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rxprep naplex > Pain > Flashcards

Pain Flashcards

1
Q

Nociceptive pain

A

When sensory nerves identify tissue damage

-visceral and somatic

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2
Q

Visceral pain

A

Injury to internal organs

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3
Q

Somatic pain

A

Injury to the skin, muscles, bones, or ligaments

Musculoskeletal

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4
Q

Pathophysiological pain

A

Damage or malfunction of the nervous system

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5
Q

Acetaminophen MOA

A

Thought to inhibit PG synthesis in CNS, resulting in decreased pain impulse generation

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6
Q

REMS

A

Risk Evaluation and Mitigation Strategy

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7
Q

COX1 or COX2 - which one protects gastric mucosa

A

COX1

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8
Q

_________ is an irreversible COX1 inhibitor

A

Aspirin

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9
Q

Ibuprofen max dose

A

OTC: 1.2g/day
Rx: 3.2g/day

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10
Q

Naproxen max dose

A

1000mg/day (BID dosing)

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11
Q

Highest COX2 selectivity NSAID

A

Celecoxib

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12
Q

COX2 selective NSAIDs risks

A

Decrease GI risk, Increase MI/stroke risk

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13
Q

COX2 selective NSAIDs

A 
Celebrex
Diclofenac
Etodolac
Meloxicam
Nabumetone
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14
Q

Opioid MOA

A

Mu receptor agonists in the CNS, which primarily produce pain relief, but also euphoria and resp depression

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15
Q

Centrally-Acting Opioid Antagonists

A

Naloxone

Naltrexone

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16
Q

Codeine age CI

A

Less than 18yrs

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17
Q

Fentanyl patch dosing interval

A

q72hrs, can be q48hrs

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18
Q

Fentanyl pre-requirement of pt

A

NOT opioid-naive

-must have been using morphine 60mg/day or equivalent x7 days

19
Q

Breakthrough pain dosing range

A

5-17% of total daily dose

20
Q

Morphine 60mg/day = ______ fentanyl patch

A

25mcg/hr

21
Q

Opioid equivalents PO

A

Morphine 30mg
Hydromorphone 7.5mg
Codeine 200mg

22
Q

Opioid Equivalents IV/IM

A

Morphine 10mg
Hydromorphone 1.5mg
Codeine 130mg

23
Q

Methadone dosing

A

If used for pain, dosed 2-3x/day

24
Q

Peripherally-acting mu-opioid receptor antagonists (PAMORAs)

A

Blocks opioid receptors in the gut to decrease constipation w/o affecting analgesia
-methylnatrexone (Relistor)
-naloxegol (Movantik) take in AM on an empty stomach
D/C all laxatives prior to use

25
Q

Mu receptor agonists and NE reuptake inhibitors

A

Tramadol - max 300/400mg day - inhibits reuptake of serotonin too
Tapentadol (Nucynta)
-decrease seizure threshold

26
Q

Buprenorphine is a ________ mu-opioid agonist

A

PARTIAL

  • agonist @ low doses (tx pain)
  • antagonist @ high doses (tx addiction)
27
Q

Buprenorphine/naloxone MOA for each

A

Buprenorphine suppresses withdrawal sx

Naloxone helps prevent misuse

28
Q

If prescribing buprenorphine for opioid dependency, need

A

Data waiver. The DEA will then issue a unique number starting with “X”

29
Q

How do TCAs and SNRIs work in neuropathic pain

A

Block NE uptake

30
Q

Antispasmodics (muscle relaxants) with analgesic effects

A

Baclofen
Cyclobenzaprine (dry mouth)
Tizanidine (decrease BP, dry mouth)

31
Q

Antispasmodics (muscle relaxants) that exert effects by sedation

A

Methocarbomol (decrease BP)

Carisoprodol (Soma) C-IV

32
Q

Triptans MOA

A

Selective agonists for the 5-HT1 receptor and cause vasoconstriction by inhibiting neuropeptide release

33
Q

Triptans SE

A

Tingling/numbness, CP/tightness, dizziness, dry mouth, drowsiness

34
Q

Triptan for children

A

Rizatriptan

35
Q

Longest half-life triptans (26hrs)

A

Frovatriptan

Naratriptan

36
Q

To prevent med-overuse (rebound HAs)

A

Limit acute tx to 2-3x/week at most (10-15 days a month)

37
Q

When to use prophylactic tx for migraines

A

If using acute tx greater than or equal to 2 days/wk, or greater than or equal to 3x/month

38
Q

Uric acid crystals are an end-product of _______ metabolism

A

Purine

39
Q

Foods to avoid for gout

A

Organ meats, alcohol, high-fructose corn syrup, fruit juices, shellfish, sardines

40
Q

Drugs than increase uric acid

A

ASA (low dose)
Diuretics
Niacin
Calcineurin inhibitors

41
Q

Xanthine Oxidase inhibitors

A

Allopurinol
Febuxostat
-use with colchicine or an NSAID for first 3-6 months

42
Q

Allopurinol DI

A

Antacids decrease absorption

And take after a meal to decrease N

43
Q

Uricosurics for gout

A

Inhibit uric acid resorption and increases excretion

  • lesinurad (Zurampic) HAVE TO USE WITH ALLOPURINOL OR FEBUXOSTAT
  • probenacid
44
Q

Tumor lysis syndrome

A

Complication of chemo

  • purines released into the blood = gout attack
  • tx allopurinol

rxprep naplex (33 decks)

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