Analgesics for Pain

Question 1

Adjunct anticonvulsant

Answer 1

gabapentin, pregabalin

Question 2

Adjunct antidepressants

Answer 2

TCA: amitryptyline, nortriptyline, desipramine, imipramine
SNRI: duloxetine, venlafaxine

Question 3

Adjunct anesthetic

Answer 3

lidocaine (3 patch/day max), capsaicin, bupivacaine

Question 4

MDD of APAP

Answer 4

3000 mg/day
2000 mg/day if liver disease

Question 5

MDD aspirin

Answer 5

4000 mg/day

Question 6

MDD ibuprofen

Answer 6

3200 mg/day

Question 7

Max duration ketoprofen

Answer 7

5 days

Question 8

Max duration ketorolac

Answer 8

5 days

Question 9

Which pts can use NSAIDs for pain?

Answer 9

mild-mod pain
inflammatory pain
bone pain
dysmenorrhea

Question 10

Which pts to avoid NSAIDs

Answer 10

severe hepatic/renal impairment
age > 60
uncontrolled HTN
bleeding disorder/thrombocytopenia
concomitant anticoagulant
chemotherapy

Question 11

Mixed agonist-antagonist opioids

Answer 11

buprenorphine, pentazocine, butorphanol, nalbuphine

Question 12

central opioid analgesics

Answer 12

tramadol, tapentadol

Question 13

When taking central opioid analgesics, what meds to avoid?

Answer 13

SSRI, TCA, MAOi due to serotonin syndrome

Question 14

MDD tramadol

Answer 14

400 mg/day

Question 15

which meds to avoid in renal impairment

Answer 15

gabapentin, pregabalin, NSAIDs, celecoxib, tramadol, tapentadol, morphine

Question 16

which meds to avoid in hepatic impairment

Answer 16

APAP, NSAIDs (if severe), tramadol