Pain Flashcards
acetaminophen + hydrocodone
Lorcet, Lortab, Norco, Vicodin
acetaminophen + oxycodone
Endocet, percocet
acetaminophen + codeine
tylenol 2, 3, 4
acetaminophen + caffiene
excedrin tension headache
acetaminophen + aspirin + caffiene
excedrin extra strength
acetaminophen + caffiene + pyrilamine
midol complete
tylenol max dose
4 g
pediatric tylenol dose
10-15 mg/kg/day
acetaminophen overdose
-antidote: N-acetylcystiene
-administered intravenously or orally
-Rumack-Matthew nomogram
NSAIDs and third trimester
DO NOT USE - can prematurely close the DA
Celecoxib (Celebrex)
contraindicated in sulfa allergy
salicylate over dose
tinnitus
Kadian (morphine), Nucytna ER, oxymorphone ER, and Zohydro ER (hydrocodone ER)
do not consume alcohol with this medication. Alcohol can cause increased drug plasma levels, which can lead to potentially fatal overdose
Fentanyl
-not for opioid naive patients –> must have equivalent of morphine 60 mg/day or more for at least 7 days
morphine
10 mg IV/IM = 30 mg oral
hydromorphone
1.5 IV/IM = 7.5 mg oral
opioid allergy
- common drugs in the same chemical class that cross react with each other have COD or MORPH in the name (besides buprenoprhine)
-CODeine, hydroCODone, oxyCODone, MORPHine, hydroMORPHone, oxyMORPHone, bupreNORPHine
treatment of opioid-induced constipation
methylnaltrexone (Relistor), Naloxegol (Movantik), Lubiprostone (Amitiza)
central acting analgesics
tramadol and tapentadol (Nucynta)
-lower the seziure threshold
-caution with serotonergic drugs `
FDA approved for OUD
buprenorphine
SNRIs and TCAs used for pain
amitriptyline and duloxetine
carisoprodol (soma)
C IV
-antispasmodic
Triptan formulations
-ODT: Rizatriptan, Zolmitriptan
-nasal spray: sumatriptian, zolmitriptan
-powder: sumatriptian
-SC inj (prefilled syringes): sumatriptian
-SC inj (autoinjector): sumatriptian
Triptan contraindications
cardiovascular disease, uncontrolled HTN, ischemic heart disease
-do not use within 24 hours of another triptan or ergotamine-type medication
triptan warnings
increase blood pressure, serotonin syndrome
triptan side effects
paresthesia (tingling/numbness)
-triptan sensations
triptans for children and adolescents
almotriptan tablets, zolmitriptan nasal spray and Treximet in children > 12 YOA
rizatriptan 6-17 YOA
Frovatriptan
longest half life
ergotamine
-used in those who do not benefit from triptans
-Dihydroergotamine (DHE 45): inj, nasal spray
-serious and life-threatening peripheral ischemia from potent CYP3A4
-CI: uncontrolled HTN, pregnancy, ischemic heart disease
other migraine medication
rimegepant (Nurtec ODT)
Ubrogepant (Ubrelvy)
Lasmiditan (Reyvow) - CV
prophylactic migraine drugs
propranolol, metoprolol, divalproex, topiramate
drugs that increase uric acid
ASA
calcineurin inhibitors
diuretics (loops and thiazides)
Niacin
pyrazinamide
select chemotherapy agents
select pancreatic enzyme products
gout tx
- Colchicine, steroids (prednisone/prednisolone, methylprednisolone), NSAIDs (indomethacin, naproxen, celebrex)
- chronic tx: XOI - allopurinol or febuxostat
3: if XOI does not work and UA > 6: add on probenecid or lesinurad to daily XOI or replace XOI with IV pegloticase
colchicine gout dose
1.2 mg PO followed by 0.6 mg in 1 hour (do not exceed a total of 1.8 mg in 1 hour or 2.5 mg/day)
allopurinol
-hypersensitivity rxn - including SJS/TEN, DRESS
-HLA-B*5801 testing prior to use
