T3-Analgesics: Others-MJ Flashcards
What are the 3 “other” analgesics given for neuropathic pain?
Gabapentin & Pregabalin
Lidocaine patch
Gabapentin and pregabalin are often given for _____ pain.
Phantom limb pain
Gabaapentin and pregabalin were initially approved as anti-epileptics, but are primarily used for ____.
Neuropathic pain
What are some examples of neuropathic pain?
Shingles
Diabetic neuropathy
Fibromyalgia
What is the main differences between pregabalin and gabapentin?
Pregabalin has a LONGER half-life, it is MORE expensive, and it is a controlled substance (schedule 5)
What does it mean when we say pregabalin is a schedule 5 drug?
Schedule 5 is the lowest risk for abuse with a DEA schedule, but addiction possibility is still a concern. That’s why it even makes it on the DEA schedule. Abusing this drug increase euphoria, in other words, gives a buzz
What are the 3 adverse effects for pregabalin and gabapentin?
Peripheral edema Weight gain (often from the edema) Sedation, fatigue (dose dependent)
What kind of pain relief does a lidocaine patch provide?
Local pain relief, especially for neuralgias
How many lidocaine patches can a patient wear daily?
1-3
How many hours a day can the lidocaine patch be on?
12 hours max
If your patient wore one lidocaine patch from 0800-2000 at 2000 can you apply a new patch since they’ve only worn one patch that day?
No, there is a 12 hours max regardless of how many patches they use out of the (1-3 daily they could use). It doesn’t matter if they only used one patch. They already had it on 12 hours
What is the MOA of lidocaine patch?
Stops axonal conduction of pain (and other) signals by blocking SODIUM CHANNELS in the atonal membrane.
Lidocaine patch blocks sodium channels in the atonal membrane. What is the significance of this?
In order for an action potential to fire, sodium ions have to move from outside the axon to the inside. If the lidocaine patch BLOCKS these channels, the pain can not travel
What are 3 adverse effects of lidocaine patches?
Skin irritation and pigmentation (from adhesive)
Costs $10 per patch
Numbness, altered mental status if misused
There are 5 key things we need to point out to our patients if they are taking a lidocaine patch. What are these 5 patient education points?
You can cut these to the size needed Must apply to intact, clean, dry, hair-free skin Avoid external heat sources Fold and discard in the trash Peak effect takes 4 hours
So if a client is wearing a lidocaine patch, how much pain relief are they really getting?
Only 8 hours. They can only wear the patch for 12 hours max, but it takes 4 hours for it to reach peak effect. Pain relief is only about 8 hours total
If you had a hairy client and they had to wear a lidocaine patch, is it okay to shave their hair so you can put the patch on that location of hair-free skin?
No, shaving causes the skin to not be intact. This will be too much absorption.
REVIEW: fentanyl patch vs. lidocaine patch
What are these two patches used for?
Fentanyl is an opioid analgesic
Lidocaine is an “other analgesic” (neuropathic pain)
REVIEW: fentanyl patch vs. lidocaine patch
How often do you change each patch?
Fentanyl change every 72 hours
Lidocaine can only be worn 12 hours per DAY
REVIEW: fentanyl patch vs. lidocaine patch
How do you discard these two patches?
Fentanyl patch has to be FOLDED AND FLUSHED
Lidocaine can be folded and discarded in the trash
REVIEW: fentanyl patch vs. lidocaine patch
Which is more powerful?
Fentanyl patch
REVIEW: fentanyl patch vs. lidocaine patch
How long does it take to reach peak effect?
Fentanyl= 1 day Lidocaine= 4 hours
REVIEW: fentanyl patch vs. lidocaine patch
Which can be cut to the size needed?
Lidocaine
REVIEW: fentanyl patch vs. lidocaine patch
What are the two patient educations that are taught the same with BOTH these patches?
Can only be put on intact, clean, dry, hair-free skin
Avoid external heat sources
