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TOP 300 > Pain Management > Flashcards

Pain Management Flashcards

1
Q

generic name and class

tylenol

A

generic: acetaminophen
class: analgesic/antipyretic

drug to treat mild-moderate pain

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2
Q

indication

acetaminophen

A

pain,headache,fever

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3
Q

MOA

acetaminophen

A

centrally acting analgesic (blocks COX) and antipyretic with minimal anti-inflammatory properties

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4
Q

major contraindications

acetaminophen

A
  • hypersensitivity
  • active acute hepatic dysfunction
  • don’t use with other acetaminophen-containing products
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5
Q

BBW

acetaminophen

A

hepatotoxicity

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6
Q

rare but serious ADRs

acetaminophen

A

SJS and elevated liver function tests

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7
Q

key counseling points

acetaminophen

A
  • heed max dose limits
  • avoid alcohol
  • measure dose accurately, esp. for children
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8
Q

generic name and class

motrin/advil

A

generic: ibuprofen
class: NSAIDs

drug to treat mild/moderate pain and reduce inflammation

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9
Q

indication

ibuprofen

A

OTC: pain, headache, fever
Rx: osteoarthritis, RA

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10
Q

MOA

ibuprofen

A

nonselective inhibitor of COX-1 and COX-2, and reversibly alters platelet function and prolongs bleeding time

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11
Q

major contraindications

ibuprofen

A
  • hypersensitivity
  • Aspirin Triad: asthma, urticaria, or allergic-type reaction following aspirin or other NSAID administration
  • CABG surgery
  • treatment of perioperative pain
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12
Q

BBW

ibuprofen

A
  • cardiovascular events
  • GI toxicity
  • CABG
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13
Q

common ADRs

ibuprofen

A
  • (>10%) None known
  • Less Common (1-10%) GI distress, edema, itching, rash, dizziness, tinnitus, ototoxicity
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14
Q

rare but serious ADRs

ibuprofen

A

Stevens-Johnson syndrome, GI bleeding, thrombosis, elevated liver
functions, acute renal failure, congestive heart failure, aplastic anemia

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15
Q

key counseling points

ibuprofen

A
  • Take with food/milk
  • Avoid in HF
  • Older patients increased risk of GI
    and renal issues
  • Increased risk of CV events (fatal MI and stroke)
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16
Q

generic name and class

aspirin

A

generic: ASA, acetyl salicylic acid
class: NSAIDs

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17
Q

indication

aspirin

A

mild to moderate pain, fever, MI and stroke prophylaxis

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18
Q

MOA

aspirin

A

inhibits COX enzyme

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19
Q

major contraindications

aspirin

A
  • Hypersensitivity,
  • aspirin triad (asthma, rhinitis, nasal polyps)
  • inherited or acquired bleeding disorders
  • children <18 y of age with viral infections
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20
Q

common ADRs

aspirin

A
  • abdominal pain
  • diarrhea
  • headache
  • indigestion
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21
Q

rare but serious ADRs

aspirin

A
  • Angioedema
  • GI hemorrhage
  • GI ulcer
  • Reye syndrome
  • Stevens-Johnson syndrome
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22
Q

key counseling points

aspirin

A
  • Avoid additional aspirin, NSAIDs, or aspirin-containing products
  • Avoid ≥ 3 alcoholic drinks/d
  • not recommended for children <18 y of age with a viral illness
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23
Q

other NSAIDs in top 300

generic - brand

A
  • naproxen - naprosyn, aleve
  • diclofenac - cambia, voltaren, zipsor, zorvolex
  • etodolac - etodolac
  • indomethacin - indocin, tivorbex
  • meloxicam - mobic
  • nabumetone - relafen
24
Q

generic name and class

celebrex

A

generic: celecoxib
class: COX-2 inhibitor

Drugs to treat mild-moderate pain AND reduce inflammation

25
Q

indication

celecoxib

A

Osteoarthritis; Rheumatoid arthritis; Ankylosing spondylitis; Acute pain, primary dysmenorrhea

26
Q

MOA

celecoxib

A

inhibition of the COX-2 enzyme isoform

27
Q

major contraindications

celecoxib

A

Asthma, urticaria, or allergic-type reaction following aspirin or other NSAID administration; CABG surgery, treatment of perioperative pain, hypersensitivity to sulfonamides

28
Q

BBW

celecoxib

A

GI toxicity, cardiotoxicity and CABG

29
Q

common ADRs

celecoxib

A

hypertension, headaches, GI distress, diarrhea

30
Q

rare but serious ADRs

A

Stevens-Johnson syndrome, GI ulcers and bleeding, thrombosis, elevated liver functions, acute renal failure

31
Q

key counseling points

celecoxib

A

Celecoxib has less risk of GI effects than other NSAIDs, but increased cardiovascular toxicity

32
Q

generic name and class

MS contin, avinza, kadian

A

generic: morphine
class: opioid analgesic

drugs to treat moderate-severe pain

33
Q

indication

morphine

A

acute and chronic pain

34
Q

MOA

morphine

A

Pure mu agonist

35
Q

major contraindications

morphine

A

Hypersensitivity to opioids, acute or severe asthma, paralytic ileus, respiratory depression, GI obstruction; concurrent use or use within 14 days of MAOI

36
Q

BBW

morphine

A

Ethanol; addiction, abuse and misuse, REMS, respiratory depression, neonatal opioid withdrawal, accidental ingestion, concurrent use with benzodiazepines, medication errors

37
Q

common ADRs

morphine

A

Constipation, nausea, vomiting, hypotension, dizziness, sedation,
diaphoresis, headaches, depression, xerostomia

38
Q

rare but serious ADRs

morphine

A

Cardiac arrest, physical dependence, respiratory depression, serotonin
syndrome, adrenal insufficiency, decreased sex hormones

39
Q

key counseling points

morphine

A

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.

40
Q

other opiod analgesic top 300

generic - brand

A
  • buprenorphine/naloxone - suboxone, zubsolv
  • codeine/acetaminophen - tylenol with codeine
  • fentanyl transdermal - duragesic, ionsys
  • hydrocodone - vicodin, lortab, zohydro ER, hysingla ER
  • methadone - dolophine, methadose
  • oxycodone - oxycontin, percocet
  • tramadol - ultram
41
Q

generic name and class

flexeril

A

generic: cyclobenzaprine
class: skeletal muscle relaxant

Drugs to reduce pain from muscle contractions/spasms

42
Q

indication

cyclobenzaprine

A

skeletal muscle spasm

43
Q

MOA

cyclobenzaprine

A

Unclear, relieves muscle spasms through a central action, possibly at the brain stem level. (Structurally similar to TCA antidepressants, has anti-Ach effects)

44
Q

major contraindications

cyclobenzaprine

A

Hypersensitivity to cyclobenzaprine, concomitant MAOI use, heart failure, acute coronary phase of AMI, heart block, hyperthyroidism

45
Q

common ADRs

cyclobenzaprine

A

xerostomia, headache, dizziness, drowsiness

46
Q

rare but serious ADRs

cyclobenzaprine

A

Cardiac dysrhythmia, cholestasis, hepatitis, jaundice, anaphylaxis,
immune hypersensitivity reaction, slowed or difficult breathing when
used in combination with opioids

47
Q

key counseling points

cyclobenzaprine

A

Risk of falls in older patients. used for only short periods (up to 2-3 wk). Should avoid concomitant use with opioids. Should be used with
caution in patients with glaucoma, increased IOP, urinary retention,
etc, as cyclobenzaprine has anticholinergic-like effects. Avoid use in
elderly; may be more sensitive to effects.

48
Q

other skeletal muscle relaxants in top 300

generic - brand

A
  • baclofen - lioresal, ozobax
  • carisoprodol - soma, vabadom
  • methocarbamol - robaxin
  • tizanidine - zanaflex
49
Q

generic name and class

lidoderm

A

generic: lidocaine or benzocaine
class: local anesthetics

Drugs to reduce mild-moderate topical pain

50
Q

indication

lidocaine

A

Postherpetic neuralgia and localized pain

51
Q

MOA

lidocaine

A

stabilize neuronal membranes by inhibiting the ionic fluxes required for the initiation and conduction of impulses. Analgesia vs. complete sensory block.

52
Q

major contraindications

lidocaine

A

hypersensitivity

53
Q

common ADRs

lidocaine

A

Skin irritation (Systemic adverse reactions after appropriate application
of topical or transdermal lidocaine are unlikely because of the small amount of lidocaine absorbed)

54
Q

rare but serious ADRs

lidocaine

A

Methemoglobinemia (benzocaine containing oral products in children)

55
Q

key counseling points

lidocaine

A

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.

lidocaint topical patch 5% (Rx) and 4% (OTC)

TOP 300 (19 decks)

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