pain Flashcards
What is the brand name for Acetaminophen?
Tylenol
What are the indications for Acetaminophen?
Pain, Headache, Fever
What is the mechanism of action of Acetaminophen?
Not fully established; centrally acting analgesic (blocks COX) and antipyretic with minimal anti-inflammatory properties
What are the major contraindications for Acetaminophen?
Hypersensitivity to acetaminophen, Active acute hepatic dysfunction; Do not use with other acetaminophen-containing products
What are the black box warnings for Acetaminophen?
Hepatotoxicity
What are the common adverse drug reactions for Acetaminophen?
None
What are the rare but serious adverse drug reactions for Acetaminophen?
Stevens-Johnson syndrome, Elevated liver function tests
What are the key counseling points for Acetaminophen?
Heed max dose limits, avoid alcohol. Measure dose accurately, esp. in children.
What are the brand names for Ibuprofen?
Motrin, Advil
What are the indications for Ibuprofen?
OTC: Pain, Headache, Fever; Rx: Osteoarthritis or rheumatoid arthritis, Juvenile rheumatoid arthritis
What is the mechanism of action of Ibuprofen?
Nonselective inhibitor (COX-1) and (COX-2), reversibly alters platelet function and prolongs bleeding time.
What are the major contraindications for Ibuprofen?
Hypersensitivity to ibuprofen; Aspirin Triad: Asthma, Urticaria, or Allergic-type reaction following aspirin or other NSAID administration; CABG surgery, Treatment of perioperative pain
What are the black box warnings for Ibuprofen?
Cardiovascular events, GI toxicity, CABG
What are the common adverse drug reactions for Ibuprofen?
> 10% - None known, 1-10% GI distress, edema, itching, rash, dizziness, tinnitus, ototoxicity
What are the rare but serious adverse drug reactions for Ibuprofen?
Stevens-Johnson syndrome, GI bleeding, Thrombosis, Elevated liver functions, Acute renal failure, Congestive heart failure, Aplastic anemia
What are the key counseling points for Ibuprofen?
Take with food/milk. Avoid in heart failure. Older patients increased risk of GI and renal issues. Increased risk of CV events (fatal MI and stroke)
What is Aspirin also known as?
ASA (acetylsalicylic acid)
What are the indications for Aspirin?
Mild to moderate pain, Fever, MI, and
Stroke prophylaxis
What is the mechanism of action of Aspirin?
Inhibits cyclooxygenase (COX) enzyme
What are the major contraindications for Aspirin?
Hypersensitivity, Aspirin triad (Asthma, Rhinitis, Nasal polyps), Inherited or acquired bleeding disorders, Children < 18 y of age with viral infections
What are the black box warnings for Aspirin?
None
What are the common adverse drug reactions for Aspirin?
Abdominal pain, Diarrhea, Headache, Indigestion
What are the rare but serious adverse drug reactions for Aspirin?
Angioedema, GI hemorrhage, GI ulcer, Reye syndrome, Stevens-Johnson syndrome
What are the key counseling points for Aspirin?
Avoid additional aspirin, NSAIDs, or aspirin-containing products. Avoid ≥ 3 alcoholic drinks/day, Not recommended for children < 18 y of age with a viral illness
What is the brand name for Celecoxib?
CeleBREX
What drug class is Celecoxib in?
Cyclooxygenase-2 Inhibitors (COX2-I)
What are the indications for Celecoxib?
Osteoarthritis, Rheumatoid arthritis,
Ankylosing spondylitis, Acute pain, Primary dysmenorrhea
What is the mechanism of action of Celecoxib?
Inhibition of the COX-2 enzyme isoform
What are the major contraindications for Celecoxib?
Asthma, Urticaria, or Allergic-type reaction following aspirin or other NSAID administration; CABG surgery; Treatment of perioperative pain; Hypersensitivity to sulfonamides
What are the black box warnings for Celecoxib?
GI toxicity, Cardiotoxicity, CABG
What are the common adverse drug reactions for Celecoxib?
Hypertension, Headaches, GI distress, Diarrhea
What are the rare but serious adverse drug reactions for Celecoxib?
Stevens-Johnson syndrome, GI ulcers and bleeding, Thrombosis, Elevated liver functions, Acute renal failure
What are the rare but serious adverse drug reactions for Celecoxib?
Has less risk of GI effects than other NSAIDs, but increased cardiovascular toxicity
What are the brand names for Morphine?
MS Contin, Avinza, Kadin
What drug class is Morphine in?
Opioid analgesic
What are the indications for Morphine?
Acute pain; Chronic pain, Moderate to severe
What is the mechanism of action of Morphine?
Pure µ agonist
What are the major contraindications for Morphine?
Hypersensitivity to opioids, Acute or severe asthma, Paralytic ileus, Respiratory depression, GI obstruction, Concurrent use or use within 14 days of MAOI
What are the black box warnings for Morphine?
Ethanol; Addiction, Abuse, and Misuse, REMS, Respiratory depression, Neonatal opioid withdrawal, Accidental ingestion, Concurrent use with benzodiazepines, Medication errors
What are the common adverse drug reactions for Morphine?
Constipation, Nausea, Vomiting, Hypotension, Dizziness, Sedation, Diaphoresis, Headaches, Depression, Xerostomia
What are the rare but serious adverse drug reactions for Morphine?
Cardiac arrest, Physical dependence, Respiratory depression, Serotonin syndrome, Adrenal insufficiency, Decreased sex hormones
What are the key counseling points for Morphine?
Tolerance and physical dependence may occur; avoid abrupt discontinuation. Fatal respiratory depression has occurred. Highly concentrated oral solutions are available. Check doses carefully when using highly concentrated oral solutions. Avoid concomitant use with benzodiazepines.
What is the brand name for Cyclobenzaprine?
Flexeril
What drug class is Cyclobenzaprine in?
Skeletal Muscle Relaxant
What is the indication for Cyclobenzaprine?
Skeletal muscle spasm
What is the mechanism of action of Cyclobenzaprine?
Unclear, relieves muscle spasms through a central action, possibly at brain stem level. (Structurally similar to TCA antidepressants, has anti-Ach effects)
What are the major contraindications for Cyclobenzaprine?
Hypersensitivity to cyclobenzaprine, Concomitant MAOI use, Heart failure, Acute coronary phase of AMI, Heart block, Hyperthyroidism
What are the black box warnings for Cyclobenzaprine?
None
What are the common adverse drug reactions for Cyclobenzaprine?
Xerostomia, Headache, Dizziness, Drowsiness
What are the rare but serious adverse drug reactions for Cyclobenzaprine?
Cardiac dysrhythmia, Cholestasis, Hepatitis, Jaundice, Anaphylaxis, Immune hypersensitivity reaction, Slower or difficult breathing when used in combination with opioids
What are the key counseling points for Cyclobenzaprine?
Risk of falls in older patients. Used for only short periods (up to 2-3 weeks). Should avoid concomitant use with opioids. Should be used with caution in patients with glaucoma, increased intraocular pressure, urinary retention, etc., as cyclobenzaprine has anticholinergic-like effects. Avoid use in elderly; may be more sensitive to effects.
What is the brand name for Lidocaine?
Lidoderm (Rx); various OTC
What drug class is Lidocaine/Benzocaine in?
Local Anesthetic
What are the indications for Lidocaine/Benzocaine?
Postherpetic neuralgia and localized pain (multiple off-label uses)
What is the mechanism of action of Lidocaine/Benzocaine?
Stabilize neuropathy membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses. Analgesia vs. complete sensory block.
What are the major contraindications for Lidocaine/Benzocaine?
Hypersensitivity
What are the black box warnings for Lidocaine/Benzocaine?
None
What are the common adverse drug reactions for Lidocaine/Benzocaine?
Skin irritation (Systemic adverse reactions after appropriate application of topical or transdermal lidocaine are unlikely because of the small amount of lidocaine absorbed)
What are the rare but serious adverse drug reactions for Lidocaine/Benzocaine?
Methemoglobinemia (benzocaine containing oral products in children)
What are the key counseling points for Lidocaine/Benzocaine?
No > 12h in 24h period. Apply to intact skin, without covering with occlusive dressing or tight clothes. Patches may be cut to size. Fold patches on themselves when disposing to avoid accidental ingestion by children/pets.
What are the brand names for Baclofen?
Lioresal, Ozobax, Fleqsuvy
What drug class is Baclofen in?
Centrally Acting Skeletal Muscle Relaxant
What is the indication for Baclofen?
Spasticity
What is the mechanism of action of Baclofen?
Inhibits both monosynaptic and polysynaptic reflexes at the spinal level, possibly by hyperpolarization of afferent terminals, although actions at supraspinal sites may also occur and contribute to its clinical effect. Analogue of 5-aminobutyric acid (GABA), but there is no conclusive evidence that actions on GABA systems are involved in the production of its clinical effects.
What are the major contraindications for Baclofen?
Hypersensitivity
What are the black box warnings for Baclofen?
Avoid abrupt discontinuation of oral or intrathecal product
What are the common adverse drug reactions for Baclofen?
Nausea, Asthenia, Dizziness, Somnolence, Confusion
What are the rare but serious adverse drug reactions for Baclofen?
Slowed or difficult breathing when used in combination with opioids, Pneumonia, GI hemorrhage, Seizure
What are the key counseling points for Baclofen?
Because of the possibility of sedation, patients should be cautioned regarding the operation of motor vehicles or dangerous machinery while taking baclofen. Patients should be cautioned that the CNS effects of baclofen may be additive to those of alcohol and other CNS depressants.
What are the brand names for Buprenorphine/Naloxone?
Suboxone, Zubsolv
What drug class is Buprenorphine/Naloxone in?
Opioid Partial Agonist and Antagonist Combination, C-III
What is the indication for Buprenorphine/Naloxone?
Opioid Use Disorder
What is the mechanism of action of Buprenorphine/Naloxone?
Buprenorphine is a µ-opioid receptor partial agonist and a µ-opioid receptor antagonist. Naloxone is a µ-opioid receptor antagonist that causes opioid withdrawal when injected parenterally and is included in the formulation to reduce the risk of abuse.
What are the major contraindications for Buprenorphine/Naloxone?
Hypersensitivity
What are the black box warnings for Buprenorphine/Naloxone?
None
What are the common adverse drug reactions for Buprenorphine/Naloxone?
Vasodilation, Sweating, Headaches, Insomnia, Constipation, GI distress, Opioid withdrawal, Dizziness
What are the rare but serious adverse drug reactions for Buprenorphine/Naloxone?
Stevens-Johnson syndrome, Physical dependence, Tolerance, Elevated liver function tests, Seizures
What are the key counseling points for Buprenorphine/Naloxone?
Use a stool softener and/or laxative for preventing constipation. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol and other CNS depressants. Do not crush or swallow the sublingual tablet. Place the tablet under the tongue until it dissolves. If you are using the sublingual film, place the film under the tongue until it is dissolved. Do not chew, swallow, or move the film after placing it under the tongue.
What are the brand names for Carisoprodol?
Soma, Vanadom
What drug class is Carisoprodol in?
Centrally Acting Skeletal Muscle Relaxant, C-IV
What is the indication for Carisoprodol?
Disorder of musculoskeletal system
What is the mechanism of action of Carisoprodol?
Blocks interneuronal activity in descending reticular formation and spinal cord, resulting in muscle relaxation.
What are the major contraindications for Carisoprodol?
Hypersensitivity to carisoprodol or meprobamate, Acute intermittent porphyria
What are the black box warnings for Carisoprodol?
None
What are the common adverse drug reactions for Carisoprodol?
Drowsiness, Dizziness
What are the rare but serious adverse drug reactions for Carisoprodol?
Slowed or difficult breathing when used in combination with opioids, Seizure, Drug dependence, Withdrawal symptoms upon discontinuation after chronic use
What are the key counseling points for Carisoprodol?
Patients should avoid consuming alcohol. Patients should avoid activities requiring mental alertness or coordination until drug effects are known, as drug may cause dizziness or sedative effect. Patients withdrawing from prolonged therapy should be monitored carefully for withdrawal symptoms, including seizures.
What is the brand name for Codeine/Acetaminophen?
Tylenol with Codeine
What drug class is Codeine/Acetaminophen in?
Opioid, C-II (when in combination with acetaminophen, C-III for tablets, C-Y for liquids)
What is the indication for Codeine/Acetaminophen?
Pain
What is the mechanism of action of Codeine/Acetaminophen?
3-methylmorphine, a phenanthrene opioid with very low affinity for opioid receptors. Its analgesic activity appears to result from conversion to morphine.
What are the major contraindications for Codeine/Acetaminophen?
Hypersensitivity to codeine, Use in age < 12 y of age; Use in age 12-18 y postoperatively after tonsillectomy
What are the black box warnings for Codeine/Acetaminophen?
Abuse, REMs, Respiratory depression, Accidental ingestion, CYP2D6 in children, Neonatal withdrawal syndrome, Interactions with CYP3A4/5, 2D6, Avoid concomitant benzodiazepines and CNS depressants
What are the common adverse drug reactions for Codeine/Acetaminophen?
Nausea, Vomiting, Constipation, Somnolence
What are the rare but serious adverse drug reactions for Codeine/Acetaminophen?
Stevens-Johnson syndrome, GI bleeding, Elevated liver functions, Thrombocytopenia, Physical dependence, Tolerance, Respiratory depression, Serotonin syndrome, Adrenal insufficiency, Decreased sex hormones
What are the key counseling points for Codeine/Acetaminophen?
If using chronically, use laxative for preventing constipation. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol.
What are the brand names for Diclofenac?
Cambia, Voltaren, Zipsor, Zorvolex
What drug class is Diclofenac in?
NSAID
What are the indications for Diclofenac?
Pain, Dysmenorrhea, Migrain, Osteoarthritis, Rheumatoid arthritis, Ankylosing spondylitis
What is the mechanism of action of Diclofenac?
Nonselective inhibitor of cyclo-oxygenase-1 (COX-1) and cyclo-oxygenase-2 (COX-2)
What are the major contraindications for Diclofenac?
Hypersensitivity to diclofenac, Concurrent ketorolac use, Asthma, Allergic-type reaction following other NSAID use, CABG
What are the black box warnings for Diclofenac?
Cardiovascular, GI risk, CABG
What are the common adverse drug reactions for Diclofenac?
Headaches, GI distress
What are the rare but serious adverse drug reactions for Diclofenac?
Stevens-Johnson syndrome, GI bleeding, Thrombosis, Elevated liver functions, Acute renal failure, MI, Aplastic anemia, Hemolytic anemia
What are the key counseling points for Diclofenac?
Take with food or milk to decrease GI upset.
What is the brand name for Etodolac?
Lodine
What drug class is Etodolac in?
NSAID
What are the indications for Etodolac?
General pain, Osteoarthritis, Rheumatoid arthritis, Juvenile rheumatoid arthritis
What is the mechanism of action of Etodolac?
Nonselective inhibitor of cyclo-oxygenase-1 (COX-1) and cyclo-oxygenase-2 (COX-2) and reversibly alters platelet function and prolongs bleeding time.
What are the major contraindications for Etodolac?
Hypersensitivity to etodolac, Concurrent use of ketorolac or pentoxifylline, Allergic-type reaction following aspirin or other NSAID; CABG surgery, Treatment of perioperative pain
What are the black box warnings for Etodolac?
Cardiovascular and GI risk
What are the common adverse drug reactions for Etodolac?
(> 10% - None known), 1-10% - Edema, Itching, Rash, GI distress, Dizziness, Tinnitus, Ototoxicity
What are the rare but serious adverse drug reactions for Etodolac?
Stevens-Johnson syndrome, GI bleeding, Thrombosis, Elevated liver functions, Acute renal failure, Congestive heart failure, Aplastic anemia
What are the key counseling points for Etodolac?
Take with food or milk to decrease GI upset
What are the brand names of Fentanyl Transdermal?
Duragesic, Ionsys
What drug class is Fentanyl Transdermal in?
Opioid Analgesic, C-II
What are the indications for Fentanyl Transdermal?
Chronic pain, Chronic cancer pain, management of breakthrough
What is the mechanism of action of Fentanyl Transdermal?
Phenylpiperidine opioid agonist with predominant effects on the µ-opioid receptor and is about 50-100 times more potent as an analgesic than morphine.
What are the major contraindications for Fentanyl Transdermal?
Acute or postoperative pain, Bronchial asthma, Hypersensitivity to fentanyl, Mild or intermittent pain management, Opioid non-tolerant patients, Paralytic ileus
What are the black box warnings for Fentanyl Transdermal?
Respiratory depression, Addiction, CYP3A4/5 interactions, Fatalities in children, Formulations not interchangeable, Care with disposal, REMS program, Concurrent use with benzodiazepines or other CNS depressants, Neonatal withdrawal, Medication errors, Heat exposure
What are the common adverse drug reactions for Fentanyl Transdermal?
Application site reactions, Sweating, Constipation, GI distress, Confusion, Headache, Anxiety, Urinary retention, Fatigue
What are the rare but serious adverse drug reactions for Fentanyl Transdermal?
Stevens-Johnson syndrome, Physical dependence, Tolerance
What are the key counseling points for Fentanyl Transdermal?
Use a laxative for preventing constipation. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol or other CNS depressants. Apply to clean, dry skin. Skin breaks may increase absorption. Remove old patch when new patch applied. Febrile patients may have increased absorption. Monitor carefully.
What are the brand names for Hydrocodone?
Norco, Lorcet, Vicodin, Hysingla ER
What drug class is Hydrocodone in?
Opioid Analgesic, C-II
What is the indication for Hydrocodone?
Severe pain
What is the mechanism of action of Hydrocodone?
Binds to opiate receptors, resulting in altered perception of pain.
What are the major contraindications for Hydrocodone?
Hypersensitivity, Paralytic ileus, Respiratory depression, Severe asthma
What are the black box warnings for Hydrocodone?
Addiction, Abuse, Misuse, REMS, Respiratory depression, Accidental ingestion, Neonatal opioid withdrawal, Alcohol, CYP3A4/5 interaction, Hepatotoxicity, Concurrent use with benzodiazepines
What are the common adverse drug reactions for Hydrocodone?
Constipation, GI distress, Somnolence
What are the rare but serious adverse drug reactions for Hydrocodone?
Stevens-Johnson syndrome, Physical dependence, Tolerance, Respiratory depression, Serotonin syndrome, Adrenal insufficiency, Decreased sex hormones
What are the key counseling points for Hydrocodone?
Use a stool softener and/or laxative for preventing constipation with chronic use. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol and other CNS depressants
What are the brand names for Indomethacin?
Indocin, Tivorbex
What drug class is Indomethacin in?
NSAID
What are the indications for Indomethacin?
Ankylosing spondylitis, Osteoarthritis, Rheumatoid arthritis, Acute pain (mild to moderate), Acute gout exacerbation
What is the mechanism of action of Indomethacin?
Nonselective inhibitor of COX-1 and COX-2, and reversibly alters platelet function and prolongs bleeding time.
What are the major contraindications for Indomethacin?
Hypersensitivity, Concurrent use with ketorolac or pentoxifylline, Asthma, Urticaria or Allergic-type reaction following aspirin or other NSAID, CABG surgery, Treatment of perioperative pain
What are the black box warnings for Indomethacin?
Cardiovascular events, GI toxicity, CABG
What are the common adverse drug reactions for Indomethacin?
Headache
What are the rare but serious adverse drug reactions for Indomethacin?
Stevens-Johnson syndrome; GI bleeding; Thrombosis, Elevated LFTs, Acute renal failure, Heart failure, Aplastic anemia
What are the key counseling points for Indomethacin?
Take with food or milk to decrease GI upset. Counsel patients with heart failure to avoid NSAIDs as they may cause fluid retention which can exacerbate heart failure.
What is the brand name for Meloxicam?
Mobic
What drug class is Meloxicam in?
NSAID
What are the indications for Meloxicam?
Osteoarthritis, Rheumatoid arthritis, Juvenile rheumatoid arthritis
What is the mechanism of action of Meloxicam?
Nonselective inhibitor of COX-1 and COX-2 which results in decreased formulation of prostaglandin precursors; has antipyretic, analgesic, and anti-inflammatory properties; reversibly alters platelet function and prolongs bleeding time.
What are the major contraindications for Meloxicam?
Hypersensitivity to meloxicam, Concurrent ketorolac or pentoxifylline use, Asthma, Allergic-type reaction following other NSAID use, CABG
What are the black box warnings for Meloxicam?
Cardiovascular thrombotic events, Serious GI bleeding and perforation, CABG
What are the common adverse drug reactions for Meloxicam?
GI distress
What are the rare but serious adverse drug reactions for Meloxicam?
Stevens-Johnson syndrome, GI bleeding, Elevated LFTs, Acute renal failure, Congestive heart failure, Aplastic anemia
What are the key counseling points for Meloxicam?
Take with food or milk to decrease GI upset. Avoid use around 20 wk gestation. Pregnant women should consult HCP before using.
What is the brand name for Methadone?
Dolophine
What drug class is Methadone in?
Opioid Analgesic, C-II
What are the indications for Methadone?
Chronic pain, Drug detoxification, Opioid abuse
What is the mechanism of action of Methadone?
Binds to opiate receptors in CNS, causing inhibition of ascending pain pathways, altering perception to pain, and producing generalized CNS depression. Methadone is a phenylethylamine opioid agonist qualitatively similar to morphine but with a chemical structure unrelated to the alkaloid-type structures of the opium derivatives. Analgesic activity of (R)-methadone is 8-50 times that of (S)-methadone, and (R)-methadone has a tenfold higher affinity for opioid receptors.
What are the major contraindications for Methadone?
Bronchial asthma, Hypersensitivity to opioids, Paralytic ileus, Respiratory depression, Hypercarbia
What are the black box warnings for Methadone?
Accidental ingestion, Addiction, Abuse, Misuse, QTc prolongation, Respiratory depression, Concurrent use with benzodiazepines, REMS, Neonatal opioid withdrawal, Conditions for use in opioid addiction, CYP interactions
What are the common adverse drug reactions for Methadone?
Constipation, GI distress, Hypotension, Dizziness, Sedation
What are the rare but serious adverse drug reactions for Methadone?
Respiratory depression, Arrhythmias, Stevens-Johnson syndrome, QTc prolongation, Serotonin Syndrome, Adrenal insufficiency, Hypogonadism
What are the key counseling points for Methadone?
Use a motility-promoting laxative for preventing constipation. May cause drowsiness; avoid driving or other activities requiring motor coordination. Avoid alcohol and other CNS depressants. Seek medical attention if short of breath or extremely drowsy. Breast-feeding women should monitor child for signs of sedation and respiratory depression.
What is the brand name for Methocarbamol?
Robaxin
What drug class is Methocarbamol in?
Centrally Acting Skeletal Muscle Relaxant
What are the indications for Methocarbamol?
Musculoskeletal pain or spasm
What is the mechanism of action of Methocarbamol?
May be due to general CNS depression. It has no direct action on the contractile mechanism of striated muscle, the motor end plate, or the nerve fiber.
What are the major contraindications for Methocarbamol?
Hypersensitivity
What are the black box warnings for Methocarbamol?
None
What are the common adverse drug reactions for Methocarbamol?
Somnolence
What are the rare but serious adverse drug reactions for Methocarbamol?
Bradyarrhythmia, Hypotension, Syncope, Leukopenia, Anaphylactoid reaction, Slowed or difficult breathing when used in combination with opioids
What are the key counseling points for Methocarbamol?
Patients should avoid activities requiring mental alertness or coordination until drug effects are known, as drug may cause dizziness or sedative effects.
What is the brand name of Nabumetone?
Relafen
What drug class is Nabumetone in?
NSAID
What are the indications for Nabumetone?
Osteoarthritis, Rheumatoid arthritis
What is the mechanism of action of Nabumetone?
Prodrug, biotransformed into 6-methoxy-2-napthlacetic acid (6MNA), a nonselective inhibitor of cyclo-oxygenase-1 (COX-1) and cyclo-oxygenase-2 (COX-2), and reversibly alters platelet function and prolongs bleeding time.
What are the major contraindications for Nabumetone?
Hypersensitivity to nabumetone, other NSAIDs, aspirin or sulfonamides, Concurrent ketorolac or pentoxifylline use, Asthma, CABG surgery
What are the black box warnings for Nabumetone?
Thrombotic events, GI bleeding
What are the common adverse drug reactions for Nabumetone?
Elevated LFTs, Dyspepsia, Abdominal pain, Diarrhea
What are the rare but serious adverse drug reactions for Nabumetone?
Stevens-Johnson syndrome, GI bleeding, Thrombosis, Acute renal failure, Congestive heart failure, Aplastic anemia
What are the key counseling points for Nabumetone?
Take with food or milk to decrease GI upset
What is the brand name for Naproxen?
Naprosyn
What drug class is Naproxen in?
NSAID
What are the indications for Naproxen?
Osteoarthritis, Rheumatoid arthritis, Gout, Fever, Pain
What is the mechanism of action of Naproxen?
Nonselective inhibitor of COX-1 and COX-2
What are the major contraindications for Naproxen?
Hypersensitivity to naproxen, other NSAIDs, aspirin or sulfonamides, Asthma, Allergic-type reaction following aspirin or other NSAIDs, CABG surgery, Treatment of perioperative pain
What are the black box warnings for Naproxen?
Cardiovascular and GI risk, Thrombotic events
What are the common adverse drug reactions for Naproxen?
(>10% - None known) 1-10% - Edema, Itching, Rash, GI distress, Dizziness, Tinnitus, Ototoxicity
What are the rare but serious adverse drug reactions for Naproxen?
Stevens-Johnson syndrome, GI bleeding, Thrombosis, Elevated LFTs, Acute renal failure, Congestive heart failure, Aplastic anemia
What are the key counseling points for Naproxen?
Take with food or milk to decrease GI upset.
What is the brand name for Oxycodone?
OxyContin
What drug class is Oxycodone in?
Opioid Analgesic, C-II
What is the indication for Oxycodone?
Moderate to severe chronic pain
What is the mechanism of action of Oxycodone?
Pure µ agonist. In the CNS, it promotes analgesia and respiratory depression by decreasing the brainstem respiratory centers’ response to carbon dioxide tension and electrical stimulation. It also decreases gastric, biliary, and pancreatic secretion, induces peripheral vasodilation, and promotes opioid-induced hypotension due to histamine release.
What are the major contraindications for Oxycodone?
Hypersensitivity to oxycodone or other opioids, Asthma, Paralytic ileus, Respiratory depression, Hypercarbia
What are the black box warnings for Oxycodone?
Addiction, Abuse potential, REMS, Respiratory depression, Accidental ingestion, Neonatal withdrawal, CYP3A4/5 interactions, Concurrent use with benzodiazepines, Medication errors with oral solution
What are the common adverse drug reactions for Oxycodone?
Constipation, GI distress, Sedation, Sweating, Pruritus
What are the rare but serious adverse drug reactions for Oxycodone?
Cardiac arrest, Respiratory depression, Physical dependence, Tolerance, Severe hypersensitivity, Serotonin syndrome, Adrenal insufficiency, Decreased sex hormones
What are the key counseling points for Oxycodone?
Use laxative for preventing constipation. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol and other CNS depressants.
What is the brand name for Pentosan?
Elmiron
What drug class is Pentosan in?
Urinary Analgesic
What is the indication for Pentosan?
Pain relief from interstitial nephritis
What is the mechanism of action of Pentosan?
Low-molecular-weight heparin-like compound. Adheres to the mucosal membrane of the bladder wall and may act as a buffer to control cell permeability, which prevents irritating solutes in urine from reaching the cells.
What are the major contraindications for Pentosan?
Hypersensitivity
What are the black box warnings for Pentosan?
None
What are the common adverse drug reactions for Pentosan?
Nausea
What are the rare but serious adverse drug reactions for Pentosan?
Rectal hemorrhage, Proctitis, Thrombocytopenia
What are the key counseling points for Pentosan?
Take 1 h before or 2 h after meals with a full glass of water. Use caution and monitor for bleeding if using concomitant NSAIDs or aspirin-containing products
What are the brand names for Tramadol?
ConZip, Ultram, Qdolo
What drug class is Tramadol in?
Opioid Analgesic, C-IV
What is the indication for Tramadol?
Chronic pain (moderate to moderately severe)
What is the mechanism of action of Tramadol?
µ agonist and a weak inhibitor of serotonin and norepinephrine reuptake. In the CNS, it promotes analgesia and respiratory depression by decreasing brainstem respiratory centers’ response to carbon dioxide tension and electrical stimulation.
What are the major contraindications for Tramadol?
Hypersensitivity to tramadol or other opioids, Paralytic ileus, Respiratory depression, Bronchial asthma, Age < 12 y, Hypercapnia, MAOI use or use with last 14 d
What are the black box warnings for Tramadol?
Addiction, Abuse, Misuse, REMS, Respiratory depression, Accidental ingestions, CYP2D6 in children, Neonatal withdrawal syndrome, Drug interactions, Concurrent benzodiazepines, Medication errors, Drug interactions with P450s
What are the common adverse drug reactions for Tramadol?
Constipation, GI distress, Dizziness, Sedation, Edema, Sweating, Pruritus, Headaches, Flushing
What are the rare but serious adverse drug reactions for Tramadol?
Cardiac arrest, Physical dependence, Tolerance, Seizures, Pancreatitis, Suicidal ideation, Anemia, Serotonin syndrome, Adrenal insufficiency, Decreased sex hormones
What are the key counseling points for Tramadol?
Use a laxative for preventing constipation if used chronically. May cause drowsiness; avoid driving or other tasks requiring motor coordination. Avoid alcohol and other CNS depressants. Extended-release products must not be crushed or chewed but may be taken with or without food, and always the same way to avoid variability in absorption.
What is the brand name for Tizanidine?
Zanaflex
What drug class is Tizanidine in?
Centrally Acting Skeletal Muscle Relaxant, z2-agonist
What is the indication for Tizanidine?
Muscle Spasticity
What is the mechanism of action of Tizanidine?
Imidazole derivative, structurally unrelated to other muscle relaxants. Agonist of z2-adrenergic receptors, which decreases spasticity by increasing presynaptic inhibition; however, it does not have antihypertensive properties.
What are the major contraindications for Tizanidine?
Hypersensitivity to tizanidine, Concurrent use with CYP1A2 inhibitors
What are the black box warnings for Tizanidine?
None
What are the common adverse drug reactions for Tizanidine?
Hypotension, Xerostomia, Asthenia, Dizziness, Somnolence, Muscle weakness
What are the rare but serious adverse drug reactions for Tizanidine?
AMI, Thrombocytopenia, Hepatitis, PE, Hypersensitivity, Death, Slowed or difficult breathing when used in combination with opioids
What are the key counseling points for Tizanidine?
Be cautious of risk of dizziness and somnolence when initiating therapy; do not drive until effects of drug are known. Rise slowly from a lying/sitting position, as this drug may cause hypotension. May cause xerostomia and asthenia.
