opioid analgesics

Question 1

codeine dose

Answer 1

60mg q4-6h

Question 2

codeine is not for below __ age

Answer 2

12 years old

Question 3

how much codeine is converted into morphine

Answer 3

10%

Question 4

codeine can be combined with 300mg acetaminophen in what amounts?

Answer 4

T1: 8mg
T2: 15 mg
T3: 30mg
T4: 60mg

Question 5

name the 6 opioids

Answer 5

• codeine
• oxycodone
• hydromorphone
• meperidine (poor)
• pentazocine (poor)
• tramadol (poor)

Question 6

oxycodone adult dose

Answer 6

5-10mg q4-6h

Question 7

hydromorphone (Dilaudid) adult dose

Answer 7

2mg q4-6h

Question 8

meperidine (Demerol) adult dose

Answer 8

100mg q4-6h

Question 9

meperidine is a poor analgesic but is good if the patient __

Answer 9

has a true allergy to codein

Question 10

pentazocine adult dose

Answer 10

50mg q4-6h

Question 11

tramadol adult dose

Answer 11

50mg, or 37.5mg if with acetaminophen q4-6h

Question 12

oxycodone can be prescribed with acetaminophen in what amounts

Answer 12

2.5mg, 5mg

Question 13

t/f: NSAIDs can be used to treat TMJ pain

Answer 13

true

Question 14

what is the initial dose for analgesia for TCA

Answer 14

10 mg qhs. can be increased to 10mg BID or 20mg qhs

Question 15

TCA (-triptyline, -pramine) is used to treat

Answer 15

• TMD from stress, grinding teeth
• atypical facial pain
• fibromyalgia
• tension-type headache
• post-herpetic neuralgia
• neuropathic pain

Question 16

TCA at low doses is for __ and high doses is for __

Answer 16

low doses = analgesia

high doses = depression

Question 17

TCA doses for depression tx

Answer 17

• tryptyline and doxepin: 150mg
• imipramine: 200mg
• desipramine: 300mg

Question 18

tx for carbamazepine

Answer 18

• trigeminal neuralgia

- post-herpetic neuralgia

Question 19

name 5 drugs that can tx trigeminal neuralgia

Answer 19

• carbamazepine
• baclofen
• phenytoin
• gabapentin
• valproate

Question 20

can opioids be given prn?

Answer 20

no, must have a scheduled Rx

Question 21

t/f: opioids can be used for TMD pain?

Answer 21

true

Question 22

corticosteroid MOA

Answer 22

block phospholipase A2

Question 23

can you give corticosteroids for TMJ pain?

Answer 23

yes, but it should be given with NSAID and started on day 4

Question 24

name 4 side effects of corticosteroids

Answer 24

• acute adrenal crisis
• bone resorption
• weight gain
• hypertension

Question 25

name 5 muscle relaxants

Answer 25

• carisoprodol
• orphenadrine
• methaocarbamol
• cyclobenzaprine
• baclofen

Question 26

baclofen MOA

Answer 26

GABA-B agonist

Question 27

baclofen dose

Answer 27

5mg TID (can be increased up to 20mg TID)

Question 28

t/f: muscle relaxants can be used for tx of TMD

Answer 28

true, they reduce muscle tone

Question 29

when do patients take muscle relaxants

Answer 29

at night because they cause drowsiness

Question 30

name 6 anti-convulsants

Answer 30

• carbamazepine
• phenytoin
• gabapentin
• valproic acid
• duloxetine (SSNRI)
• venlafaxine (SSNRI)

Question 31

carbamazepine dose

Answer 31

initially, 100mg BID (200mg/day)

daily max: 1200mg

Question 32

phenytoin (dilantin) dose

Answer 32

initially, 100mg TID (300mg/day)

Daily max: 600mg

Question 33

gabapentin dose

Answer 33

initially, 300mg QD. can increase to BID, TID

daily max: 3600mg

Question 34

anti-convulsant drugs are also used to tx ____

Answer 34

neuropathic pain, such as trigeminal neuralgia and migraines

Question 35

name 2 drawbacks of anti-convulsants

Answer 35

• induce liver enzymes and altered metabolism of other drugs

- hepatotoxic

Question 36

valproic acid dose

Answer 36

250 mg

Question 37

duloxetine and venlafaxine is used to tx

Answer 37

neuropathic pain