pharma treatment of pain Flashcards
1
Q
what is mech and use of acetpminophen
A
- indirect inhib of COX in brain
- excellent anti-pyretic
- some hepatotoxicity
- careful in alcoholics and elderly
2
Q
what is dose equivalent for NSAIDs
A
2-3/10 for chonic, can be 10 for acute
3
Q
what are different types of NSAIDs
A
6 combos of
- high/low potency
- fast/intermed./slow elim
4
Q
what are 2 types of muscle relaxants and which should be used
A
- anti-spamodics - yes
non-benzo and benzo - use the non - antispacticity - don’t use
5
Q
how do anti-dep work
A
S and N are pain inhibiting in the dorsal horn
- SNRI are best
6
Q
main indications for anti-deps
A
neuropathic pain
- duloxetine for fibro and low back
- trazadone (TCA) - for sleep
7
Q
conta-indications for anti-deps
A
- glaucoma
- BPH
- prolonged QT
- liver impariment
for duloxetine , CrCl
8
Q
mech of anti-convusants
A
- both epilepsy and neuropathic pain are abnormal firing
- volagte gated Na chanel blockers
9
Q
what are uses of anti-convulsant
A
neuropathic pain
- gabapentin - mod. reduction
- pregabalin - same risk benefit, but more expensive
10
Q
2 weak opiods
A
- codeine
2. tramadol
11
Q
strong opiods
A
- morphine
- hydromorphone
- oxycodone
- methadone
- buprenophone
- tapentadol
12
Q
2 natural opiods
A
codeine
morphine
13
Q
5 things that must be done before prescribing opiods
A
- pain diagnosis
- goal setting
- assess risk of OD
- assess risk of habit formation
- involve patient in decision
14
Q
3 parts of optimal dose
A
- effectiveness- improved function
- plateauing - more doesn’t help much
- adverse effects
15
Q
5 issues in monitoring
A
- watch for abberant use
- switch opiod when necc
- driving safety
- collborative care
- special pops
