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DRUGS > Pain/MSK > Flashcards

Pain/MSK Flashcards

1
Q

naproxen

A

NSAID

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2
Q

how does naproxen/NSAIDs work?

A

inhibits sybthesis of prostaglandins which cause pain and inflammation
= reduces pain and inflammation

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3
Q

indications for NSAIDs/naproxen

A

mild to moderate pain alongside paracetamol

MSK inflammatory pain - rheumatoid arthritis, severe osteoarthritis, gout

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4
Q

contraindications of NSAIDs/naproxen

A

severe renal impairment, heart failure, liver failure
NSAID hypersensitivty
peptic ulcer disease, GI bleeding, CVD renal impairment = low dose

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5
Q

side effects of NSAIDs/naproxen

A

idigestion
GI toxicity
renal impairment
risk of CV events

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6
Q

interactions of NSAIDs/naproxen

A

increase risk of adverse effects -
GI ulceration: aspirin, corticosteorids
GI bleeding: anticoagulants, SSRIs, venlafaxine
renal impairment: ace in. diuretics

increased risk of bleeding with warfarin and reduces therapeutic effects of antihypertensives and diuretics

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7
Q

morphine

A

opiod

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8
Q

how do opioids work?

A

reduce neuronal excitability and pain transmission

reduce response to hypoxia and hypercapnia = reduce respirayroy drive and breathlessness

reduce anxiety

= reduce sympathetic nervous system

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9
Q

indications for morphine

A

rapid relief of acute severe
+ pain associated with acute MI

chronic pain when paracetamol, NSAIDs and weak opioids are insufficient

relief of breathlessness for end of life

relieve breathlessness and anxiety in acute pulmonary oedema alongside oxygen, furosemide and nitrates

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10
Q

contraindications of morphine

A

reduce doses in hepatic and renal failure/impairment and in elderly

do not give in respiratory failure except in palliative

aoid in biliary colic as can cuases spasm of sphincter of oddi which can worsen pain

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11
Q

side effects of morphine

A 
respiratory depression
euphoria and detatachment
depression
nausea and vomiting
pupillary constriction
constipation
itchy skin, vasodilation, sweating 
tolerance and dependence
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12
Q

possible interactions of morphine

A

not used with other sedating drugs

if not possible, close monitoring is necessary

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13
Q

codeine

A

opioid

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14
Q

indications for codeine

A

mild to moderate pain

diarrhoea

dry or painful cough

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15
Q

contraindications of codeine

A 
acute respiratory depression
comatose patients
head injury (affect pupils in neurological assessment)
raised intracranial pressure
acute UC
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16
Q

side effects of codeine

A 
arrhythmias
confsion
constipation
dizziness
drowsiness
dry mouth
euphoric mood
flushing
hallucination 
headache etc

dependence and addiction

17
Q

paracetamol

A

first line analgesic

antipyretic

18
Q

how does paracetamol work?

A

inhibits COX-2

= reduces fever and increases pain threshold

19
Q

indications for paracetamol

A

first line analgesic for most forms of acute and chronic pain

reduce fever

20
Q

contraindications of paracetamol

A

risk of liver toxicity - increased NAPQI produced or chronic excessive alcohol use

reduced glutathione stores

21
Q

side effects of paracetamol

A

very few

overdose = liver failure

22
Q

cure for paracetamol overdose

A

glutathione precursor acetylcysteine

23
Q

interactions of paracetamol

A

cytochrome P450 inducers - phenytoin, carbamazepine, increase rate of NAPQI production and risk of liver toxicity

24
Q

allopurinol

A

Xanthine oxidase inhibitors

25
Q

how do xanthine oxidase inhibitors/allopurinol work?

A

lowers uric acid concentrations and reduces precipitation of uric acid in joint or kidney

26
Q

indications for allopurinol

A

prevent acute attacks of gout

prevent uric acid and calcium oxalate renal stones

prevent hyperuricaemia and tumour lysis syndrome associated with chemotherapy

27
Q

contra-indications of allopurinol

A

should not be started in an acute attack of gout, but can be continued if already on it

recurrent skin rash or severe hypersensitivity to allopurinol

reduced dose in renal and hepatic impairment

28
Q

side effects of allopurinol

A

skin rash, can be more serious - stevens johnsns syndrome or toxic epidermal necrolysis

can trigger or worsen an acute attack of gout

29
Q

interactions of allopurinol

A

allopurinol inhibitsd metabolism of mercaptopurine and increases risk of toxicity

+ amoxicillin increases risk of skin rash

+ACEi or thiazides, increases risk of hypersensitivity reactions

DRUGS (13 decks)

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