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Fall 2021: Therapeutics III > Supportive Care II (Weddle) > Flashcards

Supportive Care II (Weddle) Flashcards

1
Q

Describe nociceptive pain.

A

tissue injury that activates specific pain receptors (nociceptors) that are sensitive to stimuli

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2
Q

What are the two subtypes of nociceptive pain?

A

somatic and visceral pain

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3
Q

Describe somatic pain.

A

associated with receptors on surface tissues/deep tissues such as bones, joints, muscle, or connective tissue

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4
Q

Describe visceral pain.

A

associated with receptors located in the viscera (internal organs)

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5
Q

A patient presents to your pharmacy complaining of a burning feeling in his right leg. Is this pain most likely nociceptive or neuropathic?

A

neuropathic

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6
Q

A patient presents to your pharmacy complaining of stabbing abdominal pain. Is this pain most likely nociceptive or neuropathic?

A

nociceptive

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7
Q

Many cancer patients will have a combination of ________ and ________ pain.

A

acute; chronic

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8
Q

What does OPQRSTU stand for?

A
  • What is the onset of the pain?
  • What provokes it?
  • What is the quality of the pain?
  • Does the pain radiate?
  • How severe is the pain?
  • Time of the pain
  • Understanding and impact
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9
Q

Can morphine be used in renal insufficiency? Hepatic insufficiency?

A

no; use caution

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10
Q

Can hydromorphone be used in renal insufficiency? Hepatic insufficiency?

A

yes but use lower doses/longer intervals; use caution

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11
Q

Which opioid product is not available in an IV formulation?

A

oxycodone

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12
Q

What adverse effects are associated with the use of oxycodone in renal failure patients?

A

oversedation and CNS toxicity

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13
Q

What is the only opioid that is safe for renal and liver dysfunction?

A

fentanyl

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14
Q

What is (arguably) the #1 benefit of methadone?

A

low cost

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15
Q

Can methadone be used in patients with renal failure? Liver dysfunction?

A

yes; not advised

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16
Q

What potential adverse event can occur with methadone?

A

QT prolongation

17
Q

True or false: each opioid has a maximum dose.

A

false

18
Q

Why should you reduce the dose by 25% when switching between two opioids?

A

cross-tolerance

19
Q

How can you combat opioid-associated constipation?

A

mild stimulant laxative +/- a stool softener

20
Q

With which opioid is pruritis most often seen?

A

morphine

21
Q

What drug should be administered for opioid-induced respiratory depression?

A

naloxone

22
Q

PCAs should be used in with caution in patients with ____________.

A

sleep apnea

23
Q

Cardiac plexus block is used commonly in patients with _________ cancer.

A

pancreatic

24
Q

When would a patient warrant intrathecal pain medication?

A

if they are refractory to other opioid therapy or increased toxicities

25
Q

On-Q pumps deliver medication ___________.

A

locally

26
Q

Cancer patients are considered to be in a ____________ state.

A

hypercoagulable

27
Q

What VTE treatment option is best for patients without gastric/gastroesophageal lesions?

A

DOACs (apixaban, rivaroxaban)

28
Q

What VTE treatment option is preferred in patients with gastric/gastroesophageal lesions?

A

LMWH (dalteparin, enoxaparin)

29
Q

What were the results of the CLOT trial?

A

dalteparin was more effective than warfarin in reducing risk of recurrent VTE without increasing bleeding risk

30
Q

What was the conclusion reached in the SELECT-D trial?

A

rivaroxaban was associated with relatively low VTE recurrence but higher CRNMB compared with dalteparin

31
Q

What conclusions were reached with the Hokusai VTE cancer trial?

A

PO edoxaban was noninferior SQ dalteparin in regards to recurrent VTE/major bleeding

edoxaban had higher rate of major bleeding, but lower rate of recurrent VTE

32
Q

What are some absolute contraindications for DOAC use?

A
  • stage IV/V CKD
  • active/significant liver disease
  • strong dual inhibitors/inducers of CYP3A4 + PGP
  • PGP inducers/inhibitors
33
Q

What is a vesicant?

A

drug/agent capable of producing blistering and/or serious tissue damage when infiltration into the tissue occurs

34
Q

Give four examples of injection site necrosis antidotes.

A
  1. DMSO
  2. Dexrazoxane
  3. Hyaluronidase
  4. Sodium thiosulfate

Fall 2021: Therapeutics III (25 decks)

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