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Nplex II > Pain Management, Drug Addiction, Drug Overdose > Flashcards

Pain Management, Drug Addiction, Drug Overdose Flashcards

1
Q

What is Capsaicin used for

A

Pain relief

Arthritis: OA or RA

Myalgias

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2
Q

How does Capsaicin work

A

It depletes substance P from nerve endings

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3
Q

Major AE’s of celecoxib

A

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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4
Q

Primary action of celecoxib

A

COX -2 inhibitor

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5
Q

Indications of celecoxib

A

Inflammatory arthritis, OA, acute pain

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6
Q

BBW for celecoxib

A

Increased risk of MI/stroke, GI bleeding

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7
Q

CI for celecoxib

A

Sulfa allergy, use with keterolac or other NSAIDS

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8
Q

Indications for NSAIDs

A

Analgesia, muscle spasm, OA, RA, FEVER

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9
Q

Primary action of NSAIDs

A

Inhibits peripheral COX hence preventing PG synthesis

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10
Q

AE’s of NSAIDs

A

Hepato/nephrotoxicity, HTN, Abdominal pain, GI ulcer

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11
Q

BBW for NSAID use

A

Increased risk of thromboembolism and GI bleeding

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12
Q

Other awesome effect of aspirin other than pain relief

A

Irreversible platelet COX-1 inhibitor, preventing clot formation

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13
Q

What is salicysm

A

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

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14
Q

CI for aspirin

A

Varicella, children with viruses, asthma

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15
Q

Primary action of acetaminophen

A

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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16
Q

Indications of acetaminophen

A

Fever, mild pain

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17
Q

AE of acetaminophen

A

Skin rash, nephrotoxicity, nausea, acute overdose - hepatotoxicity

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18
Q

Major interaction with acetaminophen

A

Carbamazepine and local anethetics

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19
Q

Max dose of acetaminophen

A

4 grams

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20
Q

What is used to tx acetaminophen OD

A

N-Acetyl cysteine

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21
Q

BBW for opiate drugs

A

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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22
Q

What ARE the opiate drugs?

A

Codeine
Hydrocodone
Oxycodone
Morphine
Methadone
Buprenorphine
Tramadol
Fentanyl

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23
Q

How do opiate drugs work?

A

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

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24
Q

AEs of opiates

A

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

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25
Q

What drug is often used to wean people from heroine

A

Methadone

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26
Q

AEs of methadone

A

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

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27
Q

Who can prescribe methodone

A

Certified opioid tx programs

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28
Q

Action of naloxone and naltrexone?

A

Opioid antagonists

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29
Q

Indications of naltrexone

A

Opioid and alcohol dependence

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30
Q

AEs of naltrexone

A

Insomnia, anxiety, fatigue, depression, rash

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31
Q

CI for naltrexone

A

Concurrent opioid or alcohol use

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32
Q

What is another use of naltrexone u should know?

A

AI disease and chronic pain (in LOW DOSES)

33
Q

Main indication for naloxone

A

Reversal of opioid overdose

34
Q

How is naloxone administered

A

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

35
Q

AEs of naloxone

A

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

36
Q

Primary action of gabapentin

A

BLocks voltage dependent calcium channels

37
Q

What are the indications of gabapentin

A

Partial seizures, neuropathic pain, post-herpetic neuralgia

38
Q

What are the adverse effects of gabapentin

A

Dizziness
Depression
Withdrawal seizures
Peripheral edema
Diarrhea

39
Q

What interacts with gababentin

A

Alcohol

40
Q

Primary action of pregabalin

A

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

41
Q

Indications of pregabalin

A

Neuropathic pain, fibromyalgia, post-herpetic neuralgia

42
Q

AE’s of pregabalin

A

Weight gain, dizziness, suicidality, fatigue and constipation

43
Q

CI for pregabalin

A

Do not withdraw abruptly

44
Q

Primary action of varenicline

A

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

45
Q

Indications for varenicline

A

Smoking cessation

46
Q

AEs of varenicline

A

Seizures
photosensitivity
insomnia
Fatigue
Mood or behavior changes

47
Q

CI for varenicline

A

< 18 years old

48
Q

Interactions with varenicline

A

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

49
Q

What is heroin

A

An opiate drug that is commonly abused

50
Q

Is heroin withdrawal life threatening

A

No, it just sucks

51
Q

Signs and sx of heroin withdrawal

A

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

52
Q

What substances do have life threatening withdrawal sx?

A

Alcohol and benzos

53
Q

What is ketamine?

A

A dissociative anesthetic used mostly by veterinarians and sometimes for fun

54
Q

What are the AEs of ketamine

A

Delirium, anesthesia
Hypertension
Potentially fatal respiratory problems

55
Q

What is another use of ketamine

A

Compounded topically to treat neuropathic pain

56
Q

AEs of cannabis

A

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

57
Q

Cocaine actions

A

Dopamine, NE, serotonin reuptake inhibitor

58
Q

Primary action of ketorolac

A

NSAID

59
Q

How is ketorolac administered

A

IM, IV use

60
Q

Indications for ketorolac

A

Moderate to severe pain, migraines

61
Q

AE’s of ketorolac

A

Headache, N/V, edema, rash, bronchospasm

62
Q

BBW for ketorolac

A

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

63
Q

CI for ketorolac

A

Use prior to surgery

64
Q

What interacts with ketorolac

A

NSAIDs… don’t use totgether

65
Q

Primary action of diclofenac

A

NSAID

66
Q

Indications for diclofenac gel

A

OA

67
Q

AEs of diclofenac

A

Pruritus, rash, contact derm, alopecia, abdominal pain

68
Q

BBW for diclofenac

A

Increased risk of MI/stroke and GI bleeding

69
Q

Adverse effects for fentanyl patch

A

Well obviously addiction
Avoid excess heat

70
Q

CI for fentanyl

A

MAOI use with in 14 days
Asthma
GI obstruction

71
Q

Indications for tramadol

A

Pain- moderate to severe and chronic

72
Q

AEs of tramadol

A

Seizure, adrenal insufficinecy, constipation, deprssion, withdrawal

73
Q

CI for use of tramadol

A

MAOI use within 14 days

74
Q

Primary action of buprenorphine

A

Opioid agonist antagonist

75
Q

Buprenorphine inidcations

A

Opioid dependence, moderate to severe pain

76
Q

AEs of buprenorphine

A

Sedation, headache, bronchospasm, dependency, mood changes

77
Q

CI for buprenorphine

A

Respiratory depression, asthma, gi obstruction

78
Q

Interactions with buprenorphine

A

Do not use with benzodiazepines, alcohol, or other opiates

Nplex II (10 decks)

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