxicity
May be used as a sole agent or with opioids in post op pain
Ketamine
Prolongs onset and duration of LA
Ketamine
Intrathecal reduces N/V
Versed
MOA of versed
Binds to GABA A receptor, increases GABA A ,allowing Cl influx
Also binds to d opioid receptors
2 meds risk of neurotoxicity
Ketamine & Versed
ketamine due to metabolite
Epidural & intrathecal antiemetic
Droperidol
Increases suicidal instincts
Ziconotide
Only nonopioid approved for FDA for neuropathic pain
Zicotidine Spinal