Lidocaine
Amide local anesthetic (Na channel blocker)
Block of VSSC acts to diminish excessive channel activity and the pain associated with neuropathic damage
Bupivacaine
Amide local anesthetic (Na channel blocker)
Morphine
Opioid (μ) receptor agonist
Schedule II
Relieves severe pain (post-operatively and in acute trauma (IV/IM)
Oral sustained release form can be used for chronic pain
Hydrocodone
Opioid (μ) receptor agonist
Antitussive
Weak analgesic
Similar to codeine
Oxycodone
Opioid (μ) receptor agonist
Equipotent with morphine
LOTS of abuse
Codeine
Opioid (μ) receptor agonist Schedule II or III Most commonly used opioid analgesic CYP2D6 metabolism and 10% of caucasians are deficient, so not a good analgesic for those pts ANTITUSSIVE Less potent than morphine
Tramadol
Opioid (μ) receptor agonist
Also blocks monoamine uptake to potentiate descending pain pathway (like antidepressants)
Fentanyl
Opioid (μ) receptor agonist Schedule II 100x more potent than morphine Used for post-operative and peri-operative pain management Short duration of action Can have severe respiratory depression
Combos of opioid agonists with NSAIDs
Codeine-acetaminophen (Tylenol #3), Codeine-aspirin, Hydrocodone-acetaminophen (Vicodin), Hydrocodone-ibuprofen (Vicoprofen), Oxycodone-acetaminophen (Percocet),
Buprenorphine
Partial Opioid Agonist (μ) Can precipitate mild withdrawl Can cause analgesia Partially antagonize effects of morphine Long-acting In patch form Used for maintenance therapy
Naloxone
Opioid antagonist
Naproxen
Non-Selective COX-1 / COX-2 Inhibitor
Celecoxib
COX-2 Selective Inhibitor
Acetaminophen
COX-2 Inhibitor (CNS)
Ketamine
NMDA receptor antagonist
Glutamate antagonist at NMDA receptors in ascending pain pathway blocking acute nociceptive pain
Prevents central sensitization process in chronic pain
Ketamine administration can reduce the development of tolerance to long-term opioid use
Adjuvant analgesics
Antidepressants, anticonvulsants
Generally more useful in chronic pain syndromes
Migraine – Abortive therapy
Ibuprofen, Naproxen, Acetaminophen
Sumatriptan
Dihydroergotamine
Dihydroergotamine
Ergot Compound
Migraine abortive therapy
Sumatriptan
5-HT1D Agonist
Migraine abortive therapy
First-line drugs for moderate to severe migraines
Causes cerebral vasoconstriction
Migraine – Prophylactic therapy
Beta Blockers Calcium channel blockers ACE inhibitors Anticonvulsants Antidepressants
Donepezil
Cholinesterase inhibitors
Used for dementia
Memantine
NMDA-glutamate antagonist
Used for dementia
Thiamine
Wernicke’s encephalopathy
