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Pharmacy NP > Opioids > Flashcards

Opioids Flashcards

1
Q

Pain

A

unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage

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2
Q

Nociceptive

A

Somatic and Visceral

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3
Q

Neuropathic

A

Peripheral and Central

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4
Q

Adjunctive Pain Control Options

A

Physical methods (hot and cold), Therapeutic Neuroscience, Coping skills, Cognitive behavior, Acupunture, Mindful Meditation, Transcutaneous electrical nerve stimulation

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5
Q

Interventional Techniques for Chronic Pain

A

Injections, Spinal fusion, Percutaneous disc compression, Radiofrequency rhizotomy, Neuromodulatory tx, vertebroplasty, hyphoplasty

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6
Q

Freedom from Cancer Pain ladder*

A

Opiod for moderate to severe pain of non-opiod and adjucts

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7
Q

Pain persisting or increasing ladder*

A

Opioid for mild to moderate pain non opioid and adjuvants

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8
Q

Route preferred for analgesic medicine

A

Oral

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9
Q

Administration time frame

A

Should be given BTC (by the clock) rather than on demand.

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10
Q

Dose for analgesic

A

Determined on an individual basis

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11
Q

ibuprofen and naproxen are contraindicated with patients whom have

A

angiodedema

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12
Q

Different Pain States & Mechanisms

A

acute nociception, tissue injury, nerve injury & sensory versus affective

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13
Q

Adjuncts for the pain ladder

A

Steroids, antidepressants and anticonvulsants

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14
Q

topical agents for analgesics

A

5% lidocaine and or 8%capsaicin

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15
Q

8% capsaicin

A

Apply for 60 minutes under supervision of a physician.

Avoid in diabetic peripheral neuropathy

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16
Q

5% lidocaine

A

Dosing​

Available in cream or patch.

Apply to site of pain 12 hours on, 12 hours off.

Max of three patches at one time.

Make sure it doesn’t go into the systemic system when using it for local anesthetic (can cause arrythmias), can give alongside epi

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17
Q

Tramadol has _______ receptor activity

A

weak mu opioid

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18
Q

tramadol can be used for this disorder

A

seizure disorder (can lower seizure threshold)

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19
Q

use a small dose of tramadol for

A

renal impairment reduce the dose

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20
Q

concomitant snri,ssri,tca and or maoi

A

tramadol

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21
Q

botulinum toxin can cause

A

paralysis of resp muscles

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22
Q

other peripherally acting and misc spasmolytics

A

Botulinum Toxin​

Dantrolene: Malignant Hyperthermia (CP, SPI pts) ​

Carisoprodol, Metaxalone, Methocarbamol​

Sedative, Blockade of nociceptive pathways

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23
Q

Centrally Acting Spasmolytics act on

A

in the brain and higher centers of spinal cord

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24
Q

Centrally Acting Spasmolytics can increase

A

functional capacity

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25
Q

Centrally Acting Spasmolytics can relieve

A

discomfort

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26
Q

this medication can cause Opioid induced constipation-

A

methylnatrexone

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27
Q

medications used in pain management

A

Nonopioid analgesics​

Acetaminophen​

Nonsteroidal anti-inflammatory drugs​

Opioids​

Morphine and congeners; fentanyl and congeners​

Dual-mechanism analgesics​

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28
Q

Opioid antagonist

A

Naloxone

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29
Q

what can happen with NSAIDS and pregnancy

A

prolong labor

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30
Q

what can happen with NSAIDS and heart failure

A

Can impair ADH –> increase Na and H2O, so they can retain fluids

31
Q

gi box warning and NSAIDS

A

GI bleed

32
Q

heart & kidney NSAIDS adverse effect

A

Can drop GFR​

**pt w/ heart dsease, their kidneys wont diuresis as well and their risk of MI increases

33
Q

two medications that are propionic acid derivatives

A

ibuprofen and naproxen

34
Q

aspirin class is

A

salicylates

35
Q

how do you administer aspirin and dosages

A

81 to 325 PO daily low dose for cardioprotective; they have an antiplatelet effect that lasts 8-10 days; high dosages are seen with water retention heart failure patients

36
Q

pain comes through during well controlled pain moderate to sever episodes of pain- NAME THAT PAIN

A

BREAKTHROUGH

37
Q

related to a mass or tumor or the treatment of cancer itself.; side effects of chemo radiation or surgery
NAME THAT PAIN

A

CANCER PAIN

38
Q

NAME THAT PAIN Should be happening after tissues healed; 3-6months; dysregulation of pain receptors

A

chronic

39
Q

NAME THAT PAIN naughing cramping aching; usually localized to a joint to a muscle or bone; pretty well localized ; show me with your finger where

A

SOMATIC

40
Q

NAME THAT PAIN deep squeeze or pressure chest pain can radiate all over cardiac in origin abdominal pain deep, pelvic, very vague but cannot tell you exactly the organs in pain are diffuse in nature.

A

Visceral

41
Q

NAME THAT PAIN numbness tingling burning paresthesia and classic sign; electric like pain shooting through the foot

A

Neuropathic

Peripheral-fingers toes
Central – migraine related

42
Q

ACUTE PAIN

A

serves as a purpose warning sign something not right <4 weeks*

43
Q

sodium rushing in does what to the cell

A

depolarization

44
Q

inhibitory neuron

A

GABA tries to balance out the excitability

45
Q

prostaglandins PGI2

A

prevent platelet aggregration potent vasodilator and smooth muscle relaxation

46
Q

thromboxane

A

platelets DO aggregate; potent vasoconstrictor and smooth muscle proliferation;

47
Q

NSAIDs have ___,____ and ___ property

A

antiinflammatory, analgesics and antipyretic

48
Q

Excretion where of NSAIDS

A

renally

49
Q

adverse effects of aspirin

A

GI intolerance, gastric duodenal ulcers, hepatotoxicity asthma and rashes & rarely renally toxicity

50
Q

this fetal disease could be is you give aspirin <20 years of age

A

reyes syndrome

51
Q

these two medications are enolic acids (oxicams)

A

meloxicam and piroxicam

52
Q

meloxicam and piroxicam are ____cox

A

non selective cox inhibitors

53
Q

3 acetic acid derivatives

A

diclofenac
ketorolac
indomethacin

54
Q

box warning for celecoxib

A

increased incidence of MI and stroke

55
Q

celecoxib can interfere with

A

coumadin

56
Q

what type of patient can benefit from cox 2 inhibitor celecoxib

A

rheumaoid arthritiis

57
Q

side effect of celecoxib

A

g; developed to minimal gi ulcers and bleeding

58
Q

reversal of tyenol

A

mucomyst within 8-16 hours

59
Q

patient receiving 60mg a day of morphine would benefit from this m

A

fentanyl patch

60
Q

not a first line agent and has a short duration of action relatively low potency to reduce post anesthesia tremors/rigors

A

meperidine (demerol)

61
Q

this drug has multiple drug interactions that can cause cns excitability, delirium, hallucinations tremors and seizures

A

meperide (demerol)

62
Q

indicated for mild-moderate pain with weak opioid activity

A

codeine

63
Q

the drug is metabolized to morphine by the liver

A

codeine

64
Q

this prodrug can cause severe anaphylaxis

A

iv codeine

65
Q

this partial agonist is a nonselective for mu over delta/kappa receptors

A

buprenorphine

66
Q

this drug is to be used postop analgesia and opioid use disorder with methadone

A

buprenorphine

67
Q

can be given SL,dermal, parental causes less respiratory depression but lasts longer

A

buprenorphine

68
Q

contraindications for opioids

A

avoid combining a partial with a full

risk of resp depression

fetal dependency in preg use

hepatic impairment since metabolism occurs in the liver

half life is prolonged in renal impairment and metabolites may build up depending on the drug used

69
Q

oral agents for neuropathic pain

A

1,2,3rd line treatments; gabapentiods; tcas, snris,topical and then tramadol

70
Q

cyclobenzaprine (flexiril)

A

tricyclic antidepressant short term acute peripheral injury

71
Q

a2 adrenergic agonist that can drop your blood pressure

A

clonidine

72
Q
A
73
Q
A

Pharmacy NP (8 decks)

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