Pain

Question 1

What is the difference between nociceptive and neuropathic pain?

Answer 1

Nociceptive: Tissue damage causes stimulation of sensory nerves

Neuropathic: damage or malfunction of the nervous system

Question 2

What is the difference between acute and chronic pain?

Answer 2

Acute: sharp and sudden pain
Chronic: pain that persists for 3 months → dull pain

Question 3

Mild pain

Answer 3

Non-opioid +/- adjuvant

Question 4

Moderate pain

Answer 4

Opioid for mild-mod
+/- non-opioid
+/- adjunct

Question 5

Severe pain

Answer 5

Opioid for mod-severe
+/- non-opioid
+/- adjunct

Question 6

Max dose of APAP

Answer 6

4 g/day

Question 7

Pediatric dose of APAP

Answer 7

10-15 mg/kg Q4-6H

Question 8

Strength of children APAP suspension

Answer 8

160 mg/5 mL

Question 9

Antidote for APAP

Answer 9

NAC

Question 10

Which NSAID have least GI risk? CV risk?

Answer 10

COX2

Nonselective

Question 11

ADRs of NSAIDs

Answer 11

1. Increased BP
2. Premature closure of ductus arteriosus (Avoid in 3rd trimester)
3. Nausea (take with food or use enteric coated)
4. Photosensitivity
5. Dyspepsia, ab pain, nausea

Question 12

What medication is used to intensionally close the patent ductus arteriosus

Answer 12

Used within 14 days:
IV indomethacin or ibuprofen

Question 13

Max dose of ibuprofen

Answer 13

3.2 g/d

Question 14

Pediatric dose of ibuprofen

Answer 14

5-10 mg/kg/dose Q6-8H

Question 15

OTC limit of Ibuprofen

Answer 15

10 days

Question 16

NSAID that has the highest risk for CNS ADRs

Answer 16

indomethacin

Question 17

OTC of Naproxen

Answer 17

220 mg Q8-12H

Question 18

Max dose of naproxen

Answer 18

1000 mg/d

Question 19

BBW of ketorolac

Answer 19

Max duration 5 days

Question 20

ADR of ketorolac

Answer 20

↑ bleeding, acute renal failure, liver failure

Question 21

Non-selective NSAIDs

Answer 21

Ibuprofen
Naproxen
Ketorolac
Indomethacin

Question 22

Selective CoX2 inhibitors

Answer 22

Celecoxib
Diclofenac
Meloxicam

Question 23

Highest COX2 selectivity

Answer 23

Celecoxib

Question 24

CI of Celebrex

Answer 24

Sulfonamide allergy

Question 25

Dosing of topical voltaren gel

Answer 25

2-4 g to affected joint QID (total body max: 32 g/d)

Question 26

BBW of Diclofenac

Answer 26

Athrotec: avoid in pregnancy due to misoprostol

Question 27

Cardioprotective dosing of ASA

Answer 27

81-162 mg QD

Question 28

ADR of ASA

Answer 28

Reye's syndrome Dyspepsia, heartburn, bleeding

Question 29

Used for GI protection while on chronic NSAIDs

Answer 29

PPI

Question 30

Counseling when taking ASA and another NSAID

Answer 30

ASA on 1 hr before or 8 hr after ibuprfen

Question 31

Physical dependence

Answer 31

Physiologically adapted to a drug and experience physical sx of withdraw with discontinued

Question 32

Addiction

Answer 32

Strong desire or compulsion to take the drug despite harm → drug seeking behavior

Question 33

OUD

Answer 33

Problematic pattern of opioid use that causes significant impairment or distress

Question 34

Tolerance

Answer 34

A higher opioid dose is needed to produce the same level of analgesia that a lower dose previously provided

Question 35

Opioid hyperalgesia

Answer 35

When the opioid dose is increased that pain becomes worse rater than better

Question 36

What is break-through pain

Answer 36

Sharp spikes of severe pain that occur despite the use of an ER opioid

Question 37

Opioid BBW

Answer 37

1. Addiction, abuse, and misuse 2. Respiratory depression 3. Fatal overdose

Question 38

What schedule are opioids

Answer 38

C-II