Pain Management Flashcards
Max daily dose of Tylenol
-4g
Where do you go to find out if a patient is opioid naive?
- Ask pt
- PMP
- Medication fill history
Initial IV dose of hydromorphone to an opioid naive pt
-0.2 to 1mg IV Q2-3hrs
What should we be monitoring
- Pain relief
- Mental status
- Blood pressure
- Bowel function
- Respiratory rate
What else should be prescribed to a pt receiving opioid therapy
- Naloxone
- Bowel Regimen
What is the oxycodone to morphine ratio
20mg oxycodone x 1.5mg/1mg morphine = 30MME
NM Senate Bill 221
- RPh cannot prescribe opioids
- But we should prescribe naloxone to any of our pts on opioids
Information needed to determine appropriate pharmacotherapy
- Pain assessment
- Vitals
- Labs
- Imaging
How to treat someone with mild pain (1-3)
-Nonopioid
+/- adjuvant therapy
ex. Tylenol, NSAIDs, COXIBs
How to treat someone with moderate pain (4-6)
- Low dose opioid
- Tylenol, NSAIDs, COXIB, etc.
How to treat sever pain (7-10)
- High dose opioid
- Low dose opioid
- Tylenol, COXIB, NSAIDs
Give an example of an appropriate bowel regimen
-Senna 17.2mg BID PRN
What is multimodal pain control
-Using two or more different methods to manage pain
List some multimodal analgesics
- NSAIDs
- COX2 inhibitors
- Ketamine
- Gabapentin/Pregabalin
- Steroids
- Acetaminophen
Methocarbamol
- Causes skeletal muscle relaxation
- Should be avoided in the geriatric population
- Is in the same class as baclofen and cyclobenzaprine
