Pain Management Flashcards
Acetaminophen most effective analgesic dose?
1000mg
Acetaminophen monitoring
LFTs (hepatic function)
True or false: NSAIDs may be combined with prophylactic heparin or enoxaparin
True
NSAID monitoring
Hgb/Hct, Plt, signs of bleeding
Which gabapentanoid is associated with fewer adverse effects?
Pregabalin
Which classes of antidepressants may be used to treat chronic neuropathic pain or fibromyalgia?
SNRIs, TCAs
What is the onset of effect for SNRIs used to manage pain?
2-4 weeks
Adverse effects of SNRIs
Increased BP, sedation, insomnia, nausea, anorexia, dizziness
Adverse effects of TCAs
Anti-muscarinic (Can’t see, can’t see, can’t poop, can’t spit), orthostatic hypotension, QTc prolongation
When should TCAs be administered?
Bedtime
Difference between spasticity and spasm
Spasticity: disorder of motor neurons, increased muscle tone and stiffness
Spasm: localized, involuntary of muscle spasm arising from trauma, muscle strain, or cramping
Which two of the following medications are often used to address issues with spasticity?
a. Cyclobenzaprine
b. Methocarbamol
c. Tizanidine
d. Carisoprodol
e. Baclofen
c. Tizanidine
e. Baclofen
Which of the following medications can be used to address issues with both spasticity and spasm?
a. Methocarbamol
b. Tizanidine
c. Carisoprodol
d. Baclofen
b. Tizanidine
Appropriate dosing range of subdissociative ketamine
0.1– 0.3 mg/kg/hr
Sub-dissociative ketamine precautions/CI
AMS, exacerbation of psychosis in schizophrenia, pregnancy
Which of the following is metabolized into inactive metabolites?
a. Morphine
b. Hydromorphone
c. Oxycodone
d. Hydrocodone
b. Hydromorphone
Which of the following is structurally different from the others?
a. Fentanyl
b. Hydromorphone
c. Hydrocodone
d. Morphine
a. Fentanyl
Morphine is metabolized into which two metabolites?
M3G (can buildup and lead to nephrotoxicity) and M6G (less active)
Methadone dosing for chronic pain
Very small doses given 2-3 times a day starting as low as 2.5mg
First line treatment for acute sickle cell crisis
Opioid therapy with consideration given to baseline opioid use
What is chronic pain?
Persistent or recurring pain >3 months
True or false: Long acting opioids should be used PRN
False. They should be scheduled
