Pain meds - important Flashcards
pharm action of 1st gen NSAIDS - aspirin, ibuprofen
inhibit COX-1 and COX-2 enzymes
list 5 NSAIDs
N - naproxen
S - salicylate acid (Aspirin)
A - acetylsalicylic acid (Aspirin)
I - ibuprofen & indomethacin
K - ketorolac
therapeutic use of aspirin, ibuprofen
- suppress inflammation
- mild to mod pain
- reduce fever
- dysmenorrhea (period cramps)
- aspirin: inhibit platelet aggregation
adverse effects of ibuprofen
- GI issues, heartburn (dyspepsia), ulceration
- Kidney dysfxn
- thromboembolic events (blood clots), heart attacks
- hypertension
NSAIDS acronym for adverse effects
- N: not good for GI, Heart (HTN, HF)
- S: sticky blood clots (except aspirin)
- A: asthma worsening, or nasal polyps
- I: increased bleed risk; easy bruising/tarry stool or acute hypotention w/ tachycardia; take with food unless with PPI
- D: dysfunctional kidneys
- S: swelling heart; HTN/HF worsening
what foods to avoid for NSAIDs
EGGO acronym
E: vit. E
G: gingko
G: garlic
O: omega 3 oils
adverse effects of aspirin
- GI bleed
- kidney dysfxn
- Salicylism (overdose aspirin toxic) first signs ototoxic
- Reye’s syndrome in kids when they have influenza or varicella
Reye’s syndrome symptoms
vomiting
seizures
confusion, LOC
associated with kids that has a viral infection that leads to liver and brain damage leading to death
early treatment for Reye’s syndrome
- diuretics and electrolytes to prevent swelling of brain
- treat for bleed
considerations for NSAIDS - ibuprofen, aspirin
- take aspirin w/ proton pump inhibitor Omeprazole or Trilisate to lower risk of GI bleed
- recommend acetaminophen for kids
- discontinue 1wk before scheduled surgery
- no alcohol
- take with food/milk/water
contraindications for NSAIDs - ibuprofen, aspirin
- teratogenic
- peptic ulcer dx
- bleed d/o
- kidney issue
- heart issue (aspirin)
- hypertension (ibuprofen)
- not for children
Name the 2nd gen NSAID
celecoxib
pharm action of celecoxib
COX-2 inhibitor
adverse effects of celecoxib
- less GI issues
- renal dusfxn, cardiovascular, CVS events more prevalent
therapeutic use of celecoxib
- suppress inflammation
- mild to mod pain
- reduce fever
- dysmenorrhea
considerations for celecoxib
- take with food/milk/water
- no alcohol
- don’t take with antacids
contraindications for celecoxib
- teratogenic
- liver/kidney issues
- children
- GI bleed
- anemia
pharm action of acetaminophen
COX inhibitor that has limited CNS effects
therapeutic use of acetaminophen
- mild to mod pain
- fever reduction
adverse effect of acetaminophen
- liver damage (overdose)
- hypertension (daily use, and in women)
antidote for acetaminophen
acetylcysteine (Mucomyst, Acetadote)
considerations for acetaminophen
- no more than 4g/day
- alcohol increases risk of liver damage
contraindications for acetaminophen
alcohol use d/o
bupivacain usage
for chronic pain as a numbing agent such as back pain
list 4 antiemetics
ondansetron,
metoclopramide
hydroxyzine
phenothiazine
what medication to give when transitioning pt from PCA pump to oral meds
Percocet - mix of oxycodone and acetaminophen
what antidepressant can be given as an adjuvant
trazodone at night
list 3 antiseizure med that are adjuvant to opioids
gabapentin,
lamotrigine
pregabalin
what’s the medical cannabinoid med
dronabinol (Marinol)
oxycotin vs. oxycodone
oxycodone tend to be immediate release and easier to abuse, comes in extended release form which is the oxycotin that takes about 12 hrs to onset
important to remember for extended release opioids
give on time even if the pt doesn’t claim to be in pain
what is methadone used for
treat opioids disorder and chronic severe pain, give low doses for opioid d/o
baclofen usage
muscle relaxer
