pain killers Flashcards
what are the symptoms of Reyes Syndrome caused by NSAIDs
Initial symptoms can include: vomiting, lethargy, drowsiness, rapid breathing, seizures (fits).
As the condition progresses, the symptoms may become more severe: personality changes, delirium, coma. Blood tests: lft’s, wcc
which NSAID has the LOWEST risk of cardiovascular side effects
naproxen
which NSAIDs can INCREASE the risk of thrombotic events, particularly if used long term
- high dose of ibuprofen
- diclofenac
why should ibuprofen not be taken with lithium
there is a severe interaction. ibuprofen increases concentration of lithium
TRUE OR FALSE
constipation is a common side effect of diclofenac
true
which NSAID can cause acute kidney injury
ibuprofen
why might codeine NOT be appropriate for a patient from middle eastern and african/ethiopian descent
0.7% of people from Middle Eastern and African/Ethiopian descent may be “ultra fast metabolisers” who rapidly metabolise codeine to morphine through a genetic
variant of cytochrome P450 CYP2D6.
Other pain meds (not codeine) can sometimes be more appropriate
what is the interaction between Tramadol and SSRIs
Tramadol can cause serotonin syndrome when given in combination with an SSRI
TRUE OR FALSE
NSAIDs are contraindicated in mild to severe heart failure
true
which controlled drug is used to treat intractable cough in palliative care
morphine
which painkillers are NOT suitable in patients with renal failure
- morphine (accumulates in renal impairment, resulting in CNS depression)
- codeine (its metabolites are significantly reduced in renal impairment)
- ibuprofen (systemic NSAID) - avoid in severe renal
impairment
note: oxycodone is also affected in renal failure, however it may be preferred to morphine in some circumstances. so if necessary, can use oxycodone
Which analgesic is contraindicated in patients with uncontrolled epilepsy?
Tramadol
