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Dental Orofacial Pain > TMD Tx > Flashcards

TMD Tx Flashcards

1
Q

ACUTE PAIN CAN BECOME CHRONIC IF IT LASTS
MORE THAN ____-_____ months OR THE TIME IT
WOULD TAKE CONNECTIVE TISSUE TO HEAL

A

3 TO 6 MONTHS

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2
Q

CHRONIC TMD PAIN SYNDROMES LAST AT MORE THAN ___ MONTHS

A

6 months

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3
Q

What are the 4 COMMON CO-EXISTING PAIN CONDITIONS?

A
  1. TMD
  2. FIBROMYALGIA
  3. HEADACHES (MIGRAINES, TENSION-TYPE, AND TAC’S)
  4. IRRITABLE BOWEL SYNDROME (IBS)
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4
Q

What is the max dose of tylenol for chronic pain?

A

3000 mg/day

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5
Q

What is the typical max dose of tylenol without chronic pain?

A

4000 mg/day

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6
Q

PARACETAMOL (GENERIC IN SOME FOREIGN COUNTRIES)
* APAP (ACETYL-PARA-AMINOPHENOL)
* NO ANTI-INFLAMMATORY EFFECTS
* MINIMAL INCREASED RISK OF BLEEDING
* OVERDOSE: HEPATOTOXICITY

A

Acetaminophen

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7
Q

What is max rec dose for Ibuprofen?

A

3.2 g

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8
Q

What is max rec dose for aspirin?

A

4 g

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9
Q

Percocet and Roxicet contains what drugs?

A

Tylenol and Oxycodone

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10
Q

Vicodin and Norco contain what drugs?

A

Tylenol and Hydrocodone

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11
Q

Advantages of ______ opioids
* MORE CONSISTENT ANALGESIA
* FEWER ADVERSE EFFECTS
* MORE TOLERANCE TO ADVERSE EFFECTS
* BETTER SLEEP ➔BETTER DAYTIME FUNCTION
* LESS EUPHORIA, ADDICTION, DIVERSION

A

Long acting opioids

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12
Q
  • AT ____ dose of NSAIDs
  • ANTIPYRETIC EFFECTS
  • ANALGESIC EFFECTS
A

Low dose

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13
Q
  • AT ____ DOSES of NSAIDs
  • MORE ANTI-INFLAMMATORY EFFECTS BESIDES MENTIONED EFFECTS
A

High dose

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14
Q
  • OTC 200MG
  • RX 400MG, 600MG, 800MG
  • MAX DOSE: 3200 MG PER DAY IN DIVIDED DOSES
  • TOXICITY: GI ULCER
  • TO REACH ANTI-INFLAMMATORY EFFECTS MUST USE 1800MG-3200MG/DAY IN DIVIDED DOSES
A

IBUPROFEN (MOTRIN®, ADVIL®)

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15
Q
  • MAX DAILY DOSE: 1500 MG PER DAY IN DIVIDED DOSES
  • TOXICITY: GI ULCER
  • COMBINATION WITH PPI ESOMEPRAZOLE TO MINIMIZE THE GI DAMAGE (BRAND NAME VIMOVO®)
A

NAPROXEN (ALEVE® 220MG OTC)

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16
Q
  • SELECTIVE COX 2 INHIBITOR
  • 100MG OR 200 MG TWICE DAILY
  • AVOID IF PATIENT HAS SULFA ALLERGY
A

CELECOXIB (CELEBREX®)

17
Q

The following are _____
 USED FOR MUSCLE OR TMJ PAIN
 (I.E. ARTHRITIS)
 NSAIDS: COMPOUNDED
 10% OR 20% INDOMETHACIN
 10% OR 20% IBUPROFEN
 10%, 15% OR 20% KETOPROFEN
 3%, 5%, OR 10% DICLOFENAC
 USED FOR MUSCULOSKELETAL PAINS
 NSAID WITH MUSCLE RELAXANTS
 1% FLEXERIL WITH10% KETOPROFEN/10% IBUPROFEN
 1% DICLOFENAC SODIUM GEL(VOLTAREN) RX OR OTCThis Photo by Unknown Author is licensed under CC BY-SA

A

Topical NSAIDs

18
Q

ADRs of ______
* RESPIRATORY DEPRESSION
* NAUSEA/ VOMITING
* SEDATION
* DIZZINESS
* CONFUSION
* PRURITUS
* CONSTIPATION

A

Opioids

19
Q
  • BINDS TO CNS OPIOID RECEPTORS AND INTERRUPTS WITH NOCICEPTIVE TRANSMISSION
  • INHIBITS THE REUPTAKE OF SEROTONIN AND NOREPINEPHRINE
  • DOSE TITRATION IS NEEDED
  • ABRUPT D/C IS NOT RECOMMENDED
A

Tramadol

20
Q

PERIPHERAL DAMAGE
* DIABETIC NEUROPATHY
* POST-HERPETIC NEUROPATHY
* IMMUNOSUPPRESSANT THERAPY FOR
CANCER TREATMENT
CENTRAL DAMAGE
* POST- STROKE
* SPINAL OR OTHER CNS DAMAGE
* TRAUMA
* MALIGNANCY
* MULTIPLE SCLEROSIS- CAN LEAD TO
TRIGEMINAL NEURALGIA

A

Neuropathic pain

21
Q

MOA
* INHIBITION OF NOCICEPTIVE PATHWAY
* INHIBITION OF NOREPINEPHRINE AND SEROTONIN REUPTAKE
* INCREASE THE SYNAPTIC CONCENTRATIONS OF 5HT3 & NE
* POTENTIATE THE ANALGESIC EFFECTS OF OPIOIDS
* SODIUM CHANNEL BLOCKING EFFECTS (LIKE LOCAL
ANESTHETICS)

A

TRICYCLIC ANTIDEPRESSANTS (TCAs)

22
Q
  • INHIBIT SEROTONIN AND NOREPINEPHRINE REUPTAKE
  • LOWER DOSES NEEDED FOR NP THAN DOSES IN DEPRESSION TREATMENT
  • DULOXETINE (CYMBALTA)
  • VENLAFAXINE (EFFEXOR)
  • DESVENLAFAXINE (PRESTIQ)
A

SELECTIVE SEROTONIN NOREPINEPHRINE
REUPTAKE INHIBITORS (SNRIS)

23
Q

FREQUENTLY ARE USED AS ADJUNCTIVE
MEDICATION IN THE TREATMENT OF ACUTE LOW BACK PAIN. THEIR
USE IN CHRONIC PAIN IS MORE LIMITED
*ALL MUSCLE RELAXANTS CAN CAUSE DIZZINESS AND SEDATION
*DIFFERENT AGENTS HAVE DIFFERENT MECHANISM OF ACTION

A

MUSCLE RELAXANTs

Dental Orofacial Pain (14 decks)

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