Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > Pain management > Flashcards

Pain management Flashcards

1
Q

Prior to surgery what NSAID type drug must be stopped 7 days in advanced? Why?

What other drugs can be given instead?

A

Stop (Acetylsalicylic acid) Aspirin 7 days prior to prevent anti-platelet functions

Replace with Acetaminophen (Tylenol) instead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What NSAID class does ibuprofen fall under

A

Propionic acids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q 
Ketorolac (Toradol) falls under which class of drugs?
How long do they last?
A

Pyrrolacetic Acids

Max of 5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How is Ketorolac (Toradol) normally administered?

A

Parenterally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Celecoxib falls under what drug class?

A

COX-2 inhibitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What apecial instructions do you ned to give to cardiace patients taking Celecoxib

A

A before C

aspirin should be given before celecoxib

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ADE with NSAIDS?

A

Upper GI bleeding
Acute Renal failure

**ask if patient is taking any meds that might cause these

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ADE with Acetaminophen?

What needs to be monitored?

A

ADE: Hepatotoxicity

Monitor: 
ALT/AST
Liver synthesis tests
   -PT/INR or Albumin
Acetaminophen serum concentration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What needs to be monitored while taking NSAIDS

A

Complete blood count, stool guaiac (if symptoms such as black tarry stools, warrant)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What benefits does taking NSAIDS like acetaminophen/aspirin provide while taking with opoids

A

Boosts the effects of opioids, therefore reducing the dosage needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What opioid class does Morphine fall under?

Is it naturally made or synthetic?

A

Phenanthrenes

Naturally occuring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What response does injecting morphine naturally cause in the body?

A

Histamine release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the dosing equivalents between IM and PO morphine?

Why is IM dosing lower than PO dosing

A

IM: 10
PO: 30

IM avoids the first pass effect so is more potent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the drug of choice usually for severe pain?

A

Morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Drug of choice for mild/moderate pain

A

NSAIDS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Codeine, Hydrocodone, Oxycodone falls under which opioid drug class

Which is naturally occurring?

A

Phenanthrenes

Codeine = natural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is codeine used to treat?

Which enzyme is codeine dependent on for metabolism in the body?

A

Mild to moderate pain and cough suppression

CYP 450 2D6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What opioid class do Meperidine and Fentanyl fall under?

A

Phenylpiperidines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the drug dose equivalent between Meperidine and Fentanyl?

A

Meperidine 100

Fentanyl 0.1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which drug produces an active metabolite known as Normeperidine?

What effects does this cause on the body

A

Meperidine

tremors, myoclonus, and seizures
and Mydriasis

21
Q

Should Fentanyl be used as a transdermal patch in acute pain?

A

No, designed to give a dose for a longer duration

22
Q

When taking Fentanyl as a trasnmucosal, intranasal and sublingual dose what instructions ned to be followed?

A

Start with lowest dose despite daily opioid intake

23
Q

What opioid class does methadone fall under

A

Diphenylheptanes

24
Q

What complications or side effects can Mehtadone cause

A

Sedation

QT Prolongation

25
Q

How often are you allowed to titrate dosing with methadone?

A

Avoid dose titrations more frequently than every 2 weeks

26
Q

What drug class does Pentazocine (Talwin) fall under?

What other medications is added with these drugs to avoid abuse potential?

A

Agonist-Antagonist or Partial Agonists

Narcan

27
Q

What drug class does Buprenorphine fall under?

A

Agonist-Antagonist or Partial Agonists

28
Q

When taking Pentazocine or Buprenorphine what effect does it have on Naloxene

A

Naloxone may not be effective in reversing respiratory depression

29
Q

What opioid drug class does Tramadol fall under

Decreasing dosage is necessary for which population?

A

Central analgesics

Renal impairment and the elderly

30
Q

What adverse effect are we most worried about with opioid use?

A 
Respiratory depression (slowing things down)
Constipation

Sleep apnea or COPD

31
Q

Which adverse drug effects will decrease over time while taking opioids?

A

Sedation

Nausea and vomiting

32
Q

High dose opioid use will cause what to occur in males?

A

Hypo-testosterone/Hypogonadism

33
Q

Who should avoid taking Codeine?

A

Children and breastfeeding women

34
Q

What drug class does Naloxone (Narcan) fall under?

A

Opioid Antagonist

35
Q

What is the downfall with given Naloxene to treat opioid abuse/overdose

A

Requires repeat dosing since some opioids can outlast duration of Naloxene

36
Q

What two drugs are most effective for Neuropathic pain

A

Tremedol

Methadone

37
Q

MOA of Gabapentin (Anticonvulsant drug)

A

may decrease neuronal excitatory neurotransmitters and nociception through voltage-gated calcium channels specifically possessing the alpha-2-delta-1 subunit

38
Q

slide 62

A

slide 62

39
Q

What adjunctive therapy can be used to treat Chronic pain?

What is their method of action

A

Tricyclic antidepressants
Serotonin
Norepinephrine reuptake inhibitor antidepressants

block the reuptake of serotonin and norepinephrine enhancing pain inhibition

40
Q

MOA of Duloxetine for chronic pain?

A

Potent inhibitor of neuronal serotonin and norepinephrine reuptake

41
Q

Regional Analgesias and their ADE?

A

High plasma concentrations
Cardiovascular effects - myocardial depression, hypotension, decreased cardiac output, heart block, bradycardia, arrhythmias, and cardiac arrest.

42
Q

What is the MOA of Ziconotide?

A

Selectively binds to N-type voltage-sensitive calcium channels located on the nociceptive afferent nerves of the dorsal horn in the spinal cord
Blocks the excitatory neurotransmitter release and reduces sensitivity to painful stimuli

43
Q

ADE of Ziconotide?

A

Confusion, dizziness, hallucinations

Urinary retention

44
Q

What medication is used to treat Fibromyalgia? Which is not recommended?

A

Acetaminophen

Opioids

45
Q

What is a Pseudoallergy when taking opiods?

A

Histamine released from mast cells but
NOT an immunologic response
Itching, flushing, sweating

46
Q

If a patient is experiencing a possible psedoallergy what can be done to reduce these side effects?

A
  1. Use of non-opiod analgesic
  2. Avoid codeine, morphine and merepiridine, drugs associated with pseduoallergies
  3. Use a more potent opioid to reduce histamine release
  4. Use an antihistamine (H1/H2 blocker)
  5. Dose reduction
47
Q

If a patient is actually experiencing an allergy from opioids what can be done to reduce these side effects

A

A non-opioid analgesic

An opioid in a chemical class different from the one to which the patient reacted, with close monitoring

48
Q

What the difference in location between Somatic and Visceral pain?

How do these types of pain differ when they occur?

A

Somatic- arising from skin, bone, joint, muscle, or connective tissue
Present as throbbing pain and localized

Visceral - internal organs.
Pain feeling as if it is coming from other structures (referred) or as a more localized phenomenon

Pharmacology (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions