Pain management and treatment for MSK Flashcards
What are the different painkillers?
- NSAIDs
- Corticosteroids
- Opioids
- DMARDs
- Biologics
- Gabapentin
- Amitriptyline (back pain)
What are the doses available for Co-codamol?
- 8 mg/500 mg
- 15 mg/500mg
- 30 mg/500mg
What are the NSAIDs?
Aspirin
Ibuprofen
Naproxen
Diclofenac
What do NSAIDs do?
inhibit COX1 and COX2 which reduces prostaglandins and arachidonic acids
What does COX 1 do?
- platatel aggregation
- BF in kidney
- production of mucus
What does COX2 do?
- inflammation
What are cautions for NSAIDs
GI and renal impairment
What is the non-analgesic use of Aspirin?
used in MI for anti-platelet
When is ibuprofen commonly used?
MSK, postoperation analgesia and dental pain (good inflammatory)
When is diclofenac used?
MSK, goat and post-op
What is the gel form of diclofenac?
voltarol
When does aspirin bleeding risk outweigh benefit
if over 60
What are the drug interactions of NSAIDs?
1) increased bleed risk if with another NSAID
2) increased GI bleed with anticoagulants or anti-depressant
3) reduces effectiveness of antihypertensives
4) reduced effectiveness of diuretics
5) methotrexate (increases toxicity)
When should methotrexate not be prescribed?
women of child bearing age or man who is likely to have child
When are NSAIDs contraindicated?
- GI bleed or ulcer
- children due to Reyes
- taking anticoagulants
- caution with renal impair, HF or inc BP
- previous hypersensitivity reaction
- caution in pregnancy (ibuprofen can close PDA)
