Pain Meds

Question 1

Ketorolac

Adverse effects

Answer 1

> bleeding time 
Period blood loss
GI bleeding/ ulceration /perf
Renal toxicity
Bronchospasm

Question 2

Ketorolac

Use, DOA, PB

Answer 2

Do not use >5days

Onset 10 min
E 1/2t = 5hrs (elderly can >30-50%
DOA = 6-8 hrs
PB = 99%
Conjugated in liver

Question 3

Ketorolac

Dose

Answer 3

30mg IV (X1 or q6h)

Daily max = 120mg

Elderly (if use) cut dose in half

Question 4

COX 1

Answer 4

Gastric protection
Produce TxA2

TxA2 = vasoconstrictor +plt inhibitor

Question 5

COX 2

Answer 5

Produce prostacyclin

Prostacyclin = vasodilator + plt inhibitor

Question 6

Adjunct analgesic: Anticonvulsant

Gabapentin

Answer 6

For:
diabetic neuropathy
Posttherapeutic neuralgia

Question 7

Adjunct analgesic: Anticonvulsant

Pregabalin

Answer 7

Gabamenergic
Analogue of GABA

For:
Diabetic neuropathy
Post-therapeutic neuralgia
Fibromyalgia

Question 8

Adjunct analgesic: Anticonvulsant

Carbamezpine (Tegretol)

Answer 8

Na Channel Blocker &
Gabamenergic

For: trigeminal neuralgia

Question 9

Adjunct analgesic: Anticonvulsant

Phenytoin (Dilantin)
Sodium Valproate (Depakote)
Clonazepam (Klonopin)
Topiramate (Topomax)

Answer 9

May relieve neuropathic pain

Question 10

Adjunct analgesic: Anticonvulsant

Lamitrogen (Lamictal)

Answer 10

Gabamenergic

Effective for central post stroke pain & HIV painful sensory neuropathies

Question 11

Adjunct analgesic: Antidepressants

TCAs
Amytriptyline
Nortriptyline

Answer 11

For: 
Diabetic Neuropathy
Post-therapeutic Neuralgia
Polyneuropathy
Nerve injury or infiltration with cancer
Depression insomnia

Question 12

Adjunct analgesic: Antidepressants

Venlafaxine (Effexor )
Duloxetine (cymbalta)
SSNRI

Answer 12

For:
Neuropathic Pain
Headache
Fibromyalgia
Postmastectomy pain