PAIN MANAGEMENT Flashcards
Max APAP dosing (per day)
4000 mg/day (McNeil limits to 3000 mg/d)
Treatment APAP OD
N-acetylcystine
Initiation of treatment for APAP OD - IV vs PO
IV - within 8-10 hrs, PO - within 24 hrs IV preferred if nauseous Oral takes 72 hrs, IV takes 21 hrs Oral SE - bad taste/smell IV SE - acute flushing, erythema, caution with asthma
Which NSAID is used for PDA?
Indomethacin
Which 2 NSAIDs can be given parenterally for mild-mod pain?
Ibuprofen IV and Ketorolac (Toradol) IV or IM
NSAIDs - SE
GI bleeding
How long can Ketorolac be given?
short term (<5 days)
What dose of ibuprofen = ASA 4g/d for anti-inflammatory?
2.4 g/d
What effect does <2.4 g/d of Ibuprofen have?
analgesia only (not anti-inflammatory)
Which NSAID does not undergo enterohepatic circulation so less GI effects?
Nabumetone (Relafan)
Which NSAIDs are less effective than ASA but may be better if asthma, bleeding risk (hemophilia, etc.) and renal dysfunction?
Non-acetylated salicylates (magnesium choline salicylate, sodium salicylate and salicylsalicylic acid)
Which NSAID is lipophilic and good for migraines?
Naproxen (good CNS penetration)
Opioid side effects and treatment
Constipation (stimulant like bisacodyl or sennakot)
Resp depression (Narcan)
Itching (premedicate Benadryl)
What agents are used at lower doses for neuropathic pain?
TCAs - Amitriptyline (Elavil), Clomiparamine (Anafranil)…
Diclofenac patch (Flector) - FDA
sprains, strains, contusions
