Pain Management, Drug Addiction, Drug Overdose Flashcards by Monica Kendall

What is Capsaicin used for

Pain relief

Arthritis: OA or RA

Myalgias

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How does Capsaicin work

It depletes substance P from nerve endings

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Major AE’s of celecoxib

Increased risk of atherosclerosis and its complications, GI bleeding, PUD, renal damage

Can also cause bronchospasm, thromboembolism, N/V, dizziness, Elevated LFTs, renal damage

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Primary action of celecoxib

COX -2 inhibitor

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Indications of celecoxib

Inflammatory arthritis, OA, acute pain

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BBW for celecoxib

Increased risk of MI/stroke, GI bleeding

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CI for celecoxib

Sulfa allergy, use with keterolac or other NSAIDS

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Indications for NSAIDs

Analgesia, muscle spasm, OA, RA, FEVER

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Primary action of NSAIDs

Inhibits peripheral COX hence preventing PG synthesis

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AE’s of NSAIDs

Hepato/nephrotoxicity, HTN, Abdominal pain, GI ulcer

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BBW for NSAID use

Increased risk of thromboembolism and GI bleeding

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Other awesome effect of aspirin other than pain relief

Irreversible platelet COX-1 inhibitor, preventing clot formation

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What is salicysm

Aspirin’s ototoxic effect: tinnitus, vertigo, and diminished hearing

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CI for aspirin

Varicella, children with viruses, asthma

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Primary action of acetaminophen

Inhibits the synthesis of prostaglandins in the CNS and works peripherally to block pain imuplse generation.
Produces antipyresis from inhibition of hypothalamic heat-regulating centers

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Indications of acetaminophen

Fever, mild pain

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AE of acetaminophen

Skin rash, nephrotoxicity, nausea, acute overdose - hepatotoxicity

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Major interaction with acetaminophen

Carbamazepine and local anethetics

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Max dose of acetaminophen

4 grams

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What is used to tx acetaminophen OD

N-Acetyl cysteine

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BBW for opiate drugs

1) risk of addiction, abuse, misuse
2) risk of respiratory depression
3) monitor pt receiving any concomitant CYP450 3a4 inhibitors or inducers
4) risk of OD in children with only 1 dose
5) neonatal opioid withdrawal
6) risk with concomitant benzo use or other CNS depressants
7) hepatotoxic with acetaminophen combo

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What ARE the opiate drugs?

Codeine
Hydrocodone
Oxycodone
Morphine
Methadone
Buprenorphine
Tramadol
Fentanyl

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How do opiate drugs work?

They deplete substance P
They bind opioid receptors and inhibit pain stimuli excitatory transmitters from nerve endings

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AEs of opiates

Euphoria (AE?)
Addiction
Withdrawal
Allergic reactions
Respiratory depression
Orthostatic hypotension

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What drug is often used to wean people from heroine

Methadone

AEs of methadone

This is how anna nicole smith died? Respiratory depression or arrest Hypotension Bradycardia Seizures Constipation (she didnt die from constipation)

Who can prescribe methodone

Certified opioid tx programs

Action of naloxone and naltrexone?

Opioid antagonists

Indications of naltrexone

Opioid and alcohol dependence

AEs of naltrexone

Insomnia, anxiety, fatigue, depression, rash

CI for naltrexone

Concurrent opioid or alcohol use

What is another use of naltrexone u should know?

AI disease and chronic pain (in LOW DOSES)

Main indication for naloxone

Reversal of opioid overdose

How is naloxone administered

Injectable: SQ, IM, IV There is also a nasal spray

AEs of naloxone

Opioid withdrawal, seizures, tachycardia, pulmonary edema, n/v

Primary action of gabapentin

BLocks voltage dependent calcium channels

What are the indications of gabapentin

Partial seizures, neuropathic pain, post-herpetic neuralgia

What are the adverse effects of gabapentin

Dizziness Depression Withdrawal seizures Peripheral edema Diarrhea

What interacts with gababentin

Alcohol

Primary action of pregabalin

Binda alpha-2 delta subunit of calcium channels to reduce neurotransmitter release

Indications of pregabalin

Neuropathic pain, fibromyalgia, post-herpetic neuralgia

AE’s of pregabalin

Weight gain, dizziness, suicidality, fatigue and constipation

CI for pregabalin

Do not withdraw abruptly

Primary action of varenicline

Agonizes and blocks alpha-4-beta 2 nicotininc Acetylcholine receptors

Indications for varenicline

Smoking cessation

AEs of varenicline

Seizures photosensitivity insomnia Fatigue Mood or behavior changes

CI for varenicline

< 18 years old

Interactions with varenicline

Nicotine. People shouldnt take it if they are still smoking.

What is heroin

An opiate drug that is commonly abused

Is heroin withdrawal life threatening

No, it just sucks

Signs and sx of heroin withdrawal

Anxiety and agitation abdominal cramping n/v diarrhea Rhinorrhea Muscles aches Diaphoresis Mydriasis

What substances do have life threatening withdrawal sx?

Alcohol and benzos

What is ketamine?

A dissociative anesthetic used mostly by veterinarians and sometimes for fun

What are the AEs of ketamine

Delirium, anesthesia Hypertension Potentially fatal respiratory problems

What is another use of ketamine

Compounded topically to treat neuropathic pain

AEs of cannabis

Long term use dependency, increase in HR and BP, anxiety and panic attacks Chronic bronchitis Respiratory cancer

Cocaine actions

Dopamine, NE, serotonin reuptake inhibitor

Primary action of ketorolac

NSAID

How is ketorolac administered

IM, IV use

Indications for ketorolac

Moderate to severe pain, migraines

AE’s of ketorolac

Headache, N/V, edema, rash, bronchospasm

BBW for ketorolac

Short term use only Bleeding risk CI in labor and delivery Not for use with other NSAIDs Hypersensitivity reaction

CI for ketorolac

Use prior to surgery

What interacts with ketorolac

NSAIDs… don’t use totgether

Primary action of diclofenac

NSAID

Indications for diclofenac gel

AEs of diclofenac

Pruritus, rash, contact derm, alopecia, abdominal pain

BBW for diclofenac

Increased risk of MI/stroke and GI bleeding

Adverse effects for fentanyl patch

Well obviously addiction Avoid excess heat

CI for fentanyl

MAOI use with in 14 days Asthma GI obstruction

Indications for tramadol

Pain- moderate to severe and chronic

AEs of tramadol

Seizure, adrenal insufficinecy, constipation, deprssion, withdrawal

CI for use of tramadol

MAOI use within 14 days

Primary action of buprenorphine

Opioid agonist antagonist

Buprenorphine inidcations

Opioid dependence, moderate to severe pain

AEs of buprenorphine

Sedation, headache, bronchospasm, dependency, mood changes

CI for buprenorphine

Respiratory depression, asthma, gi obstruction

Interactions with buprenorphine

Do not use with benzodiazepines, alcohol, or other opiates

Pain Management, Drug Addiction, Drug Overdose Flashcards

(78 cards)