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Pain Meds Flashcards

1
Q

Acetaminophen (Ofirmev):

Action

A
  • inhibits the synthesis of prostaglandins, which transmit pain signals and induce fever
  • Reduces pain by blocking the signals produced by prostaglandins
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2
Q

Fentanyl

Indications

A

Treatment of Pain as Needed:

  • Abdominal Pain
  • Burns
  • Envenomation Injury
  • Trauma
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3
Q

Fentanyl

Class

A

Analgesic; Opioid Agonist

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4
Q

Fentanyl

Contraindications

A

None

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5
Q

Acetaminophen (Ofirmev):

Side effects

A
  • nausea, vomiting
  • headache, sleep problems
  • constipation
  • itching, agitation
  • partial or total lung collapse in pediatric patients
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6
Q

Midazolam (Versed)

Indications

A
  • Seizures
  • PEDS seizures
  • Unstable Bradycardia (adult only)
    - pain associated with PACING — after fentanyl if BP ≥ 100
  • Unstable (conscious) VT: precardioversion
  • Conscious SVT: precardioversion
  • Unstable, Conscious A-fib, A-flutter
    • precardioversion
  • Overdose with excited delirium
  • Combative Patients
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7
Q

Fentanyl

Onset/Duration

A

Onset: 1-2 minutes

Duration: 30-60 minutes

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8
Q

Acetaminophen (Ofirmev):

Contraindications

A

< 2 years old

  • severe hepatic impairment
  • severe active liver disease
  • if known or suspected total dose exceeding 4000mg in 24 hours
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9
Q

Morphine (MS, MS04)

Administration

A

Slow IVP

  • document vital signs and pain scale before and after each administration
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10
Q

Morphine (MS, MS04)

Contraindications

A

None

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11
Q

Midazolam (Versed)

Contraindications

A

None

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12
Q

Ketamine (Ketalar)

Requirements

A 
- ≥ 15 years old
AND with GCS of 15
AND not pregnant
AND no known/suspected DRUGS/ETOH
AND have NOT received opioid analgesic in past 6 hours (prior to medic arrival)
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13
Q

Midazolam (Versed)

Side Effects

A

Respiratory depression / apnea

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14
Q

Ketamine (Ketalar)

BHO required for:

A
  • BP < 100
  • Change in the analgesic type
  • change in administration route
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15
Q

Fentanyl

Maximum dose for < 65 years old

A

100mcg

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16
Q

Midazolam (Versed)

Action

A
  • CNS depressant
  • Produces anterograde amnesia, then sedation
  • Stops and prevents seizures
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17
Q

Acetaminophen (Ofirmev):

Dosage/route — Adult

A

1000 mg IV x1 SO

Infuse over 15 minutes !!!!

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18
Q

Morphine (MS, MS04)

Adult IV dosage

A
  • 0.1 mg/kg IV — SO
  • MR in 5 minutes at half the initial IV dose - SO
  • MR in additional 5 minutes at half the initial dose - BHO
  • Maximum for ANY IV dose is 10mg
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19
Q

Ketamine (Ketalar)

Contraindications

A
  • Pediatrics
  • Pregnancy
  • Severe hypertension
  • Alcohol intoxication
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20
Q

Midazolam (Versed)

Onset/duration

A

Onset: IV/IO/IN = 2 minutes
IM = 15 minutes

Duration: 1-4 hours

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21
Q

Fentanyl

IN dose if ≥ 65 yrs old

A
  • 25mcg IN q15 minutes, x2. SO
  • 3rd dose of 25mcg IN = BHO

Treatment of BP < 100. BHO

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22
Q

Fentanyl

Packaging

A

50mcg/ml

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23
Q

Morphine (MS, MS04)

Packaging

A

10mg / ml

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24
Q

Fentanyl

IN dose for < 65 yrs

A

50mcg IN q15 min x2 SO

- 3rd IN dose of 50mcg is BHO…. (winds up 150mcg??)

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25
Q

Fentanyl

Action

A

Potent narcotic analgesic and sedative

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26
Q

Fentanyl

PEDS

A

<10kg

  • IV/IN. PDC BHO
  • MR PDC BHO

≥ 10kg

  • IV/IN PDC SO
  • MR PDC BHO… max 75mcg
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27
Q

Morphine (MS, MS04)

Indications

A

Treatment of Pain as needed:

  • Abdominal Pain
  • Burns
  • Envenomation Injuries
  • Trauma
28
Q

Midazolam (Versed)

Dose/route: conscious SVT, precardioversion

A

Adult:
1-5mg slow IV/IO (1mg/min) - BHO

PEDS:
PDC slow IV (1mg/min) - BHPO

29
Q

Midazolam (Versed)

Dosage for seizures (adult/PEDS)

A

Adult:
IN, IM, IV, IO - to max 5mg
D/C iv/IO dose if seizures stop
MR x1 in 10 minutes. Max, 10mg total

PEDS
PDC - IV, IM, IN

30
Q

Acetaminophen (Ofirmev):

Indications

A

Treatment of Pain as Needed:

  • Abdominal Pain
  • Burns
  • Envenomation
  • Trauma
31
Q

Midazolam (Versed)

Dose/Route: unstable Brady

A

Adult Only:
1-5 mg slow IV/IO (1mg/min) - SO
If age ≥60, consider lower dose with attention to age and hydration status

32
Q

Ketamine (Ketalar)

Packaging

A

50mg/ml

10ml multi-dose vial containing 500mg total

33
Q

Morphine (MS, MS04)

BHPO if:

A
  • Isolated head injury
  • Acute onset severe headache
  • Drug/ETOH intoxication
  • Multiple trauma with GCS < 15
  • Suspected active labor
34
Q

Ketamine (Ketalar)

Class

A

Anesthetic/Analgesic

35
Q

Fentanyl

BP requirement

A

BP ≥ 100 = SO

BP < 100. = BHO

36
Q

Ketamine (Ketalar)

Dosage (adult only), IN route

A
  • 0.5mg/kg IN SO
    50mg/kg concentration
    Maximum for any IN dose = 50mg
  • MR x1 in 15 minutes if pain remains moderate or severe, SO
37
Q

Morphine (MS, MS04)

If BP < 100

38
Q

Acetaminophen (Ofirmev):

Packaging

A

1000mg/100ml (10mg/1ml)

39
Q

Morphine (MS, MS04)

Class

A
  • opioid

- narcotic analgesic

40
Q

Acetaminophen (Ofirmev):

Onset/Duration

A

Onset: 15 minutes
Peak: 1 hour

Duration: up to 4-6 hours

41
Q

Morphine (MS, MS04)

Onset/Duration

A

Onset: 1-2 minutes

Duration: 2-7 hours

42
Q

Midazolam (Versed)

Dose/route: Excited Delirium or Combative Patients

A

Adult Only

5mg IN, IM, IV

MR x1 in 10 minutes

43
Q

Morphine (MS, MS04)

Dose/route for suspected CARDIAC/pacing

A

Adult Only:

.05mg/kg IV x1 - SO

(… half of IV dose)

44
Q

Acetaminophen (Ofirmev):

PEDS Administration

A
  • get dose PDC and draw it from vial
  • inject this dose into 100ml NS bag
  • administer as piggyback … over 1 minutes
45
Q

Morphine (MS, MS04)

PEDS dose/route

A

With signs of adequate perfusion:

  • PDC, IV/IM
  • MR - BHO
46
Q

Midazolam (Versed)

Class

A

Benzodiazepine: Sedative / Anticonvulsant

47
Q

Morphine (MS, MS04)

Action

A
  • CNS depressant acting on opiate receptors in the brain

- Potent analgesic and sedative

48
Q

Acetaminophen (Ofirmev):

Class

A

Analgesic/Antipyretic

49
Q

Midazolam (Versed)

Administration rate

A

1mg / minute (when IV/IO)

50
Q

Ketamine (Ketalar)

Side Effects

A
  • increased heart rate
  • increased blood pressure
  • increased respiratory rate
  • nausea
  • With higher doses and rapid infusion (disassociative effects):
    • Euphoria
    • Dysphoria
51
Q

Ketamine (Ketalar)

Maximum IV dose

52
Q

Morphine (MS, MS04)

Adult IM dosage

A
  • 0.1mg/kg IM — SO
  • MR in 15 minutes at half the initial IM dose - SO
  • MR in additional 15 min at HALF the initial IV dose - BHO
  • Max for ANY IM dose = 10mg
53
Q

Fentanyl

IV dose if > 65 yrs

A
  • 25mcg IV x1 SO
  • MR 25mcg slow IVP x2 q5”

Maximum SO dose = 75mcg

54
Q

Fentanyl

For Pain of suspected Cardiac Origin or External Pacing

A

ADULT ONLY:

- 25mcg IV x1 SO

55
Q

Ketamine (Ketalar)

Dosage/Route: Adult (only) IV route

A
  • 0.2mg/kg in 100ml of NS, SO
    SLOW IV drip over 15 minutes
    Maximum for any IV dose is 20mg
  • MR x1 in 15 minutes if pain remains moderate or severe, SO
56
Q

Morphine (MS, MS04)

Side effects

A
  • respiratory depression/apnea
  • decreased LOC
  • Transient hypotension
  • Nausea/vomiting
  • Pinpoint pupils
57
Q

Midazolam (Versed)

Packaging

A

5mg/1ml (or 10mg/2ml)

58
Q

Ketamine (Ketalar)

Action

A
  • Low and Slow dosing: strong analgesic effects acting on the limbic system and cortex to BLOCK afferent impulses of PAIN PERCEPTION
  • HIGH and Rapid dosing: fast acting dissociative anesthesia
59
Q

Ketamine (Ketalar)

Maximum IN dose

60
Q

Midazolam (Versed)

Dose/route: unstable conscious A-fib, A-flutter

A

Adult Only:

1-5mg slow IV/IO (1mg/min) - BHPO

61
Q

Morphine (MS, MS04)

Maximum for ANY IV dose

62
Q

Acetaminophen (Ofirmev):

Dosage/Route — PECS

A

≥ 2 y/o PDC, SO x1

Infuse over 15 minutes

63
Q

Fentanyl

IV dose IF < 65 yrs

A

Titrate to pain and vital signs:

  • up to 50mcg IV x1 SO
  • MR 25mcg IV q5” x2 SO
  • Maximum SO dose = 100mcg
64
Q

Ketamine (Ketalar)

Indications

A

Moderate-Severe Pain (score ≥5)

  • Burns
  • Envenomation Injury
  • Trauma
65
Q

Acetaminophen (Ofirmev):

BHPO for:

A
  • Isolated Head Injury
  • Acute onset severe headache
  • Drug/ETOH
  • Multiple Trauma with GCD < 15
  • Suspected active labor
66
Q

Morphine (MS, MS04)

maximum for ANY IM dose

67
Q

Acetaminophen (Ofirmev):

Maximum Daily Dose

Drugs (20 decks)

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