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TOP 200 II > Week 1 Pain Part 1 > Flashcards

Week 1 Pain Part 1 Flashcards

1
Q

Codeine/APAP 30/300mg

A

Tylenol #3

PO (tablet, liquid)

Analgesics/Anti-inflammatory

Opioid Analgesic/Analgesic Combinaiton

Opioid Analgesic (alters pain response)

Moderate-severe pain

Constipation, Sedation, N/V, Respiratory Depression, Euphoria, Itching, Dizziness

Benzodiazepines, CNS depressants, Muscle Relaxants

Boxed Warning Accidental ingestion, addiction, respiratory depression; precautions: respiratory/CNS depression, constipation

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2
Q

Fentanyl

A

Duragesic

Patch

Analgesics/Anti-inflammatory

Opioid Analgesic
Synthetic Opioid Analgesic

Moderate-severe chronic pain in opioid-tolerant patients

Constipation, Sedation, N/V, Respiratory Depression, Euphoria, Itching, Dizziness

Benzodiazepines, CNS depressants, Muscle Relaxants

Boxed Warning Accidental ingestion, addiction, respiratory depression; precautions: respiratory/CNS depression, constipation
Precautions: Cachectic, debilitated patients, and elderly

Have 4 strengths

Patient couselings

o Patch cannot be cut
o Apply to clean, dry, unbroken skin
o When patch is removed, fold upon itself and flush immediately
o Wash hands after handling
o Do not apply heat to patch
 Increased absorption  toxicity risk
o For use in opioid-tolerant patients only
 Should discontinue all other ER opioids or around-the-clock opioids when initiating
o Takes 12-24 hours when first starting for the medication to start working

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3
Q

Hydrocodone/APAP

A

Vicodin (Zohydro ER is hydrochodone only)
FYI: Lortab, Norco

Analgesics/Anti-inflammatory

Opioid Analgesic/Analgesic Combinaiton

Semi-Synthetic Opioid Analgesic

Moderate-severe pain

Benzodiazepines, CNS depressants, Muscle Relaxants

Boxed Warning Accidental ingestion, addiction, respiratory depression; precautions: respiratory/CNS depression, constipation

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4
Q

Methadone

A

Dolophine
Methadose, Methadose Intensol

PO (tablet, liquid)

Analgesica/Anti-inflammaotry

Opioid analgesic
Synthetic Opioid Analgesic

Moderate-severe pain; addiction

Constipation, Sedation, N/V, Respiratory Depression, Euphoria, Itching, Dizziness

Benzodiazepines, CNS depressants, Muscle Relaxants

Boxed Warning Accidental ingestion, addiction, respiratory depression; precautions: respiratory/CNS depression, constipation

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5
Q

Morphine

A

ER=MS Contin

Analgesics/Anti-inflammatory

Opioid Analgesic

Opioid Analgesic

Moderate-severe pain

Constipation, Sedation, N/V, Respiratory Depression, Euphoria, Itching, Dizziness

Benzodiazepines, CNS depressants, Muscle Relaxants

Boxed Warning Accidental ingestion, addiction, respiratory depression; precautions: respiratory/CNS depression, constipation

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6
Q

Oxycodone ER

A

Oxycontin

Analgesics/Anti-inflammatory

Opioid Analgesic

Semi-Synthetic Opioid Analgesic

Moderate-severe pain

Constipation, Sedation, N/V, Respiratory Depression, Euphoria, Itching, Dizziness

Benzodiazepines, CNS depressants, Muscle Relaxants

Boxed Warning Accidental ingestion, addiction, respiratory depression; precautions: respiratory/CNS depression, constipation

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7
Q

Oxycodone IR

A

Roxicodone

Analgesics/Anti-inflammatory

Opioid Analgesic

Semi-Synthetic Opioid Analgesic

Moderate-severe pain

Constipation, Sedation, N/V, Respiratory Depression, Euphoria, Itching, Dizziness

Benzodiazepines, CNS depressants, Muscle Relaxants

Boxed Warning Accidental ingestion, addiction, respiratory depression; precautions: respiratory/CNS depression, constipation

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8
Q

Oxycodone/APAP

A

Percocet
Endocet/Roxicet2

Analgesics/Anti-inflammatory

Opioid Analgesic/Analgesic Combinaiton

Semi-Synthetic Opioid Analgesic

Moderate-severe pain

Constipation, Sedation, N/V, Respiratory Depression, Euphoria, Itching, Dizziness

Benzodiazepines, CNS depressants, Muscle Relaxants

Boxed Warning Accidental ingestion, addiction, respiratory depression; precautions: respiratory/CNS depression, constipation

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9
Q

Naloxone

A

Narcan (NASAL SPRAY)
Evzio (AUTO-INJECTOR)

IM, SQ, Intranasal

Opioid Reversal

Opioid Antagonist

Blocks opioids at receptor sites

Opioid overdose; reversal of respiratory depression with therapeutic opioid doses,

opioid withdrawal, anxiety, restlessness, muscle aches, inability to sleep, sweating, ANGER

Opioids

Buddy system (family and friends need to be trained in how to properly administer), opiate withdrawal

o Patient Counseling
 Initial dose is 2 mg; may repeat every 2-3 minutes as need
• Maximum dose is 10 mg
 Immediate treatment is needed when naloxone is administered due to potential for opiate withdrawal and short duration of action

• Candidates for naloxone are those who:
o Take high doses of opioids for long-term pain (> 50mg morphine equivalents)
o Receive rotating opioid medication regimens
o Have been discharged from emergency medical care following opioid poisoning or intoxication
o Take certain extended-release or long-acting opioid medications
o Are completing mandatory opioid detoxification or abstinence programs

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10
Q

Tramadol

A

Ultram
Ultracet (combination with APAP)

Schedule: C4

Analgesics/Anti-inflammatory

PARITAL Opioid Analgesic

Opioid agonist at mu receptor; inhibits reuptake of Noriepinephrine and serotonin

Moderate-Severe Pain

Constipation/GI distress, sedation, HA, itching, sweating/flushing, physical dependence, rare: suicidal ideaion

Opioids; SNRI, SSRI, CNS acting medications (benzodiazepines, muscle relaxants)

• Patient Counseling
o Tolerance and physical dependence can occur. Do not stop abruptly.
o Laxative agents should be used to prevent/treat constipation
o Use caution when doing activities requiring alertness
o May increase risk for seizures

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11
Q

Buprenorphine Naloxone

A

Suboxone

SL tablet and film

Schedule: C3
Can only be prescribed by physicians who meet certain qualifying requirements
 DEA number starts with an X

Opioid Addiction

Opioid Analgesic/Opioid Antagonist Combinaiton

B: works as an opioid at some sites, displaces at other; N: blocks opioids

Opioid dependence
drowsiness, dizziness, CNS depression, HA, withdrawal syndrome, pain Film: gum/mouth irritation

SSRIs, opioids

o Patient Counseling
 Place the film or tablet under the tongue until it dissolves completely
 Do not swallow
 Additional film should be administered one at a time, on the opposite side of the tongue
 If multiple tablets are required, they can be administered at the same time
 Unused films should be opened and flushed down the toilet
 The same dose should be used whenever switching between tablets and film
 Monitor patients closely as the film may have greater bioavailability

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12
Q

Which of the following substances is a controlled substance?

Acetaminophen
Ibuprofen
Naloxone
Oxycodone

A

Oxycodone

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13
Q

What schedule is heroin?

CI
CII
CIII
CV

A

CI

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14
Q

Which of the following medications is a long-acting opioid?

Endocet®
Tylenol® III
Oxycontin®
Vicodin®

A

Oxycontin®

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15
Q

Would respiratory depression be more common with a long-acting or short-acting opioid medication?

Short-Acting
Long-Acting

A

Long-Acting

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16
Q

Which of the following medications has severe risk when co-administered with opioids?

Benzodiazepines
NSAIDs
Beta Blockers
Acetaminophen

A

Benzodiazepines

17
Q

How often should a Duragesic® patch be applied?

Every 12 hours
Every 48 hours—only special circumstances after significant trial
Every 72 hours
Every 96 hours

A

only special circumstances after significant trial

Every 72 hours

18
Q

Which of the following medications is converted to morphine to provide pain relief?

Methadone
Codeine
Hydrocodone
Oxycodone

A

Codeine

19
Q

What drug would you anticipate to interact with tramadol?

Benzodiazepine
Beta Blocker
Insulin
Anticoagulant

A

Benzodiazepine

20
Q

Which of the following would you expect to be a side effect of naloxone?

Sedation
Constipation
Restlessness
Hypotension

A

Restlessness

21
Q

Patients who are battling addiction could receive this medication for their opioid tolerance…

Narcan®
Suboxone®

A

Suboxone®

22
Q

• Definitions
o Narcotic:
o Opioid:

A

o Narcotic:
 Broad definition for any substance with abuse or addictive potential
 Risk for both abuse of the medication and diversion of the medication
o Opioid:
 The opioid group includes naturally derived opiates (i.e. morphine) or those synthesized to have similar properties

23
Q

• Classification of Pain
o Acute Pain
o Chronic Pain
o Cancer Pain

A

o Acute Pain
 Resulting from surgery, acute illness, trauma, labor and medical procedures
 Short-term (days) that can be a useful physiologic process to warn individuals
 WHERE WE HAVE EVIDENCE OPIOIDS ARE EFFECTIVE
o Chronic Pain
 Long-term pain that is often a result of changes to nerve function
 GENERALLY, NO DATA TO SUPPORT EFFICACY AND SAFETY OF OPIOIDS
o Cancer Pain
 Includes both acute and chronic pain
 OPIOIDS USED HERE ALSO

24
Q

_______ is converted to ________to provide its analgesic effect

A

Codeine is converted to morphine to provide its analgesic effect

25
Q

Long acting opioids

A 
Oxycodone ER (CII)
Morphine sulfate (CII)- CR or ER
Fentanyl transdermal (CII)
Methadone (CII)
26
Q

Short acting opioids

A 
Acetaminophen/codeine (CIII-tablet, CV-liquid)
Hydrocodone/acetaminophen (CII)
Oxycodone/acetaminophen (CII)
Oxycodone (IR)-CII
Morphine (CII)
27
Q

Allergies

A

o Morphine, codeine, hydromorphone, oxycodone and hydrocodone may cross react with each other

28
Q

Patient counselings

A

o Patients need a stimulant laxative to prevent/treat constipation
o May cause drowsiness and impair your ability to operate machinery
o May cause physical or psychological dependence with prolonged use (May be habit-forming)
o Do not CUT or CRUSH controlled release medications (e.g. OxyContin®, MS Contin®)
o Can take with food to minimize nausea/vomiting

TOP 200 II (14 decks)

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