Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

cornelius 2 > post op pain > Flashcards

post op pain Flashcards

1
Q

what can make acute pain worse

A

anxiety

increased sympathetic output

poor rest

inadequate oral intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

opioids and non opioids modulate pain..

A

peripherally and centrally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

serious side effects of NSAIDS

A

GI toxicity

decreased renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

absolute contraindications to NSAIDs

A

allergy

pregnancy

erosive or ulcerative conditions of the GI mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

relative contraindications to NSAIDs

A

asthma

anticoagulant therapy or hemorrhagic disorders

compromised renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

COX-2 selective NSAIDs action

A

anti inflammatory, anty pyretic, analgesic

protect normal physiologic processes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

why dont we just use COX-2 inhibitors only

A

poor efficacy in third molars

expensive

only one option

increased embolic phenomena

SULFA ALLERGY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how does acetaminophen work

A

probably blocks PG synthesis in CNS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

does acetaminophen have anti inflammatory effects n

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

recommended daily maximum for tylenol

A

FDA: 4000 mg/day

McNeil Consumer: 3000 mg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

daily maximum of tylenol for ppl with liver disease

A

2000 mg/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

which opioid receptors are more potent as far as analgesia, resp depression, sedation

A

mu > kappa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

rank from most potent to least: hydro, oxygen, codeine

A

oxy > hydro > codeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do tylenol and semi synthetic opiate receptors work together

A

synergistically

reduces Amt of opioid needed, tylenol dictates dose/frequence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what converts oral opiates to active metabolites

A

cyp450

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

codeine active metabolite

A

morphine (effect entirely from metabolite)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

hydrocodone active metabolite

A

hydromorphone (effect from parent drug and metabolite)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

oxycodone active metabolite

A

oxymorphone (effect almost entirely from parent drug)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

how many caucasians are deficient in cyp450

A

4-10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

pentazocine MOA

A

oral agonist-antagonist

analgesic at kappa, antagonist at mu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

is pentazocine good for third molars

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

tramadol MOA

A

central dual action:

weak binding at mu

inhibit incoming nociceptive impulses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what type of pain is tramadol good for

A

chronic

24
Q

is tramadol better than opioid-tylenol combos

A

no

25
Q

how long/what severity is pain for dentoalveolar surgery usally

A

mild to moderate

3-5 days

26
Q

pre surgical eval for pain

A

type of surgery, expected pain

pre existing medical condiitons/medications

patients previous experience

27
Q

why is giving po analgesics prior to surgery a good idea

A

inhibits PG synthesis

lessens nocicpetion during procedure will reduce overall post op analgesic requirement

28
Q

what local anesthetic should you give prior to sx

A

bupivicaine

blocks input to CNS, decreases central hyper excitability, less pain and analgesic intake and 4h and 8 h, easier to maintain pain free state

29
Q

which analgesics better for dental pain

A

NSAIDs better than opioids (inflammatory)

30
Q

what is NSAID of choice

A

ibuprofen, nothing is proven to be better or cheaper

31
Q

t/f: NSAIDs have ceiling effect for analgesic properties

A

true

32
Q

how to chose dose of NSAID

A

according to contribution of inflammation to the pain experienced

33
Q

dose frequency for non narcotic analgesics

A

around the clock on fixed schedule regardless of pain severity

prn = haphazard drug levels

34
Q

ibuprofen dose and max dose

A

600 mg q6h

3200 mg

35
Q

tylenol dosage, max dose

A

650 mg q6h (healthy); 3000 max

500 mg q6h (liver pt); 2000 max

36
Q

breakthrough pain management

A

small doses of short acting opioid agents if non-opioid regimen is already optimized

37
Q

codeine + acetaminophen brand name, dose

A

tylenol #2 = 15
tylenol #3 = 30
tylenol #4 = 6-

38
Q

hydrocodone + acetaminophen brand name, dose

A

norco 5/325

39
Q

oxycodone + acetaminophen brand name, dose

A

percocet 5/325

40
Q

stepped approach

A

step one: ibuprofen 600 mg q6h, tylenol 650 mg q6h

step two: norco or percocet prn

41
Q

Dr. Kennedy’s plan for routine third molars

A

pre emptive: ibuprofen 600 mg po, ketorolac 30 mg IV

local: 2% lido, 0.5% bupivicaine

post op: ibuprofen/tylenol q6h for 72 hours, norco one tab prn for severe pain

42
Q

dosing may not exceed ____g morphine equivalent doses

A

30 mg

43
Q

opioid rx requirements

A

CDT code and days worth

44
Q

which trimester is best for tx preggo

A

second

45
Q

what local to use for preggo

A

lido

46
Q

analgesics for preggo

A

no NSAIDS

tylenol, narcotic w/ OB approval ok

47
Q

chronic opioid users pain management

A

post op pain is in addition to pain they already have

discuss pre op with pt and doctor

optimize daily non-opoiod routine

tolerance may require increase in opioid dosage

48
Q

rehab ppl pain management

A

discuss up front

use LA, NSAIDs

dont rx something they have abused in the past

49
Q

drug rxn that is not anaphylaxis tx

A

DC drug

antihistamines

corticosteroids

50
Q

are allergic reactions common with opoids

A

no but adverse effects are

51
Q

how to avoid adverse effects of opioids

A

dose reduction

opioid rotation

manage adverse effects

52
Q

corticosteroids uses in dentistry

A

topical

enteral (po) for trismus/edema

tx of non anaphylactic drug allergy

53
Q

contraindications to corticosteroid use

A

history of chronic infection

peptic ulcer dz

DM

poor wound healers

caution w/ simultaneous NSAID use

54
Q

how many adrenal crisises have there been in last 66 yeras

A

6

55
Q

when to consider stress dose of steroid

A

20 mg prednisone per day for more than two weeks in the past two months

cornelius 2 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions