Pain study guide Flashcards
MOA for opioids
Interact with opioid receptors (mu & kappa)
3 main types of drug receptor interactions
- Opioid agonist (mu and kappa activated)
- Opioid antagonist (mu and kappa blocked)
- Mixed opioid agonist-antagonist (one blocked, one activated)
MOA for NSAIDs
- Inhibit cyclooxygenase (COX 1 & 2)
- Peripherally acting at nociceptors
- COX break down arachidonic acid to prostaglandins, which induce pain, NSAIDs block it (enzymes from converting to prostaglandins)
When are adjuvants needed?
- Refractory to opioids
- Neuropathic pain
- Can be used alone or in combination with opioids
MOA for COX 2 Inhibitors
-ONLY blocks COX 2
COX 2 Inhibitor drug
Celecoxib (Celebrex)
Route for Fentanyl (Sublimaze)
IM, IV, transdermal
Route for Hydromorphone (Dilaudid)
PO, SQ, IM, IV
Route for Levorphanol (LevoDromoran)
PO, SQ, IV
Route for Meperidine (Demerol)
PO, IM, IV
Route for Methadone (Dolophine)
PO
Route for Morphine
PO, IM, IV
Route for Oxymorphone (Opana)
SQ, Rectal, PO
Route for Codeine
PO, IM
Hydrocodone (Hycodan)
PO
Oxycodone (OxyContin)
PO
Role of Naloxone
- Opioid antagonist
- Used for opioid overdose
- Usually used in respiratory depression
- Duration of action is SHORTER than opioids (might need to re-dose)
- Very short duration
- Family members or caregivers can be trained
Ibuprofen-like NSAIDs are different in chemical structure but all have the same:
- MOA (block COX 1 & 2)
- Analgesic properties (mild to moderate pain)
- Anti-Inflammatory properties
- Anti-pyretic properties
- Ability to damage the GI mucosa
Exceptions for Ibuprofen-like NSAIDs
- Ketorolac (IM,IV, PO,Intranasal)
- Ibuprofen lysine (IV)
- Diclofenac (Topical)
Drug classes for adjuvants
- Anti Seizure
- Benzodiazepines
- Bisphosphonate
- Corticosteroids
What is the role in therapy for acetaminophen?
1) Non-inflammatory pain
2) Mild to moderate pain
3) Reduces pain & fever
4) Found in combination with over the counter products and opioid analgesics
5) Substitute when NSAIDs are contraindicated
