Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NAPLEx > Pain > Flashcards

Pain Flashcards

1
Q

acetaminophen

A

Tylenol, FeverAll (rectal suppository), Ofirmev (injection)
max 4,000 mg
avoid APAP abbreviation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

acetaminophen + hydrocodone

A

Lorcet, Lortab, Norco, Vicodin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

acetaminophen
+ codeine

A

tylenol #2, 3, 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

acetaminophen
+ caffeine

A

Excedrin tension headache

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

acetaminophen
+ aspirin/caffeine

A

Excedrine Extra strngth, Excedrine Migraine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

acetaminophen
+ caffeine/pyrilamine

A

Midol Complete

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

acetaminophen
+ Butalbital/Caffeine

A

Fioricet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

cox-1 and cox-2 non-selective NSAIDs

A

all agents have GI risk, CV risk in post-operative CABG setting`
Ibuprofen
Indomethacin
Naproxen
Ketorolac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ibuprofen

A

Advil, Caldolor, Motrin IB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Indomethacin

A

Indocin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

OTC self- tx days? ibuprofen
also notes

A

less then 10
IV injection is indicated for closure of PDA in premature infants
severe skin reaction including SJS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

notes high risk in indomethacin

A

CNS side effects especially in psych conditions… (think of the depression chapter)

IV injection is indicated for the closure of PDA in premature infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

NSAIDs and the Ductus Arteriosus (DA)

A

Do not use NSAIDs in the third trimester of prego can cause the premature closure of DA

IV NSAIDs (indomethacin, Ibuprofen) can be used within 14 days after birth to close a patent ductus arteriosus (PDA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

naproxen

A

aleve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

naproxen
+ esomeprazole

A

Vimovo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Katerolac

A

Toradol, Acular (ophthalmic), Sprix (Nasal Spray)
usually used after surgery never before if that’s the case..

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Sprix

A

katerolac nasal spray
prime five times before use and discard 24 hrs after opening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

max duration of Katerolac

A

5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

NSAIDS GI risk

A

increases the risk of serious GI adverse events, including bleeding and ulceration.
Elderly, and pt taking systemic steroids, SSRIs and SNRIs are at greatest risk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

CV risk NSAIDs and renal

A

Risk of MI and stroke avoid use in pt w/ CV disease or risk factors. except aspirin

can decrease renal clearance by reducing blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Aspirin is an

A

irreversible cox 1 cox 2 and is an effective antiplatelet agent that provides CV benefit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

increased cox 2 selective

A

lower risk for GI complications (but still present). Increased risk MI/stroke (avoid w/ CV risk, avoid increased dose and longer duration in pt at risk for CV disease), the same risk for renal complications
celecoxib
diclofenac
meloxicam
Nabumetone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

celecoxib

A

Celebrex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

celecoxib
+ amlodipoine

+ tramadol

A

consensi

seglentis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

celecoxib
notes and contra

A

contra: sulfa allergy
highest cox-2 selectivity
avoid prego: risk greatest at >= 30 weeks gestation
severe skin reaction…

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

diclofenac

A

voltaren (gel) otc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

diclofenac
+ misoprostol

A

arthrotec
avoid in females of childbearing potential… can increase uterine contractions (abortifacient)
but misoprostol is used to replace the gut-protective prostaglandins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

meloxicam

A

mobic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

aspirin/acetylsalicylic acid

A

ascriptin, Bufferin, Ecotrin: EC/buffered

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

aspirin
+ omeprazole

A

Yosprala
Durlazo and Yosprala are slow releases, do not use if you need an immediate effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Durlazo

A

ER capsule
aspirin

Durlazo and Yosprala are slow releases, do not use if you need an immediate effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Warning w/ salicylates NSAIDs

A
  • hypersensitivity reaction risk, including SJS
  • AVOID aspirin in children and teenagers w/ any viral infection due to the potential risk of Reye’s syndrome! (symptoms: somnolence, N/V, lethargy, confusion)
  • avoid third trimester of prego
  • GI bleed and ulceration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Magnesium salicylate

A

non-acetylated salicylates
Doan’s extra strenght

34
Q

salicylate overdose can cause

A

tinnitus!
also:
aspirin w/ other ototoxic agents (e.g. aminoglycosides, IV loop diuretics).. can increase tinnitus risk

35
Q

codeine

codeine + acetaminophen

A

codeine tablets- C-II
combo products tablets/capsules- C-III

Tylenol #2, 3, 4

36
Q

key things about codeine

A

FDA avoid in <18 cold and cough products w/ codeine
ultra-rapid metabolizers be careful or avoid especially lactating women

37
Q

fentanyl

A

duragestic, sublimaze
atiq: oral transmucosal lozenges on a stick “loollipop”
lazanda: nasal spray
subsys: spray, SL
fentora: buccal tabs

38
Q

use of fentanyl

A

if outpatient, chronic pain management only
not used in opioid-naive pts
pt who has been using equivalent to morphine 60 mg/day or more for 7 days!
short t1/2 when given IV

39
Q

atiqu disposal

A

cut off the stick and flush unused/unneeded doses

40
Q

transmucosal IR fentalny requires

A

REMs program and documentation of patient’s opioid tolerance w/ each prescription

41
Q

fentanyl patch use

A
  • effect seen up to 8-16 hrs. d/c all around the clock opioids drugs when the patch is applied
  • apply to hairless skin (cut hair if needed)
  • do not apply > 1 patch at a time
  • can only be covered w/ adhesive film dressing Bioclusive or tegaderm
  • removed before MRI
  • dispose of patch in toilet
42
Q

hydrocodone IR (combo products only)
warning and notes

A

+ acetaminophen (Vicodin, norco…)
+ chlorpheniramine (tussiCaps)
warning: Cyp3A4 substrate!!!!!!
notes: do not use <18

43
Q

hydrocodone ER
warning:
Note:

A

Zohydro ER (capsule), Hysingla ER (tablet)
Warning: Cyp3A4 substrate!!!!!!
Note: preferably avoid use if breasting, abuse-deterrent formulations

44
Q

Hysingla ER
Note:

A

QT prolongation has occurred at doses >160mg/day

45
Q

hydromorphone

A

Dilaudid: 1mg/ml
high potency injections (HP)- risk for medication error, use ONLY in opioid-tolerant pt 10mg/ml

46
Q

methadone

A

dolophine

47
Q

methadone box warnings and notes

A

box warning: QT prolongations!
Notes: variable half-life

48
Q

Meperidine

A

Demerol

49
Q

meperidine warnings and notes

A

warning: renal impairment/elderly at risk for CNS tox. avoid w/ or within 2 weeks of MOA
Notes: NO LONGER recommended for analgesic

metabolite normeperidine. renally cleared! accumulation leads to CNS tox and seizures

50
Q

Morphine ER

A

MS Contin, Kadian

51
Q

Morphine injection

A

Duramorph, Infumorph

52
Q

Oxycodone IR

A

Roxicodone, Oxaydo
warning: cyp3A4 substrate!!!

53
Q

Oxycodone CR, ER

A

OxyContin (CR), Xtampza (ER)
warning: cyp3A4 substrate!!!

54
Q

Oxycodone + acetaminophen

A

Endocet, Percocet
warning: cyp3A4 substrate!!!

55
Q

oxycodone abuse-deterrent formulations

A

Oxaydo, OxyContin, Xtampza ER

56
Q

Xtampza ER caps note

A

can be opened up and content can be administered w/ soft food or through a gastric tube

57
Q

oxycodone notes:

A

avoid high fat meals w/ higher dose (except re-formulated OxyContin)
if renally impaired start a lower dose or avoid oxycodone due to accumulation of parent and /or active metabolite

58
Q

oxymorphone

A

Opana
do not use w/ moderate-to-severe liver impairment!
take on empty stomach!

59
Q

conversion

A

drug IV/IM(mg) oral(mg)
morphine 10 30
Hydromorphone 1.5 7.5
oxycodone _ 20
hydrocodone _ 30
codeine 130 200
fentanyl 0.1 _
Meperidine 75 300
Oxymorphone 1 10

60
Q

genal opioid box warning

A
  • addiction abuse and misuse can lead to overdose and death
  • respiratory depression can be fatal
  • use of any opioids w/ benzo, CNS depressants, including OH can increase the risk of death
    -** Kadian, Nucynta ER, Oxymorhone ER, and Zohydro ER: DO NOT consume with -OH! can increase drug plasma levels, which can lead to a potentially fatal overdose **
  • accidental ingestion/exposure of even one dose can be fatal to children
  • crushing, dissolving or chewing of the long-acting products can cause delivery of potentially fatal dose
  • life-threatening neonatal opioid withdraw w/ prolong use during prego
61
Q

acetaminophen overdose

A
  • tx: N-acetylcysteine (NAC, acetadote)
  • it increases glutathione precursor
  • Rumac-Mathew nomogram for dosing
62
Q

which opioids use w/ OH specifically avoid even though avoid with all

A
  • Kadian, Nucynta ER, Oxymorhone ER, and Zohydro ER: DO NOT consume with -OH! can increase drug plasma levels, which can lead to a potentially fatal overdose
63
Q

opioid allergy cross-react

A

cod or morph (except buprenorphine has norph)
CODeine MORPHine
HydroCODone HydroMORPHone
OxyCODone OxyMORPHone

bupreNORPHine
Heroin (diacetyl-morphine)

64
Q

opioid-induced constipation (OIC)

A

stimulant laxatives (including senna) first line
bisacodyl tablet for prophylaxis or suppository for tx

can use PAMORAs for only opioid-induced constipation
peripherally-acting mu-opioids receptor antagonists (PAMORAs)
can try lubiprostone

65
Q

Methylnaltrexone

A

Relistor
contra: GI obstruction
warning: GI perforation
stay close to toilet after injection lol
d/c all laxatives prior to use…
only use when otc laxative failed
- PAMORAs

66
Q

Naloxegol

A

Movantik
contra: GI obstruction, strong cyp3A4 inhibitors
warning: GI perforation
d/c all laxatives prior to use, can reintroduce if suboptimal response after 3 days
- PAMORAs

67
Q

lubiprostone

A

amitiza

68
Q

tramadol

A

ultram
- seizure risk, serotonin syndrome risk (MOA avoid or 14 days..)
- boxed warning: serious risk w/ ultrarapid metabolizers (risk in breastfeeding mothers)
- do not use in <12 and <18 if tonsillectomy/adenoidectomy surgery

69
Q

tapentadol

A

Nucynta
- seizure risk, serotonin syndrome risk (MOA avoid or 14 days..)
- stronger than tramadol

70
Q

Narcan

A

onset of actin is slower than injection, 4mg one nostril and if needed to re-dose, use the other nostril

71
Q

Naloxone

A

injection
2-3 min redose if needed

72
Q

Buprenorphine

A

belbuca (bucal film), butrans (patch)
subclade: once monthly injection- pt must be on a stable dose for 7 days

73
Q

buprenorphine
+ naloxone

A

suboxone (sublingual film)
zubsolv (sublingual tab)

74
Q

buprenorphine warning: and what do prescribers need?

A

QT prolongation (>20mcg/hr, CNS depression, and severe dental AE with oral formulations…

prescribers need the X number: drug addiction treatment act

75
Q

gabapentin

A

Neurontin
gralise tab: for PHN

76
Q

gabapentin enacarbil

A

Harizant ER: for Postherpetic neuralgia (PHN) (think of shingles pain….) and restless legs syndrome
take w/ food

77
Q

gabapentin
warnings and notes

A

warning: increase seizure frequency if rapidly stoped
notes: off-label use fibromyalgia, pain (neuropathic), headache, drug abuse, alcohol withdrawal
IR, ER, and gabapentin encarbil are not interchangeable

78
Q

pregabalin

A

lyrica
warning: increase seizure frequency if rapidly stoped
notes: provided use in fibromyalgia, PHN and neuropathic pain associated w/ diabetes and spinal cord injury

79
Q

carbamazepine

A

Tegretol
only FDA-approved medications for the tx of trigeminal neuralgia

80
Q

baclofen

A

Lioresal
boxed warning: abrupt withdrawal of intrathecal baclofen has resulted in severe effects (high fever, lethargy, rebound/increased capacity, muscle rigidity and rhabdomyolysis) leading to organ failure and death

81
Q

cyclobenzaprine

A

Amrix, Fexmid, Flexeril
serotoninergic, do not combine w/ other serotonin agents
can cause arrhythmias….

82
Q

tizanidine

A

zanaflex
centrally acting alpha-2 agonist

NAPLEx (75 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions