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Pedia > Pedia Pain Mgt Nelson > Flashcards

Pedia Pain Mgt Nelson Flashcards

1
Q

Give examples of nonopioid meds (common ones)

A 
Para/acetaminophen
Asa
Nsaids (ibup, ketorolac)
Coxibs (celecoxib)
Gabapentin
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2
Q

Examples of nonopioid pain meds (quite uncommon to you)

A

Antipsychotics (quetiapine, risperidone, chlorpromazine, haloperidol)
Ssri (fluoxetine)
Sucrose soln via pacifier or gloved finger

Naprosyn
Choline magnesium salicylate
Nortriptyline, amitriptyline, desipramine

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3
Q

Para has no ___ and ___ effects

A

Antiplt

Adverse gastric effects

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4
Q

Aspirin

Associated with ___ syndrome

A

Reye Syndrome

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5
Q

Dose of para

A

10-15 mg/kg PO/IV q4-q6

20-30 mg/kg PR q4

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6
Q

Ibup dose

A

8-10 mg/kg PO q6

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7
Q

For neuropathic pain (2)

A

Gabapentin

TCA (Nortriptyline, amitriptyline, desipramine)

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8
Q

Adr

Aspirin

A

Gastritis

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9
Q

Adr

Nsaids

A

Antiplt effects

Gastritis

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10
Q

Risk of ___ in prolonged Qtc syndrome if given TCA

Can also enhance ___

A

Dysrhythmia

Suicidal ideation

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11
Q

Adr

Gabapentin (5)

A

Sedation, dizziness, ataxia, headache, behavioral changes

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12
Q

Check for ___ before initiating antipsychotics

A

Normal Qtc

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13
Q

Antipsychotics useful when ___

A

Arousal is amplifying pain

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14
Q

Adr

Antipsychotics

And how to treat

A

Extrapyramidal reactions

Diphenhydramine

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15
Q

For children with anxiety disorders in which arousal amplifies pain

Clue: SSRI

A

Fluoxetine

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16
Q

Cox-1:
Cox-2:

Cox enzymes produce___ causing pain

A

Gastric mucosa, platelets

Inflammation, cortical renal blood flow regulation

Prostaglandins

17
Q

Avoid NSAIDS in (3)

*coxibs can substitute

A

Bleeding diathesis
When surgical hemostasis is concern (tonsillectomy)
Bone healing

18
Q

Increased risk of ___ and ___ in coxibs and nsaids

A

Heart attack

Stroke

19
Q

Opiods

Natural:
Synthetic:

A 
Opium poppy (opiates)
Opioids
20
Q

Opioid

Indications (4)

A

Mod to severe pain
Acute post op pain
Sickle cells crisis pain
Cancer pain

21
Q

Opioids

Common SE

A

Constipation - most common
n and v
Urinary retention
Pruritus

22
Q

Opioids

Mgt of consti

Acute (1)
Chronic (2)

A

Stool softeners and laxatives
Methylnaltrexone
Lubiprostone

23
Q

Opioids

Mgt of vomiting

A

Anti emetics:

Phenothiazine
Butyrophenones
Antihistamines
Serotonin receptor antagonist (ondansetron, granisetron)

24
Q

Opioids

Mgt of pruritus and complix

A

Low dose iv naloxoneq

25
Q

Give some opioids

A 
Morphine
Fentanyl
Hydromorphone
Oxycodone
Hydrocordone
Meperidine
Methadone
26
Q

More potent than morphine (2)

A

Fentanyl

Hydromorphone

27
Q

Common ADR opioids

A 
Resp dep
Constipation
N and v
Pruritus
Excessive sedation
Urinary retention
28
Q

Opioid

Mgt of resp dep

A

Naloxone

29
Q

Opioid

Mgt of excessive sedation

A

Methylphenidate

Dextroamphetamine (not for young kids)

30
Q

Opioid

Mgt of nausea and vomiting (5)

A 
Metoclopramide
Trimethobenzamide
Prochlorperazine
Ondansetron
Granisetron
31
Q

Opioid

Mgt of pruritus (5)

A 
Hydroxyzine
Naloxone
Ondansetron
Nalbuphine
Cyproheptadine
32
Q

Opioid

Mgt of constipation

General types (8-9)

A

Water, fiber, vegetable

Bulk laxatives
Lubricants
Surfactants
Stimulants
Enema
Electrolytic/osmotic
33
Q

Opioid

Bulk laxatives (2)

A

Metamucil

Maltsupex

34
Q

Opioid

Lubricant

A

Mineral oil

35
Q

Opioid

Surfactant

A

Sodium docusate

36
Q

Opioid

Stimulants (2)

A

Bisacodyl (dulcolax)

Senna

37
Q

Opioid

Electrolytic/osmolytic (2)

A

Milk of magnesia

Polyethylene glycol

38
Q

Opioid

Mgt of urinary retention

A

Straight cath

Indwelling cath

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