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Practical Therapeutics 1 > OTC Analgesics > Flashcards

OTC Analgesics Flashcards

1
Q

Analgesia

A

The inability to feel pain

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2
Q

Analgesics

A

Drugs that work through various mechanisms to reduce inflammation, the perception of pain, the intensity or duration of pain, or other various mechanisms to decrease the ability to feel pain

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3
Q

Classes of analgesics (4)

A

1) acetaminophen
2) NSAIDs
3) local anesthetics
4) counterirritants

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4
Q

Acetaminophen (Tylenol) indications

A

pain and fever (good for pain scale 1-6)

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5
Q

Acetaminophen (Tylenol) US box warning

A

1) risk of medication errors and hepatotoxicity- dosing errors resulting in accidental overdose
2) cases of acute liver failure at times requiring transplantation or causing death - do not exceed maximum doses

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6
Q

MOA Acetaminophen (Tylenol)

A

1) analgesic effect –> acts in CNS

2) antipyretic effect : inhibition of the hypothalamic heat regulating center

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7
Q

contraindications Acetaminophen (Tylenol)

A

sever hepatic impairment or severe active liver disease

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8
Q

ADR and contraindication of Acetaminophen (Tylenol)

A

well tolerated- contraindicated in severe liver impairment

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9
Q

Acetaminophen (Tylenol) route

A

CAN BE IN A SUPPOSITORIES (unwrap and insert)

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10
Q

Pediatric Acetaminophen (Tylenol) dosing - KNOW

A

1) various concentrations exist
2) typical dosing is 10-15 mg/kg per dose - not to exceed 5 doses a day
3) ensure you have the correct concentration when you’re recommending doses

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11
Q

Non-steroidal anti-inflammatory drugs (NSAIDS) indications

A

Mild to moderate pain, management of inflammatory diseases and rheumatoid diseases, fever, dysmenorrhea, osteoarthritis

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12
Q

US Boxed warnings Non-steroidal anti-inflammatory drugs (NSAIDS)

A

1) increased risk of serious CV thrombotic events including myocardial infarction and stroke
2) increased risk of serious GI bleeding

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13
Q

MOA of Non-steroidal anti-inflammatory drugs (NSAIDS)

A
  • reversibly inhibit COX1 and COX2

- decreased formation of prostaglandin precursors (antipyretic, analgesic, and anti-inflammatory properties)

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14
Q

Contraindications of Non-steroidal anti-inflammatory drugs (NSAIDS)

A

use in coronary artery bypass graft surgery (CABG)

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15
Q

Non-steroidal anti-inflammatory drugs (NSAIDS) ADR cardiovascular

A

increased risk of adverse cardiovascular events - MI, CVA, new onset HTN, new onset or exacerbation of HF
- done by inhibiting sodium resorption in the kidneys –> sodium water retention increased BP

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16
Q

Non-steroidal anti-inflammatory drugs (NSAIDS) GI effects

A
  • COX 1 inhibition results in a reduction in mucosal protective prostaglandin E2
  • longer duration of therapy increases the risk for GI inflammation or ulcers
17
Q

Non-steroidal anti-inflammatory drugs (NSAIDS) Hematologic effects

A
  • prolong bleeding time and increase risk for hemorrhage

- COX1 inhibition decreases thromboxanes- decreased platelet adhesion and aggregation

18
Q

Non-steroidal anti-inflammatory drugs (NSAIDS) kidney effects

A

acute and chronic kidney injury, interstitial nephritis- reduce production of nephroprotective prostaglandins, increase in vasoconstriction of the afferent arteriole and impaired renal blood flow

19
Q

Non-steroidal anti-inflammatory drugs (NSAIDS) hepatic effects

A

Rare

- mild transaminase increase, rarely serious liver injury (this is more of a problem with tylenol)

20
Q

OTC NSAIDS

A

1) motrin –> ibuprofen
2) Aleve –> naproxen
3) voltaren gel -> diclofenac
4) aspirin

21
Q

Counter irritant : Capsaicin indications

A

muscle/joint pain, neuropathic pain, diabetic neuropathy

22
Q

MOA of Counter irritant : Capsaicin

A
  • it reduces the synthesis of substance P ( one of the agents that tells your body its in pain)
  • agonist at TRPV1
  • NOCICEPTOR DEFUNCTIONALIZATION
23
Q

WARNINGS of Counter irritant : Capsaicin

A

DO NOT USE ON WOUNDS , damaged, broken, irritated skin; do not cover with bandage; do not apply within 1 hour before or after bath, water, sauna; do not use in combo with external heat sources; don’t combine with topical analgesics

24
Q

Routes of Counter irritant : Capsaicin

A

Patches - 8%

25
Q

ADR of Counter irritant : Capsaicin

A

application site burning, erythema, pain

26
Q

ADR of Counter irritant : Capsaicin

A

application site burning, erythema, pain

27
Q

Lidocaine indications

A

temporary relief of minor localized pain

28
Q

US box warning lidocaine

A

life threatening and fatal events in infants and young children - seizures, cardiopulm arrest, and death
- lidocaine toxicities - antiarrhythmic effects

29
Q

moa lidocaine

A

blocks the initaiton and conductions of nerve impulses

30
Q

ADR lidocaine

A

erythema at application site

31
Q

menthol and methyl salicylate indications

A

temporary relief and minor localized pain

32
Q

MOA menthol and methyl salicylate

A

menthol - counterirritants (similar to capsaicin)

33
Q

ADR menthol and methyl salicylate

A

erythema at application site

Practical Therapeutics 1 (10 decks)

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