Flashcards in 00 Pain Management Deck (47)
What is the MOA of Salicylates?
IRREVERSIBLY inhibit COX-1 and COX-2, prevent prostaglandin formation, inhibit platelet aggregation
What is the generic name of Cystex?
Sodium Salicylate (nonacetylated salicylate)
When should Cystex be avoided?
(Sodium Salicylate): avoid in sodium-restricted patients, cardiovascular disease
What is the generic name of Doan's?
When should Doan's be avoided?
(Magnesium Salicylate): Avoid in renal insufficiency
What medications fall under the Enolic Acids (NSAIDs)?
What medications fall under the Acetic Acids (NSAIDs)?
Diclofenac, Etodolac, Sulindac, Ketorolac
What medications fall under the Propionic Acids (NSAIDs)?
Ibuprofen, Naproxen, Ketoprofen
What medication falls under the COX-2 Inhibitor (NSAID)?
Celecoxib (only one left on the market)
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
Which NSAIDs have once daily dosing?
Meloxicam, Piroxicam, Nabumetone, Oxaprozin
Which NSAID is commonly used for gout exacerbations?
What is NSAID use like in pregnancy?
Generally avoid. Category B 1st & 2nd trimester, Category D in 3rd
What are the opiate side effects?
SPEND: Sedation, Postural hypotension, Euphoria, Nausea, Derm rashes. SCRAM: Sex hormone drugs needed, Constipation, Respiratory depression, Addiction, Miosis
What is the drug of choice for pain associated with myocardial infarction?
What impairment is morphine not a good choice with?
What is the generic name of Roxanol?
IR Morphine (Q4h)
What is the generic name of Kadian?
CR Morphine (Q12h)
What is the generic name of MS Contin?
CR Morphine (Q12h)
What is the generic name of Avinza?
ER Morphine (Q24h)
What is the generic name of Lorcet?
Hydrocodone + APAP
What is the generic name of Lortab?
Hydrocodone + APAP
What is the generic name of Tylenol #3?
Codeine + APAP
What is the generic name of OxyIR?
IR Oxycodone (Q4-6h)
What is the generic name of Oxycontin?
ER Oxycodone (Q12h)
What is the generic name of Dilaudid?
IR Hydromorphone (Q4-6h)
What is the generic name of Exalgo?
ER Hydromorphone (Q24h)
What is the generic name of Opana?
What is the generic name of Ultram?
What is the MOA of Ultram (Tramadol)?
Inhibits reuptake of serotonin and norepinephrine
What are the toxicities related to Ultram (Tramadol)?
Seizures. Nausea & Dizziness
What is the generic name of Butrans?
Buprenorphine Patch (Q7 days)
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
When might the Butrans Patch not work well?
In patients needing > 80mg/day morphine equivalent
What is the generic name of Demerol?
What is a unique indication for Demerol (Meperidine)?
Rigors as well as moderate-severe pain
What are the ADRs like for Demerol (Meperidine)?
Many ADRs, risk of seizures d/t metabolite normeperidine
When can Fentanyl be used?
Only for opioid-tolerant patients (60mg morphine equivalent/day x at least 7 days)
What is the generic name of Duragesic?
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
What is a risk with Methadone?
Risk of QTc prolongation, baseline ECGs
If a patient has a true allergy to codeine, morphine, hydrocodone, etc., what may he/she safely take?
Methadone. Meperidine. Fentanyl
What is the generic name of Narcan?
Naloxone (for overdose of opiates)
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
What are the 3 FDA-approved medications for Fibromyalgia Syndrome (FMS)?
Lyrica (Pregabalin). Cymbalta (Duloxetine). Savella (Milnacipran - SNRI w/ some NMDA inhibition)
How does the analgesic activity of Celecoxib compared to traditional NSAIDs?
Less analgesic activity compared to traditional NSAIDs