ROGERS Flashcards
what percent of americans have chronic pain
30%
subjective questions to ask a pt about pain
PQRSTU
precipitating factors
quality of pain
region
severity
time related
impact on U
also what have you tried
objective factors of pain
behavior changes
dilated pupils
paleness
sweating
tachycardia
tachypnea
which pain scale is helpful in kids?
Wong-Baker
(faces)
what is nociceptive pain
tissue
what is neuropathic pain
nerve
non-pharm options for pain
correct cause
exercise
acupuncture
massage
heat/ice
chiropractor
treatment ladder step 1
non opioid
+/- adjuvant analgesic
treatment ladder step 2
opioid for mild/mod pain
+ non opioid
+/- adjuvant analgesic
treatment ladder step 3
opioid for mod/severe pain
+ non opioid
+/- adjuvant analgesic
Tylenol dosage forms
tablet
capsule
chewable
liquid/gel
IV
suppository
Tylenol dosing adults
325-1000 mg q4-6h
max: 3-4 g /day
Tylenol dosing kids
10-15 mg/kg q4h
max: 75 mg/kg/day or 3-4 g
Tylenol hepatotoxicity likely with what dose
> 10 g dose
NSAID side effects
GI bleed
nephrotoxicity
fluid retention
increase in CV events
when to avoid NSAIDs
liver disease
CKD
Beers
CV history
counseling tip for NSAIDs
take with food
aspirin
tablet
capsule
chewable
ec tablet
er capsule
suppository
ASA dosing adult
325-1000 mg q4-6h
max: 4 g /day
ASA in children
AVOID
when to avoid ASA
children
pts on blood thinners
what is Reyes syndrome
swelling in brain and liver
(when kids have a viral infection)
ibuprofen dosage forms
tablet
capsule
chewable tablet
IV
suspension
ibuprofen dosing adult
200-800 mg q6-8 h
max: 3200 mg /day
ibuprofen dosing kids
> 6 months
5-10 mg/kg q 4-6h
max: 40 mg/kg/day or 2400 mg
diclofenac dosage forms
tablet
capsule
IV
suppository
topical gel
topical solution
ophthalmic
patch
diclofenac dosing
50 mg PO q8h or 2-4g QID topically
naproxen dosage forms
tablet
capsule
DR/ER tablet
suspension
naproxen dosing
220-500 mg PO q6-12 h
max: 1000 mg/day
ketorolac dosage forms
tablet
IV/IM solution
nasal spray
ophthalmic
ketorolac dosing adults
15-30 mg IV q6h
10 mg PO q6h
ketorolac dosing kids
0.5 mg/kg/dose IM/IV q6h
maximum duration of ketorolac
5 days
when is oral dosing used with ketorolac
continuation of IV or SUBQ
celecoxib dosage forms
capsule
oral solution
celecoxib dosing
200 mg PO BID
gabapentin / pregabalin uses
fibromyalgia
neuropathies
post op pain
gabapentin doing and max dose
100-300 mg TID
3600 mg / day
pregabalin dose and max
75 mg BID
max: 600 mg
pregabalin is what schedule
IV
gabapentin is what schedule
not scheduled
pregabalin and gabapentin side effects
sedation
dizzy
gabapentin and pregabalin are ____ dosed
renally
venlafaxine max dose
225 mg /day
duloxetine max dose
60 mg/day
duloxetine renal considerations
avoid in CrCl < 30
side effects of nortriptyline and amitriptyline
anticholinergic
sedation
when to use amitryptiline and nortriptyline in fibromyalgia/neuropathy
last line
max of nortriptyline and amitriptyline dose
150 mg /day
when to use muscle relaxants
musculo skeletal pain / pulled muscle
muscle relaxant drugs
cyclobenzaprine
baclofen
methocarbamol
carisoprodol
tizanidine