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Pain > Pain > Flashcards

Pain Flashcards

1
Q

FeverAll rectal

A

APAP

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2
Q

Lortab

A

APAP + hydrocodone

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3
Q

Excedrin

A

Caffeine + APAP

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4
Q

Excedrin Extra, Excedrin Migrain

A

Caffeine + ASA + APAP

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5
Q

Midol Complete

A

APAP + Caffeine + pyrilamine

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6
Q

Ofirmev IV

A

APAP

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7
Q

Main conceren with Tylenol

A

hepatotooxicity

< 4000 mg/day

n-acetylcysteine (NAC) as reversal agent

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8
Q

Risk of non-aspirin NSAIDs

A

***require a MedGuide for prescriptions!!!!

-GI risk of bleeding and ulceration
-CV risk of MI and stroke
-CABG - contraindicated after!

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9
Q

SE of NSAIDs

A

-renal damage
-increase BP
-premature closure of ductus arteriosus (do NOT use NSAIDs in 3rd trimester)
-Nausea (take with food)
-Photosensitivity

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10
Q

Irreversible COX-1 and COX-2 inhibitor

A

Aspirin

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11
Q

Caldolor

A

Ibuprofen

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12
Q

What pain medication can you NOT use with a sulfonamide allergy?

A

Celecoxib (Celebrex)

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13
Q

Vimovo

A

Naproxen + Esomeprazole

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14
Q

Toradol

A

Ketorlac
**MAX duration is 5 days

  • nasal spray - spray 5 times to prime before using
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15
Q

COX-2 selective inhibitors

A

Diclofenac (Voltaren)
Celecoxib (Celebrex)

some:
-Meloxicam (Mobic)
-Nabumetone

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16
Q

Salicylate overdose

A

tinnitus!!!!
AVOID ASA in children!!!

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17
Q

Opioid SE

A

CONSTIPATION
N/V
respiratory depression
Pruiritus (especially morphine)

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18
Q

When is it appropriate to use fentanyl?

A

NOT used in opioid naive patient…

patient who has been using equivalent to morphine 60 mg/day for at least 7 days!!!!!

19
Q

Fentanyl patch counseling

A

effect within 8-16 hours after applying
-apply to hairless skin
-do not cover with heating pad
-keep away from children!

20
Q

Codeine

A

Prodrug of morphine coverted by CYP 2D6

***ultra rapid metabolizers caution of death!

**DO NOT use in children < 12 years and in < 18 followed by tonsillectomy

Codeine + APAP = CIII
Codeine alone = CII
Codeine + solution = CV

21
Q

Actiq

A

Fentanyl “lollipop”

22
Q

Opioids that are CYP3A4 substrates

A

Hydrocodone
Methadone
Codeine
Fentanyl
Oxycodone

***caution with use of strong CYP inducers or inhibitors!!!!

Not: hydromorphone, morphine, meperidine

23
Q

What opioid has a risk of QTc prolongation?

A

Methadone (Dolophine)

24
Q

What opioid must you avoid with MAO inhibitors due to its seotonergiv effects?

A

Meperidine (Demerol)
Tramadol (Ultram)

25
Q

What is the main side effect of morphine (MS Contin)?

A

Pruiritis
***treat with diphenhydramine

26
Q

What are the POTENT opioids?

A

Fentanyl
Hydromorphone (Dilaudid)
Oxymorphone

27
Q

Coversion between Morphine IV to PO

A

1:3

28
Q

Coversion between Hydromorphone to Morphine

A

PO 7.5 : 30
IV 1.5:10

29
Q

Conversion between morphine PO to oxycodone PO

A

30:20

30
Q

What medications should you try to avoid with opioid use?

A

Benzodiazapines
CNS depressants

31
Q

Which opioids do not cross react with opioid allergy?

A

Methadone
Fentanyl
Meperidine

32
Q

What are the best treatment recommendations for opioid-induced constipation?

A

Stimulant laxatives (Senna or Biscodyl)

then
PAMORAs:
-Methylnatrexone (Relistor)
-Naloxegol (Movantik)

then
Lubiprostone (Amitiza)

33
Q

Ultram

A

Tramadol C-IV
Prodrug coverted by CYP 2D6

***ultra rapid metabolizers caution of death!

**DO NOT use in children < 12 years and in < 18 followed by tonsillectomy

SEIZURES, and risk for HYPOglycemia

34
Q

What pain medication can lead to HYPOglycemia?

A

Tramadol

35
Q

What agents are available for opioid abuse?

A

Naloxone (Narcan)
Buprenorphine (Butrans patch, Belcuca buccal patch)
– QTc prolongation
Buprenorphine/Naloxone (Suboxone)

36
Q

What is required for prescribers in order for them to prescribe Suboxone for opioid dependence?

A

DATA 2000 waiver
the DEA number will start with X

37
Q

What is approved for Post-herpic pain?

A

Gabapentin (Horizant)
Pregabalin

38
Q

Side effects of gabapentin and pregabalin

A

Peripheral edema
weight gain
somnolence

39
Q

Which are muscle relaxants used as adjuvants for muscle pain or spams?

A

Baclofen (Lioresal)
Cyclobenzaprine (Amrix, Flexeril)
Tizanidine (Zanaflex)
Carisoprodol (Soma)
Methocarbamol (Robaxin)
**cause drowsiness!!!

40
Q

Lidoderm counseling points

A

Adjuvant topicals for pain
**patch and you CAN cut
do not apply more than3 at one time

41
Q

What are other topical adjuvants for pain?

A

Capsaicin (causes burning)
Methyl salicylate (IcyHot0
Lidocaine
Diclofenac gel

42
Q

Counseling for diclofenac gel

A

Use card to dose
- hands or elbows 2 g
- feet or knees 4 g
do not shower for at least 1 hour after application

43
Q

What are the COX-2 selective drugs?

A

Celecoxib (Celebrex)
Diclofenac (Voltaren or Flector patch)
Meloxicam (Mobic)
Etodolac
Nabumetone

Pain (3 decks)

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