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Flashcards in 00 Pain Management Deck (47):
1

What is the MOA of Salicylates?

IRREVERSIBLY inhibit COX-1 and COX-2, prevent prostaglandin formation, inhibit platelet aggregation

2

What is the generic name of Cystex?

Sodium Salicylate (nonacetylated salicylate)

3

When should Cystex be avoided?

(Sodium Salicylate): avoid in sodium-restricted patients, cardiovascular disease

4

What is the generic name of Doan's?

Magnesium Salicylate

5

When should Doan's be avoided?

(Magnesium Salicylate): Avoid in renal insufficiency

6

What medications fall under the Enolic Acids (NSAIDs)?

Meloxicam, Piroxicam

7

What medications fall under the Acetic Acids (NSAIDs)?

Diclofenac, Etodolac, Sulindac, Ketorolac

8

What medications fall under the Propionic Acids (NSAIDs)?

Ibuprofen, Naproxen, Ketoprofen

9

What medication falls under the COX-2 Inhibitor (NSAID)?

Celecoxib (only one left on the market)

10

What is important to know about the length of use for Ketorolac?

More GI toxicity than other NSAIDs, not to exceed more than 5 days of use

11

Which NSAIDs have once daily dosing?

Meloxicam, Piroxicam, Nabumetone, Oxaprozin

12

Which NSAID is commonly used for gout exacerbations?

Indomethacin

13

What is NSAID use like in pregnancy?

Generally avoid. Category B 1st & 2nd trimester, Category D in 3rd

14

What are the opiate side effects?

SPEND: Sedation, Postural hypotension, Euphoria, Nausea, Derm rashes. SCRAM: Sex hormone drugs needed, Constipation, Respiratory depression, Addiction, Miosis

15

What is the drug of choice for pain associated with myocardial infarction?

Morphine

16

What impairment is morphine not a good choice with?

Renal impairment

17

What is the generic name of Roxanol?

IR Morphine (Q4h)

18

What is the generic name of Kadian?

CR Morphine (Q12h)

19

What is the generic name of MS Contin?

CR Morphine (Q12h)

20

What is the generic name of Avinza?

ER Morphine (Q24h)

21

What is the generic name of Lorcet?

Hydrocodone + APAP

22

What is the generic name of Lortab?

Hydrocodone + APAP

23

What is the generic name of Tylenol #3?

Codeine + APAP

24

What is the generic name of OxyIR?

IR Oxycodone (Q4-6h)

25

What is the generic name of Oxycontin?

ER Oxycodone (Q12h)

26

What is the generic name of Dilaudid?

IR Hydromorphone (Q4-6h)

27

What is the generic name of Exalgo?

ER Hydromorphone (Q24h)

28

What is the generic name of Opana?

Oxymorphone

29

What is the generic name of Ultram?

Tramadol

30

What is the MOA of Ultram (Tramadol)?

Inhibits reuptake of serotonin and norepinephrine

31

What are the toxicities related to Ultram (Tramadol)?

Seizures. Nausea & Dizziness

32

What is the generic name of Butrans?

Buprenorphine Patch (Q7 days)

33

What must you do before starting Butrans Patch?

Taper the patient's long-acting opioids for up to 7 days to no more than 30mg of oral morphine or equivalent

34

When might the Butrans Patch not work well?

In patients needing > 80mg/day morphine equivalent

35

What is the generic name of Demerol?

Meperidine

36

What is a unique indication for Demerol (Meperidine)?

Rigors as well as moderate-severe pain

37

What are the ADRs like for Demerol (Meperidine)?

Many ADRs, risk of seizures d/t metabolite normeperidine

38

When can Fentanyl be used?

Only for opioid-tolerant patients (60mg morphine equivalent/day x at least 7 days)

39

What is the generic name of Duragesic?

Fentanyl Transdermal

40

If a patient is on 50mg of morphine equivalent/day, what Fentanyl patch should they be on?

25mcg (MICROGRAMS). Common practice is to use a 2:1 ratio

41

What is a risk with Methadone?

Risk of QTc prolongation, baseline ECGs

42

If a patient has a true allergy to codeine, morphine, hydrocodone, etc., what may he/she safely take?

Methadone. Meperidine. Fentanyl

43

What is the generic name of Narcan?

Naloxone (for overdose of opiates)

44

What are some different medication options for Neuropathic Pain?

AEDs (Gabapentin, Pregabalin, Topiramate, Carbamazepine, Oxcarbazepine). Anesthetics (Lidocaine). Corticosteroids. SNRIs (Venlafaxine, Duloxetine). TCAs (Amitriptyline, Desipramine, Nortriptyline). Opiates. Topical preps

45

What are the 3 FDA-approved medications for Fibromyalgia Syndrome (FMS)?

Lyrica (Pregabalin). Cymbalta (Duloxetine). Savella (Milnacipran - SNRI w/ some NMDA inhibition)

46

How does the analgesic activity of Celecoxib compared to traditional NSAIDs?

Less analgesic activity compared to traditional NSAIDs

47

What is sometimes combined with NSAIDs to decrease the incidence of GI bleeding?

Misoprostol